Follow the Voice of Life

This community-based programme was developed with the active participation of MSM and provides a range of peer services and professional psychological counselling and support for MSM, as well as their partners, friends, and families. Follow the Voice of Life uses community mobilisation, peer outreach, social marketing, information and education communication (IEC), motivational and discussion groups, and training for community leaders to reach decisionmakers and clients. A 3-stage peer counselling model includes gender analysis in outreach, assessment, and support for MSM in Orenburg. The first stage provides one-to-one counselling and support on sexual health, behaviour, safe sex, HIV and sexually transmitted infection (STI) testing and treatment, as well as on sexual orientation and gender identity. At this stage, gender-related questions and concerns are considered and inform how the subsequent service delivery is managed. The second stage matches clients to peers and outreach workers for ongoing one-to-one support. The third stage connects clients to groups of peers.

Programme activities use a gender-equitable approach in an effort to ensure access by all. For example, Follow the Voice of Life has a "Tolerance Charter," which is a set of internal rules and laws on equality for all New Life staff members and clients. This charter is designed to break down stigma and discrimination between different at-risk groups who may also subscribe to traditional gender norms. Regularly during working meetings, representatives of different intended groups - women and men living with HIV, people who inject drugs, sex workers, people released from prison, and MSM - meet together and discuss common problems. New Life also holds a personal growth group, at which issues are discussed such as identity, individuality, and the uniqueness of each person, as well as sexual orientation, gender identity and equality, and "tolerance for diversity."

Outreach teams include both men and women, an approach that is designed to promote positive change in social norms and gender stereotypes and also reduce stigma and discrimination when female outreach workers tell their friends and relatives about where and with whom they work. During outreach in an open space, such as a park or beach, a mixed group of men and women is a safety feature for both outreach workers and their clients because it attracts less attention than an all-male group.

Follow the Voice of Life focuses not only on prevention of HIV and other STIs but on the issues MSM face in their daily lives. According to New Life, in Orenburg, there are no safe public places for MSM where they can discuss problems and meet with peers. The programme provides such a space for MSM who first meet clients of the programme and then their friends and partners. This dynamic is designed to contribute to community mobilidation for MSM, identification of community leaders, and training on topics such as HIV/STI prevention and treatment, safe sex, self empowerment, sexual orientation and gender identity, and harmful gender norms. New Life's programme also provides an anonymous place, free from violence, homophobia, and stigma and discrimination, to access health services and medical care and to meet with psychologists, doctors, and peer counsellors or outreach workers.

New Life offers a 24-hour informational psychotherapy phone hotline available 7 days a week that is staffed by trained peers and psychologists. The hotline is anonymous, an important resource for many MSM who are afraid to ask for information in person but are comfortable asking over the phone. Phone counsellors provide information and counseling on many issues MSM face such as HIV and STI testing, relationships, available services, and psychological support on gender identity.

Roundtables with government institutions are an example of New Life's advocacy at the governmental level to increase awareness and promote protection of MSM.

HIV/AIDS, Gender, Rights.

Research indicates that Russia has the second highest HIV prevalence in Eastern Europe and Eurasia. Although criminal prosecution for homosexuality was abolished in Russia in 1993, no laws exist protecting the rights of MSM. In a majority of regions, state organisations are working only with groups mandated by the Ministry of Health: people living with HIV, youth, children, and pregnant women. What has been described as the high level of homophobia, stigmatisation, and discrimination due to Russian social norms drive MSM underground, which limits and sometimes blocks their access to information, prevention programmes, and medical services, and often leads to human rights violations. This discourages MSM from seeking help from health facilities.