Report exploring the link between MSM, homophobia and HIV/AIDS in countries: Bosnia and Herzegovina, Croatia, Montenegro and Serbia TableReport of exploring Contents the link between MSM, homophobia and HIV/AIDS in countries: Bosnia and Herzegovina, Croatia, Montenegro and Serbia Within the project: Developing UNDP Cross-Country Cooperation(Bosnia and Herzegovina, Croatia, Montenegro and Serbia) Financially supported by UNDP Country Office Support Facility (COSF) United Nations Development Programme (UNDP) is the UN’s global development network, advocating for change and connecting countries to knowledge, experience and resources to help people build a better life. We are on the ground in 166 countries, working with them on their own solutions to global and national development challenges. As they develop local capacity, they draw on the people of UNDP and our wide range of partners. Short extracts from this publication may be reproduced unaltered without authorisation, on condition that the source is indicated. The views expressed in this paper are those of the authors and do not necessarily represent the views of UNDP. Copyright © 2010. Editor in chief: Iva Jovović Authors (in alphabetical order): Valerio Baćak, Zoran Dominković, Hrvoje Fuček, Kristijan Grđan, Branko Kolarić, Danijel Lončar and Dinko Štajduhar. Published by: United Nations Development Programme (UNDP) in Croatia Radnička cesta 41, 10 000 Zagreb, Hrvatska Proofreading (English): Irena Bilić Design and cover: Krešimir Kraljević First edition: 2010 Acknowledgements: Special thanks go to respondents who have taken the time to provide answers and inputs to the authors. We thank col- leagues from UNDP Regional HIV/AIDS Team under leadership of Mr. Shombi Sharp with support from colleagues Dudley Tarlton and John Macauley. We are grateful to our sub-regional UNDP Colleagues: Mrs. Miljana Grbić, Mrs. Itana Labović and Mr. Nešad Šeremet, who offered valuable advice, suggestions and contacts for their respective countries. Table of Contents Executive Summary 1. Homophobia in South-eastern Europe - Prevalence, Consequences, and Prevention 9 1.1. Introduction 9 1.2. Meaning and Impact of Homophobia 9 1.3. A Snapshot of Homophobia in the Region 10 1.4. Local Responses to Homophobia 11 1.5. Recommendations for Homophobia Prevention 13 1.5.1.Young People and Schools 13 1.5.2. Law Enforcement and Homophobia 13 1.5.3. Social Marketing and the Media 14 1.5.4. Internalized Homophobia 14 1.6. Conclusion 15 2. MSM- men having sex with men 17 2.1. Introduction 17 2.2. The Term 18 2.3. “MSM” in the Region, Introduction 18 2.4. Silent men 19 2.5. What’s Sex Got to Do with It? 20 2.6. Continued: MSM in the Region 20 2.7. Instead of Conclusion 21 3. Legal Status of Sexual and Gender Minorities in South-eastern Europe 23 3.1. Introduction 23 3.2. Human Rights Standards 23 3.2.1. Human rights definition 23 3.2.2. Violations of human rights 23 3.2.3. The International Covenant on Civil and Political Rights (ICCPR) 24 3.2.4. First Optional Protocol to the ICCPR 26 3.2.5. Second Optional Protocol to the ICCPR 26 3.2.7. Protocol 12 to the ECHR 26 3.2.8. The European Charter on Human Rights and Fundamental Freedoms 27 3.2.9. The European documents relevant for sexual and gender minorities 27 3 3.2.10. The European Parliament Resolution A3-0028/94 27 3.2.11. The European Parliament Resolution A5-0050/00 27 3.2.12. The Council Directive 2000/78/EC 27 3.2.13. The European Parliament Resolution on Homophobia in Europe 28 3.2.14. The Council of Europe Recommendation CM/Rec (2010) 28 3.3. Right to life, safety and protection from violence 28 3.3.1. Legal background in the region 28 3.3.2. Violence against sexual and gender minorities 29 3.3.3. Availability of effective remedies 30 3.3.4. Forced psychiatric treatment 31 3.3.5. Conclusions and recommendations 32 3.4. Right to expression and public assembly 33 3.4.1. Practice of the European Court on Human Rights 33 3.4.2. Zagreb Pride 34 3.4.3. Belgrade Pride 34 3.4.4. Queer festival Sarajevo 35 4.4.5. Conclusions and recommendations 35 3.5. Right to be protected from discrimination 36 3.5.2. Practice of the European Court on Human Rights 36 3.5.3. National anti-discrimination legislations 36 3.5.4. Conclusions and recommendations 39 3.6. Right to family life 40 3.6.1. European context 40 3.6.2. Situation in the region 41 3.6.3. Conclusions and recommendations 42 3.7. Summary of recommendations 42 RIGHT TO LIFE, SAFETY AND PROTECTION FROM VIOLENCE 42 RIGHT TO EXPRESSION AND PUBLIC ASSEMBLY 43 RIGHT TO BE PROTECTED FROM DISCRIMINATION 43 RIGHT TO FAMILY LIFE 44 4. Health of MSM 45 4.1. Introduction 45 4.2. Bosnia and Herzegovina 46 4.3. Croatia 49 4.4. Montenegro 52 4.5. Serbia 53 4.6. Instead of conclusion 56 4.7. References 57 5. Academic education on LGBT population in three helping professions in countries of South-eastern Europe 59 5.1. Summary 59 5.2. Introduction 59 5.3. On data collection 61 5.4. Overview of the data collected and discussion by country 62 5.4.1. Bosnia and Herzegovina 62 4 5.4.2. CROATIA 64 5.4.3. MONTENEGRO 69 5.4.4. SERBIA 70 5.5. Conclusion and recommendations 73 5.6. List of participants 74 5.7. References 75 6. Activism and non-governmental response 79 6.1. Introduction 79 6.2. Bosnia and Herzegovina 80 6.3. Croatia 81 6.4. Montenegro 83 6.5. Serbia 84 7. Prevention tips- manual on prevention activities 87 7.1. Prevention 87 7.1.1. Safer sex 87 7.1.2. Condoms and lubricants 88 7.2. Risk and vulnerability assessment 88 7.2.1. More than sex 88 7.2.2. Work with organizations in society (NGOs) 89 7.2.3. Work with “gatekeepers” 89 7.2.4. Work with health service providers 89 7.2.5. Principles obstructing HIV prevention 90 7.3. Strategies of HIV/STD prevention for MSM and with MSM 91 7.3.1. Health-promotion strategies focused on individuals 91 7.3.2. Under the open skies 91 7.3.3. On a secret mission 92 7.3.4. Materials 92 7.3.5. Groups 93 7.3.6. Workshops 93 7.3.7. Strategies for gradual increase, targeting and improvement of delivery of services and products 94 7.3.8. Condoms 94 7.3.9. Lubricants 95 7.3.10. Counselling 95 7.3.11. Ethical issues and confidentiality 96 7.3.12. Other services 96 7.4 Strategies for mobilizing the community 97 7.4.1. Celebration time 97 7.4.2. Safe house 97 7.4.3. On-line 98 7.4.4. In prison 98 7.5.1. Various settings 99 7.5.2. Visibility and representation 99 7.5.3. Link with the police 100 7.5.4. Social advocacy 100 7.5.5. Political advocacy 101 7.6.6. Religion 101 5 Acronyms 103 6 Executive Summary The term ‘Men who have sex with men’, frequently shortened to MSM - describes a behaviour rather than a specific group of people. It includes self-identified gay, bisexual, or heterosexual men, many of whom may not consider them- selves gay or bisexual including transgender populations. MSM presents a topic that many governments and certain individuals would prefer not to talk about and choose to be silent on these issues, failing to acknowledge these behaviours and address them, which unfortunately helps the HIV and AIDS epidemic to grow. Therefore, the prevention programs addressing MSM are vitally important. However, this population is often seriously neglected because of official denial by governments, the relative invisibility of MSM, stig- matization of male-to-male sex, ignorance and/or lack of adequate information. All four countries (Bosnia and Herzegovina, Croatia, Montenegro and Serbia) experience low level HIV/AIDS epidem- ics. The dominant way of HIV transmission in these countries is through sexual intercourses. Though a much lower proportion among all HIV cases are officially attributable to homosexual transmission, the problem of under-reporting of homosexual transmission among those diagnosed with HIV is often mentioned in the country reports. Many people feel uncomfortable to name MSM as a way of HIV transmission in their individual case when talking to doctors. Since the year 2003 and the beginning of the Global Fund to fight AIDS, Tuberculosis and Malaria (GFTAM) donations to the countries in the sub-region, a significant amount of financial resources and technical assistance was poured into scaling up treatment and prevention activities. The prevention activities were also improved in both the coverage of us- ers as well as in the number and density of service delivery points. There are still negative practices in place such as: • National legislation and policies that hinder a creation enabling environment to prevent HIV among MSM; • Lack of relevant data on stigma and discrimination (from quantitative surveys or qualitative research); • Social, cultural and political circumstances that influence the level of stigma and discrimination towards MSM; • Evidence of unlawful practices (e.g. in health services, workplace, etc). Therefore, we prepared a report that would enable national authorities for better understanding of social and political context that would lead to comprehensive planning of prevention activities among MSM and other sexual minorities, even lead to a development of a larger scale sub-regional project. 7 Homophobia in South Eastern Europe- Prevalence, Consequences and Prevention Chapter 1 1.