Responding to an alarming rise in HIV incidence among MSM in Thailand, Mplus, a community-based organisation formed to improve the sexual health of men that have sex with men (MSM), produced animations for their HIV/AIDS outreach and prevention programs. The animations are new educational resources produced to increase understandings of safe sex practices and address low perceptions of personal risk to HIV/AIDS among Chiang Mai’s diverse MSM population.
Mplus works to provide HIV/AIDS outreach and prevention to the diverse community of MSM in Chiang Mai. This includes men who identify as gay or bisexual, transgenders, Thai and migrant male sex workers and “hidden” MSM who can be homosexual, bisexual or straight. Reflecting the community to who they provide outreach, Mplus produced animations to be used as an educational resource in each of the communities identified above. The animations are context specific to needs of Chiang Mai’s MSM community as identified in the research, but Mplus is using them in regional HIV/AIDS outreach and prevention. The animations will expand Mplus’ innovative HIV prevention, where outreach workers take condoms and safe-sex information to places where MSM meet for sex to make their use more acceptable and less stigmatised.
Mplus understands organised responses to HIV/AIDS must begin at the community level and that community engagement is an essential part of HIV/AIDS prevention. To produce the animations, Mplus first researched the sexual practices of young MSM, transgenders, Thai and migrant male sex workers (MSW) to focus on understanding their sexual practices as they are socially produced. Then, using the data generated from the research, they co-authored narratives, drafted storyboards and produced animations making use of powerful context-specific, stories generated through interviews with MSM, MSW and transgenders in their local community.
The animations will help MSM understand the risks associated with various sexual activities and the consequences of unsafe sex for themselves and their partners/spouses. The animations will also attempt to provoke emotional reactions from viewers as they become closely familiar with the thoughts and feelings of characters, some of who became HIV+ in contexts and situations familiar to those of their local community.
Jit Srichandorn, an Mplus outreach worker says: “It is not easy to get our clients to change their behaviour, but the animations offer a screen-based resource with sound and moving images that provokes them to think differently about their risk to HIV. It also gives us a new educational resource to use in our peer- outreach that generates a lot of discussion.”
The first animation warns of the danger of connecting for sex on the Internet and drinking alcohol at local disco and ‘forgetting” to use a condom. The animation helps viewers—specifically young MSM—understand the risk associated with alcohol and unprotected sex as well as the proper use of a condom to prevent HIV/AIDS.
Mplus produced the second animation to empower transgender individuals to negotiate condom use with their partners. The narrative resonates with their lived experiences and provides a catalyst for informed discussion in outreach to this population that goes beyond simply advocating condom use. It is about raising awareness and self esteem.
Mplus produced the third animation to be used in their outreach to male sex workers and then translated it into three local dialects (Karen, Shan & Burmese). They are currently using this animation in site-based peer-education programs to help migrant sex workers understand personal risk to HIV before they engage in sex work. Learchai Keawyoo, who provides outreach to this population says: “I don’t speak the Shan dialect, but having this animation in Shan provides me with a resource that is engaging and easy for MSW to understand. After they view the animation, they have safe sex information in their own language.”
The fourth animation was produced for ‘hidden MSM’. Thailand has a ‘hidden’ subgroup of MSM who do not identify themselves as gay or bisexual and it is difficult to target them with HIV prevention outreach. It is believed these men meet in a secretive and marginalised fashion in parks, restrooms, or other public places. Frequently, the male-to-male sex between these often masculine-identified MSM happens quickly and furtively due to the location. This lack of time often leads to unsafe sex without condoms. It is important to point out that HIV epidemics move from vulnerable groups to the general population when there are links between the two. The link between MSM, MSW and women in Thailand is well established. This animation aims to educate ‘hidden’ MSM about their personal risk to HIV as well as the risk the pose to the women they have sex with. These often cohabitating, primarily heterosexual, female partners/spouses now represent one-third of all new HIV/AIDS cases in Thailand.
Mplus is incorporating the animations into a locally-adapted and community-based Popular Opinion Leader program. This is an HIV/AIDS risk-reduction program in which groups of trusted, well-liked people are recruited and trained to conduct a particular type of peer outreach. Mplus+ choose this model because it has shown evidence of being effective in decreasing risk behaviours in racially and ethnically diverse groups of MSM. By using animations in their outreach, popular opinion leaders will be able to provide a compelling visual educational resource that can also be shared via Bluetooth technology. Mplus hopes individual MSM will begin to share the animations on mobile phones in their networks to raise awareness to personal risk to HIV/AIDS. Additionally, Mplus is incorporating the animations into an online peer education program. Mplus shows the animation in their current site based HIV/AIDS outreach and prevention programs at universities, workshops, bars, saunas, massage parlors, karaoke lounges, and brothels.
Mplus’ animations will help MSM and MSW understand HIV prevention through descriptions of bodily fluids that transmit the virus, how bodily fluids are transferred into the human body, and various context-specific scenarios where risky behaviour may lead to HIV infection. Importantly, the animations will also model practical ways of increasing the ability of MSM and MSW to negotiate safe sex with potential partners or clients. This kind of collaborative research built stronger alliances between MSM and MSW (of all genders) and is improving advocacy efforts around sexual health and rights, particularly in relation to HIV/AIDS prevention in Chiang Mai.
Mplus produced the animations with the help of a grant from The Australian Association of AIDS Organisations (AFAO) in collaboration with researchers from The Open University (UK) and The McCormick Faculty of Nursing, Payap University (Thailand). Mplus is currently working in collaboration with The Open University (UK), The Swedish Federation for Lesbian, Gay, Bisexual and Transgender Rights (RFSL) and Bridges Across Borders South East Asia (BABSEA) to expand their outreach and prevention programs in a new project funded by The Foundation for AIDS Research (amfAR). For more information visit Mplus at www.mplusthailand.com. The animations were made by Lanna Media in Chiang Mai.
Dr Christopher S Walsh is a Senior Lecturer in Educational ICT and Professional Development at The Open University (UK) and works as a volunteer with Mplus. Nada Chaiyajit is a transgender activist and volunteer at Mplus, and Pad Thepsai is Mplus’ drop-in manager.
Reader's Comments
dont you know that guyz..!!! u must use it..!!!
Condoms also prevent a number of other STI's as well, and often more people I see are wearing them because they are scared of catching the lesser ones, because they don't think they know anyone with HIV. Most they all know someone who has had something like gonorrhea, so think it is more likely to catch if they aren't careful.
I think about massage boys in Chiang Mai (most of then are Shan, right ? ) Fortunately i use cd everytime.
Keep up the great work Mplus. Good luck :)
For one, when someone say he/she is monogamous... there's only a 50% chance that it's true. Out of all the men I've ever met, and I've met quite a few, only one was 100% monogamous.
Condoms and safe sex practices - that's the only way to stop the spread of HIV.
Chrysostom, to STOP spreading of HIV, the best way is NO SEX, NO DRUG ABUSE.
In light of the lack of CSE in most regional countries including Singapore, the NGOs in the region should jointly produce a series of such clips to concisely deliver the key points in a typical CSE curriculum. We have to realise that the teenagers and those in their early 20s are the group most at risk, and animation is more likely to appeal to them than are books, websites, school-based courses, seminars, phone counselling and face-to-face counselling. In terms of the effectiveness and the appeal, such animation clips have no rival.
While we the minority who speak English, have easy access to the internet and have the patience to read tons pages of sex-related information are here discussing about the importance safer sex, there are probably hundreds or thousands times more MSM persons in our region who don't have these privileges and are, thus, ignorant about the key points about STDs. How could we efficiently spread the message to them in an appealing manner? The most logical solution is to use animation.
There are a few trends that are favourable to the use of animation. First, mobile phone, MP4 and PC ownership in this region (Asia ex-Japan) is accelerating. China already has more mobile phone users than the US, and I think its netizens population should very soon top the world, if it still hasn't. Thanks to the faster, cheaper and faster copycats in China, the market is flooded with all sorts of such media devices selling at dirt cheap prices.
Second, owning such new media devices has become a necessity for the mentioned at-risk group. Due to peer pressure, students would ask from parents, work part-time, cheat or sell his/her body in order buy at least one of these devices if he/she hasn't got one. Many who already own one would buy more as new models emerge in the market.
Lastly, the latest technologies such as Bluetooth allows efficient sharing of data between media devices. A person who holds a Bluetooth-enabled mobile phone can easily transfer such video clips from his phone to his friends who hold similarly enabled devices.
To facilitate exchange, such clips should preferably be:
1) created in the most common format that may be viewed using most hand-held devices;
2) In short segments, since youngsters have shorter attention span
3) Takes up less disk space so that transferring between hand-held devices is easier
4) Includes info on how to obtain further info and advice for those who want to know more: phone number of counselling agencies; URL of websites with DETAILS beyond the key points addressed in the clips; phone number of clinics offering anonymous HIV screening.
5) Available in multiple languages. This can be easily done by the participating NGOs from different countries
6) Include a concluding request for the viewers to distribute the clips to his friends and sex partners via Bluetooth, email, etc. Research shows that word-of-mouth marketing is the most effective form of marketing. If these clips are distributed to viewers by their friends, the clips would earn a much higher credibility.
Of course, after all these years the evidence is that condoms work.
People here who critisize the use of condoms as not being effective only encourage people not to use them. Why would they bother if they believe that they are not effective. What you say and write here can have serious consequences for somebody. Think before you write something silly.
Please guys ALWAYS use condoms and safe sex.
This report states that "
1) Using data from the National HIV Behavioral Surveillance System (NHBS) involving gay men in five large US cities, researchers found that over 50% of HIV transmissions in US gay men are from main sexual partners and 46% of infections were from partners who were believed to be HIV-negative;
2) The majority of HIV transmissions (68%) were estimated to be from main partners, with 32% thought to be from casual partners. This trend was observed in all age groups.
#19 is right. Monogamy doesn't protect you from HIV. The reason is simple, and it's proven in the above-quoted report. You may be faithful to your BF, but it doesn't guarantee that he doesn't sleep around. So, if you thought that since you are faithful, you can safely not use condoms, you may then get HIV from him. Your BF can either be:
1) Already HIV+; or
2) Initially HIV-, but became HIV+ later after sleeping with others without telling you.
So, the best protection against HIV is Condoms, not Monogamy.
Hope they'll do more short clips for the danger of oral sex and life after getting infected...
People need to be educated to understand and accept this sickness.
Where is this HIV thing coming from? I just don't get it.
Great work for the animation.!!!
but its a great start
but I agree the music needs a bit of reworking, can't some cool DJ help out?
http://agence-to-buzz.com/le-nouveau-spot-aides-fait-dans-le-sexy-graffiti/
1) Mint/mouth rinse advertisements in an office setting don't stereotype all office workers as having bad breath;
2) Calcium-enriched milk advertisements don't stereotype all seniors as being fragile and hence unemployable;
3) Wonder Bra advertisements don't stereotype all women as being flat.
The point is, if you have bad breath, if you lack calcium intake or if your breasts happen to be flatter, then buy those products. Those who don't have these problems need not take offence. Similarly, these clips are meant to tell those gays who sleep around that they should practice safer sex. Those who don't sleep around need not take offence.
The fact is there are many gays who sleep around and practice unsafe sex. You may not be one of them, but you can't deny that they exist and that they do need to be informed.
what you wrote may be the reaction this animation will generate among gay men, who are more familiar with, and will thus less likely surprised by, the beginning section of the told story, and thus who are likely to focus more on the HIV awareness purpose. However, now you see the video has been put on YouTube and is likely to viewed by the general public. What kind of reaction will those who are neutral or even hostile to gay community have for it? This is the concern.
Recall a previous news that a young gay boy was brutally killed and burned. A policeman investigating the case was allegedly to comment, "He deserves it!" We can throw tons of blame onto the policeman; however, this animation is possible to feed such opinions among such people on gay community as a whole. Existing bias could be deepened.
I don't doubt the producers are meant to do goodness. I simply believe there are other creative ways to promote HIV awareness without the need to tell a story of betraying your lover as if it is commonly accepted as the moral norm among gay people.
Promoting HIV awareness is of coz a big issue. But we don't have to compromise another big issue, demonstrating that the gay community, like the mainstream society, value faithfulness, which may be a larger war given that people around the world are fighting for the right to marry.
I'm not offended by the animation. I'm concerned with it. People who view it may have reactions different from what the producer meant to convey.
1) Gays
2) Bisexuals
3) Transgenders.
But you did highlight a point, which is why the straights got missed out? Is the producer suggesting indirectly that straight people can't be promiscuous and be at risk as well? To avoid being misunderstood, the producer should add one more clip to the series for:
4) Straight men and women.
By so doing, the series would look more balanced. Each of the 4 groups of infection-prone individuals is addressed to convey the fact that it's not just MSM who are at risk. Lesbian sex is the safest of all forms of sex. Woman-to-woman transmission of HIV is rare, so this group might be left out for good reason.
Then, MSM won't misconstrue that they had been stereotyped or stigmatised. More importantly, the producer can then reach out to the largest group--- the straight people (95% of population)-- who also form the majority (>50%) of new HIV cases. Among the newly infected persons, the majority had been infected via straight sex.
Perhaps an even more important message that should be included in these clips (for groups 1-3) is:
"According to professional psychologists, doctors and psychiatrists worldwide, homosexuality is NOT a mental illness. Sexual orientation is not a choice, but results from a complex interaction of environmental, cognitive and biological factors. There is no scientific evidence that homosexuality can be changed using any therapy. But there is scientific evidence that trying to change homosexuals' orientation may cause significant emotional damage. #
According to the United Nations Secretary General, 'Stigma remains the single most important barrier to public action. It is a main reason why too many people are afraid to see a doctor to determine whether they have the disease, or to seek treatment if so. It helps make AIDS the silent killer, because people fear the social disgrace of speaking about it, or taking easily available precautions. Stigma is a chief reason why the AIDS epidemic continues to devastate societies around the world.*'
As such, correct understanding of sexual orientation and tolerance towards homosexuals is very important in the fight against HIV epidemic."
#Details can be found on American Psychological Association's website at www.apa.org
* The above quote of Mr Ban Ki-Boon can be found in the article, "The Stigma Factor" [ http://www.washingtontimes.com/news/2008/aug/06/the-stigma-factor/ ]
Yes, maybe if one views all the videos as a series and thinks hard, he or she may be able to get the message exactly as the producer intends to convey. My question is that once these videos are uploaded to YouTube, how many people will be that diligent to view all of them and then think very hard to figure out the message behind it?
For one who happens to click into the first video, his impression is likely to be, "oh, this boy betrays his boyfriend and have a hook-up, and then gets HIV. Oops, he may deserves it...Gay men are really messy in the sexual life.." This is my concern.
Essentially, is the boyfriend element necessary for the HIV awareness message? Does it highlight the message? I really don't think so. It simply confuses it unnecessarily. Why not simply have it to be that the boy go out with the other man and then..." As a Chinese saying put it, I think the boyfriend element is to add paws to a snake you are painting.
Therefore, I strongly recommend the produce withdraw the current version and post a new version deleting the boyfriend element. The new message will be clearer and more straightforward.
Looking back at the history, when the result in California, USA showed that the gay population was the majority of HIV-infected people, the society labelled HIV a gay disease. However, due to various interventions, straight sex has surpassed gay sex as being the chief mode of HIV transmission today. So, the educated and young people are generally aware that unprotected straight sex is equally risky. In fact, only the illiterate or lowly educated still perceive HIV as a gay disease. So, we certainly need to decrease the proportion of MSM in the new cases, because only then can we show the result that HIV is not to be associated with gay sex.
Next, let me address your notion that promiscuity is bad. Now, if 2 persons haven't made any promise to be committed to exclusively each other, what is wrong in them sleeping around with others after having casual sex? So, let me ask you what's so bad EVEN IF we promote fucking around, that is, what you alleged in #33, "It appears to promote fucking around before promoting use of condom. We cannot use fighting HIV to reinforce the stereotype that gay men are purely sex animals."
It is a philosophical series of questions:
1) What's bad about fucking around?
2) What's so bad about being 'purely sex animals'?
3) Does having more casual sex mean that a person can't be also good citizens?
As far as HIV transmission is concerned, Protection is certainly a more important factor than Promiscuity, and even more than Morality. Let me examine these 3 factors. If a Promiscuous person practices Protected sex consistently, and even if he is IMMORAL (e.g. has sex with others despite being in a committed relationship, he is much, much less likely to be infected with HIV than if he were both MORAL and Non-Promiscuous but practices UNPROTECTED sex. The reason had been given. Even if he doesn't cheat, his BF may, so if he practices unprotected sex, he may get it from his BF who got infected from casual sex. The research finding supporting this argument had also been given. In an earlier Fridae article, it was reported that more than 2/3 of new HIV cases got the infection from their MAIN PARTNERS, not casual partners.
But don't be mistaken. I am not discounting the importance of encouraging trust in romantic relationship. But it is a separate issue, not HIV issue. As far as HIV transmission is concerned, as I explained, Protection far exceeds in importance than Promiscuity and Morality combined.
Beside Protection, the other important factor to focus on is Screening. Taken together, Protection+Screening can significantly reduce HIV transmission rate, EVEN IF Morality and Promiscuity factors were to worsen as described.
We know that condoms are very effective in protecting us from infected bodily fluids. The other factor that can significantly determine whether infection can occur is viral load. If we can encourage more people to go for screening and get those who are HIV-positive to undergo treatment, there is a very high likelihood that we can reduce their viral load. Protected sex alone is already a very, very effective means to significantly reduce the likelihood of HIV transmission, but with reduced viral load, we can make it even less likely for the living HIV-carriers to infect the uninfected. Many HIV-positive persons who had detected their status and undergone treatment have undetectable level of viral load, which means the amount of virus in their blood and sperm is so small that it is quite unlikely for him to infect others, and especially those who practice protected sex with him.
Should we 'encourage' promiscuity? I think it is a question of individual choice. If a person chooses to be committed to a lover, then it is only moral for him to honour his promise to be faithful to the latter. But if he is single, and his casual partners have sex with him knowing that there is no string attached, there is no cheating or betrayal involved if he chooses to leave this partner and goes on to the next. So, instead of saying that we shouldn't encourage promiscuity, I think it's more reasonable to suggest that we should not encourage cheating.
My point is that the audience's reaction decides the effectiveness of this ad. Not mine, not yours, but the general audience. We cannot limit our vision to the gay community. My point is that we also need to consider possible side effect this ad could cause among the general public.
Your moral analysis is too individual-specific. And the word "choice" pops up again and again. In the US, those who are opposed to gay marriage keep hammering out the message that being gay is a personal choice of life styles. I don't want to make a moral judgment on this. This is not the point. Of coz, if you want to advocate your position in this moral debate, it's totally fine, but obviously this is not the mission you want to achieve with this ad.
So again, the key questions are:
(1) Do you think the boyfriend elements are helpful to sharpen the HIV protection message?
I simply think it's a distraction. Why bother to include this could-be-controversial moral element into a pure technical protection message?
With the boyfriend element, the message is "if you hook up with another man when you have a boyfriend, you should use condom". Without it, the message would be "when you hook up with anybody, you should use condom". Isn't the latter message clearer?
You say promiscuity is part of the reality. I'm not sure how big this "reality" is. But the key question is, do we have to include this piece of reality into the message to make it vivid? Are the gay boys so stupid as to need this extra reminder? The most vivid part of the video may be the scale showing the boy's loss of weight. Instead, I don't see how the boyfriend element improves the message.
(2) Do you think the benefit from the protection side outweigh the potential negative PR backfire from the general public?
If you firmly believe the answer two both questions are yes, let's conclude this debate. Otherwise, let's amend the video.
Two other points he raised should also be taken into consideration.
1) Would it encourage MSM to be promiscuous?
Perhaps the 'Doctor' in the clip could offer one more piece of advice. People who reduce the number of sex partners by, for example, maintaining a monogamous relationship, can reduce the chance of being infected or infecting others IF HE ALSO PRACTICES SAFER SEX CONSISTENTLY.
2) Would the society view MSM as being promiscuous?
Perhaps the 'Doctor' in the clip could highlight another fact: "People, straight, gay, bisexual or transgendered, are all exposed to HIV risk. HIV doesn't target any particular sexual orientation, but those who practices unprotected sex. Whether to be promiscuous is a personal choice. Many gays, as are many straight men, have chosen not to be promiscuous."
Lastly, it would be even more helpful if the 'Doctor' also mentions the position of the United Nations and professional psychologists, doctors and psychiatrists:
"According to professional psychologists, doctors and psychiatrists worldwide, homosexuality is NOT a mental illness. Sexual orientation is not a choice, but results from a complex interaction of environmental, cognitive and biological factors. There is no scientific evidence that homosexuality can be changed using any therapy. But there is scientific evidence that trying to change homosexuals' orientation may cause significant emotional damage. #
According to the United Nations Secretary General, 'Stigma remains the single most important barrier to public action. It is a main reason why too many people are afraid to see a doctor to determine whether they have the disease, or to seek treatment if so. It helps make AIDS the silent killer, because people fear the social disgrace of speaking about it, or taking easily available precautions. Stigma is a chief reason why the AIDS epidemic continues to devastate societies around the world.*'
By making the 4 changes described above, plus adding a clip to educate the STRAIGHT about HIV risk as well, I believe the shortcomings could be overcome.
Namely, the shortcomings that can be overcome are:
1) Straight people would not think that they are not at risk
2) MSM would not think they are stigmatised as the only group that is exposed to HIV and responsible for the epidemic
3) MSM are not 'encouraged' to cheat on their BF/wife
4) Married bisexual men would not think it is OK to cheat on their wife as long as they practice protected sex with their casual male partners
5) Society would not think that ALL gays are promiscuous (though, as I suggested, we can't say that those who are promiscuous are bad. If they are not cheating and practice safer sex, they are not being immoral by sleeping around.)
6) Widespread misunderstanding about homosexuality (myth that it is a mental disorder and that it could be 'cured' or 'prayed' away) and sexual orientation generally could be corrected
7) Society is educated about the harmful effects of stigma. Stigma is the worst enemy.
Queer Thailand: Culture, Society & Sexual Identity
Course Dates: Sunday 4th July – Friday 23rd July 2010
Gays, Girls, Gender Bending, Ganja, and Gambling. Thailand is a country of many paradoxes. As a Buddhist Kingdom with the world's longest reigning monarch, Thailand somehow harmoniously balances contemporary sexual freedoms with traditional values. Known around the world as a "Gay Paradise," Thailand provides an excellent location to study and explore variant gender identities and expressions -- a kind of "Asian Mystique"-- which challenges many from the West.
As anyone who comes to Thailand soon discovers, gender and sexuality are in a constant state of change as fluid, contingent and adaptable performances. Androgyny permeates and possibilities abound. Globalization, tourism, technology, and the information society have all impacted Thailand in recent decades to create a fascinating space within which to explore reformed, emergent and traditional expressions of gender and sexuality. It is within this gendered space of "Queer Thailand," with its many myths and mystiques, that this course journeys.
This course will include an introduction to gender/queer theory and proceed to use case studies of gender performance in Thailand to provide a fascinating comparative study for Gender/Sexuality/Women's Studies students and/or others with open minds that wish to explore this topic. Although previous coursework in gender studies will prove helpful, it is not a prerequisite for this class. Fieldtrips and interaction with Thai LGBTQ students and the activist NGO community will enhance classroom learning.
http://www.educationabroadnetwork.org/?id=203
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