Human right violations impact directly on key populations’ access to services. But beyond access to services, the hostile environment also impacts negatively on studies being conducted. Stigma and discrimination make it significantly more difficult to enrol key populations in research, which hampers the study's validity and open the door to bias.
Conducting research among key populations clearly requires engagement of key populations. But we need to remember that for a community that has been marginalised for so long, all it takes to destroy trust and engagement is one wrong word. Just one.
EHPSA has several studies in its key populations’ portfolio, all of them focusing on men having sex with men. The contribution of these studies to the body of knowledge and to policy and practice is underpinned by early, responsible and continuous stakeholder engagement.
The gruelling reality depicted through the dehumanising stories of violations amplifies the task ahead. Compounding factors that make it such a challenge to address the needs of key populations and ensure that no one is left behind can be summarised;
• Stigma and discrimination in the communities
• Criminalisation and the existence of negative policy frameworks
• Insufficient data
• Ill-informed health providers
• Paternalistic public health approaches
• Exclusion of key populations from policy development spaces
• Exclusion of key populations from research spaces
Despite the massive challenges, key populations themselves remain resilient and indicate that the data exists and that key populations are not invisible. Researchers need to work in a genuine partnership with key populations and key populations will work with the researchers, till the end of AIDS.
A statement that policy maker and EHPSA participant from Kenya, Helgar Kaswii Musyoki, has taken to heart a long time ago, “Nothing for us, without us. As government we cannot do anything without the populations in the room when decisions are made,” she said during one of the conference satellite sessions.
I am left with only one thought and wish the solidarity with key populations could extend its reach to tackle the equally challenging situation around HIV in prisons.
EHPSA’s technical lead: evidence into practice
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