amfAR, The Foundation for AIDS Research

GRASSROOTS: The GMT Initiative Blog

Grassroots reports on the work of amfAR-supported research teams and advocates responding to the devastating impact of HIV among gay men, other men who have sex with men, and transgender individuals (collectively, GMT).

Belgrade, Serbia: The Pulse of Youth

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Posted by Jirair Ratevosian, February 14, 2011

“We are the pulse of the youth,” declares Isein Fetoski. He is describing SPY—Safe Pulse of Youth—a well established community-based organization in Serbia dedicated to the needs of MSM in and around Belgrade.  I spent some time this week with Fetoski and the SPY crew to learn about the outreach and research activities performed here. 

For more than five years, SPY (with support from the Global Fund) has implemented outreach services, including Internet outreach, promotion of voluntary counseling and HIV testing, and psychosocial support.


SPY staff (L to R): Loodi Nicky, Isein Fetoski, Dejan Zagrajski, Aleksandar HelterSkelter Skundric,and Ivan Ivanovic.,

Now, staff members report a disturbing trend of young MSM engaging in high-risk behavior—although “they are not lacking knowledge,” says Daniel Meskovic, co-founder of SPY.

In 2010, SPY received a community award from amfAR’s MSM Initiative to study the factors influencing HIV risk-taking behavior among MSM in Belgrade. “By understanding the patterns of HIV risk and sexual behavior and studying predictor variables such as personality and psychological factors, we are better able to meet the needs of MSM,” explained Meskovic. Until now, this type of research among MSM had not been carried out in Serbia.

While HIV prevalence among the general population in Serbia is low, as in many countries in the region, rates are notably higher among vulnerable groups; among MSM, HIV prevalence is estimated between 3.6- 6.1%. Internalized homophobia, stigma, and lack of appropriate health services are all factors fueling the spread of HIV among young Serbians.  Homophobia remains deeply engrained in the Balkan culture, evidenced by the eruption of anti-gay violence during Belgrade’s gay pride march this past October.

Serbia’s economic and social problems, deepened by the global recession, are not making things easier. In fact, SPY and other stakeholders are acutely concerned that the Serbian government will no longer be able to finance free and anonymous testing for HIV. Despite that, the important work continues. As Fetoski explains, “We are fighting to save our own lives.”

Dominican Republic: Every Scar Has a Story

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Posted by Ben Clapham, February 4, 2011


The idea of a transsexual identity did not exist in the Dominican Republic until recently. LGBT communities mainly considered a biological man dressed in woman’s clothing to be a transvestite or, worse, a drag queen.

D.R. has an overall HIV prevalence of 0.8 percent, but a recent study shows that 25 percent of female transsexual sex workers have HIV. Many have been victims of abuse from early on and have experienced sexual coercion and/or violence; very few have had access to education or prevention or treatment centers equipped to work with them. Mental health services for these vulnerable women are almost nonexistent.

Seeing the hardships facing female trans sex workers, COIN, an organization in Santo Domingo that provides sexual and reproductive health services, identified them as a priority for HIV prevention efforts and began offering them services. The program has been successful in gaining the trust of an extremely cautious and guarded community.

“I was a sex worker for a long time, but now I am a social worker,” proclaimed Nairobi, a leader in the female trans sex worker community. “I work with the girls and share my experiences so their lives can be better. One day, they won’t have to depend on sex for their survival and HIV can be less of a threat to their lives.”

Every two weeks, Nairobi and other health promoters go to the sites where the women work to notify them that COIN’s mobile clinic will be coming the following day. One woman told me, “I never miss the mobile clinic days. Even if that day is my day off, I will come.” The mobile clinic team seems to know every detail of these women’s lives. Every scar has a story to it; every wound a painful memory.

Every week at the center the women come and speak with a psychologist on subjects ranging from self-confidence to social integration at a workshop called “An Afternoon with Mama.” The women act as a family, supporting and protecting one another. For some of them, this is the only family they have.