Creating Space

GHC specializes in working with people who are at especially high risk of becoming infected with HIV. Certain behaviors combined with stigma and discrimination makes some people more likely to become infected or transmit HIV to others. Studies have identified sex workers, drug users and men who have sex with men (MSM) as “most at risk populations” (MARPs) or “key populations” for HIV infection and transmission. As sex work, men having sex with men (MSM) and drug use are illegal activities in many countries, those who engage in these activities are discriminated against, which limits their willingness to come forward for health care and other assistance. This establishes a pattern of high risk and lack of access to services.

As public health specialists, we know that people need to reduce their number of sexual partners, increase condom use, reduce drug and alcohol use, never share injection equipment and get tested for HIV regularly. However, from the perspective of MARPs, these things may not be easy to do or may not seem like high priorities. At GHC, we believe the key to successful behavior change programming is to create space in which MARPs feel safe enough to share their own perspectives on the issues and challenges they face. GHC’s tools then provide a structure that allows MARPs to create community-driven solutions.

Of course, sex workers, drug users and MSM in developing countries are not the only people who may feel they have no space in which to talk freely about what concerns them, and HIV is not the only public health or social issue affecting people. All over the world in both rich and poor nations, certain groups and sub-sets of society are marginalized and may have less access to health resources for a variety of reasons. GHC’s tools are appropriate to address these groups as well, as the essence of our approach is to give a voice to those who may otherwise not be heard. As GHC’s tools are based on widely applicable behavioral principles, our methods are suitable to a wide range of health and social issues.

In order to truly advocate for appropriate services for underprivileged and marginalized groups, public health professionals must understand the lives of their target populations. GHC’s methodologies create a space for participants to tell us what they see as real issues and concerns. No matter a person’s level of education or place in society, when public health professionals work with someone in an authentic way to understand what makes his/her life challenging, positive results are possible.