The Problem

The needs and experiences of people living with HIV/AIDS in Asia Pacific are changing, especially in the wake of the COVID-19 pandemic. ‍

People living with HIV/AIDS in Asia Pacific experience a multifaceted nexus of health challenges, discrimination, reduced economic opportunity and social disadvantage. While HIV rates are decreasing in Asia Pacific, gay men and men who have sex with men (MSM) overwhelmingly represent the majority of new infections. In 2020, 44% of new HIV infections occurred through sexual transmission between men, despite a 12% decrease in total HIV infections in all of Asia, and 29% reduction in AIDS related deaths. Transgender people and sex workers also experience high transmission rates.

Concurrently, LGBTIQ+ people in Asia Pacific are more likely to attempt suicide, with almost half of all transgender people having attempted suicide, and higher estimates suggest that LGBTIQ+ people make up 20-40% of homeless populations. In 2020, LGBTIQ+ populations were more affected by COVID-19, as the nexus to homelessness meant this population faced difficulty in social distancing, and the prevalence of HIV meant compromised immunity.

Given the large intersection of simultaneous poor health, social, and economic outcomes for LGBTIQ+ people in Asia Pacific, organisations on the frontlines advocating and fighting for better outcomes are faced with many priority areas, and must take needs of many populations into account. These organisations need a framework that allows them to identify priority areas to focus on, while maximising their resources for maximum impact across these areas.

APCOM is an organisation facing these challenges in 2021 as they looked to develop their organisational strategy for the future.

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APCOM is a HIV advocacy organisation, based in Thailand, that works across the dimensions of HIV, health, social and economic outcomes for LGBTIQ+ people in Asia Pacific. APCOM's premier programs are 'TextXXX', a regional approach to addressing HIV testing rates in MSM in Bangkok, Ho Chi Minh City, Manila, Yogyakarta and Jakarta, and the 'PULSE' survey, generating thousands of insights on lived experience.
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spur: was engaged to develop a framework that would allow APCOM to prioritise areas of need for their new organisational strategy, as identified by their stakeholders, and critically, assess their impact in the community. The challenge was framing an approach that effectively and sustainably allocated APCOM's resources, while meeting the widespread needs of the community.

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The Process

Holistic analysis and recommendations

1 · Research

The first phase was concerned with deep inspection of the context, current trends and stakeholders in APCOM's ecosystem. This included an understanding of the number of LGBTIQ+ people in Asia Pacific, the prevalence of HIV in different communities and the state of LGBTIQ+ rights fights in Asia Pacific. For example:

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2 · Analysis of Data

Prior to our engagement, APCOM had undertaken a comprehensive stakeholder engagement process to understand what is important and most needed by the communities it serves. Part of our engagement was the analysis and synthesis of this engagement and data. Three key themes emerged as the priority areas for APCOM's future activities:

• Advocacy and rights;
• Capacity building; and
• Access to HIV prevention services.

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These were identified in the context of priority communities of MSM and transgender people.  

It also raised further questions of:

• How might we engage intersectional perspectives of the communities APCOM has touch points with, for example, recognising the experience of transgender sex workers, or gay men who inject drugs?
• How might we harness the data we do have on LGBTIQ+ communities, while improving these efforts?
• How does COVID-19 continue to play a part in health outcomes for LGBTIQ+ communities?
• How do we ensure the privacy and security of APCOM's stakeholders in the movement towards online activities during COVID-19?
• How might we capture regional differences in program rollout across Asia Pacific?

There are no 'right' answers here. While these are discussions spur: can certainly facilitate, these are questions that are very organisational and capacity specific.

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3 · Strategy and recommendations

The final recommendations provided to APCOM were designed to be used as a prioritisation and impact guide. Priority areas were identified on the back of research into the most pressing of issues faced by LGBTIQ+ and HIV populations, and aligned with the priority of APCOM's stakeholders elicited from the survey as well as analogous organisations in the global HIV-prevention and LGBTIQ+ space. The final recommendations presented these priority areas in a decision-making framework to understand what is possible given organisational capacity, compared to what the community is saying it needs, and critically, logistical requirements and impact potential of any priority area.

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The Impact

An impactful organisational strategy that incorporates community voices and intersectionality, while achieving sustainability in organisational resources.

APCOM is currently in the process of finalising and implementing its 2021+ strategy.

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