Summary

Based on two needs assessments with 60 Asian responders, ReShape and partners, Dr
Hideta Nakamura, Garry Brough, Simon Collins, initiated a series of seven Zoom sessions in
2021 including an introductory overview and sessions on U=U, Youth, Free from Stigma,
PrEP in the context of Combination Prevention, Chemsex and Mental Health Issues, How to
support Peer Supporters, plus a special hybrid symposium, U=U in Asia, at the 35th annual
meeting of the Japanese Society for AIDS Research in Tokyo

Community interpreters provided simultaneous translation in Bahasa Indonesian, Bahasa
Malaysian, Japanese, Mandarin and Urdu. Over 400 registered project participants, primarily
HIV peer supporters from Afghanistan, China, Hong Kong, India, Indonesia, Japan, Malaysia,
Mongolia, Nepal, Pakistan, Philippines, Singapore, South Korea, Sri Lanka, Taiwan, Thailand
and Vietnam participated in one or more of the activities. All participants received
captioned videos and documents from the sessions. As the season progressed, experienced
and emerging Asian activists assumed more lead roles in the sessions. Here is the
participants’ series evaluation

Origins of the project

Project discussions started in early 2020 when Simon Collins introduced Hideta Nakamura, a
Japanese infectious disease doctor doing a postdoc at Chelsea and Westminster Hospital to
the ReShape team. Through a process of mutual mentoring, research and discussion two
projects were proposed: a clinical training for young Japanese infectious disease specialists
treating patients with HIV, and an HIV peer support training for Asian HIV peer supporters in
Japan with Simon Collins and Garry Brough. ReShape introduced Dr Nakamura to EACS, a
meeting was held and EACS agreed to develop a pilot country training with Dr Nakamura.
ReShape received funding for the peer support training. Both events were scheduled to take
place in conjunction with the November 2020 annual meeting of the Japanese Society for
AIDS Research in Tokyo. The Covid-19 pandemic put both projects on hold

Simon Collins and Garry Brough suggested that instead of delaying the HIV peer support
training we transfer it to an online series based on HIV peer supporters’ needs

A survey on HIV issues was conducted in February of 2020. After the first Covid wave, a
second HIV peer support survey was conducted. These needs assessments were the
basis for the 2021 training & exchange series

Narrative of the 2021 sessions

Online we wanted to ensure participants’ experiences were as much like face-to-face
sessions as possible. We wanted to create a safe space for peer supporters and activists to
share knowledge, experience and hope in conversations more than a rigid one-way training.
We called the sessions “training & exchanges”, the sessions were in meeting format rather
than webinar format, and commentators were encouraged to use as few slides as possible.
We actively encouraged participants to share details, links and contacts in the Zoom chat

Simultaneous interpretation was very important and we were able to provide the sessions in
English, Bahasa Indonesian, Bahasa Malaysian, Japanese, Mandarin and Urdu with fantastic
community activists who were not only interpreting, but also taking part in discussions. We
felt that this was key to the success of the project; boosting the inclusivity of the sessions;
getting as many HIV activists and peer supporters involved to get qualitative feedback from
across Asia

To manage the tech aspects of the series we hired Anjula Weeranayake, a Sri Lankan IT
contractor who now also provides technical support for ReShape

The first overview session in May 2021 focussed on U=U with Simon Collins (i-Base)
presenting the history of U=U, the science behind it and providing information that activists
and PLHIV could bring to healthcare professionals and policy makers in their countries.
Garry Brough led a discussion about the best ways HIV peer supporters and their peers can
communicate with each other and with their doctors about U=U. Bruce Richman’s U=U
campaign slides highlighted different country’s U=U campaigns around the world. The focus
of the discussion shifted to making change at the national level, planning national HIV
strategies to put U=U on the agenda; developing support documents. Simon and Garry
introduced the concept of community-initiated negotiations in HIV history and shared their
experiences in “bringing key stakeholders to the table” to enable successful decision making
and policy making, in particular. (“Bringing key stakeholders to the table” was a recurring
concept in the 2021 series which will now be explored in 2022 sessions on negotiations and
collaborations

Narrative of the 2021 sessions

June’s training & exchange session was on Youth, with guest commentators Michelle Bockor
and Thuletule Milambo (Positively UK); Alip, Febri and Ikana (Inti Muda, Indonesia) and
Jason (AIDS Concern, Hong Kong). Michelle and Thuletule, young women, shared their own
personal journeys with HIV peer support and the challenges of working as peer supporters
in the UK. Alip, Febri and Ikana shared about their work with youth shelters in Indonesia, the
challenges that they have within the healthcare system and the amazing work that they are
doing. Jason discussed some of the services that AIDS Concern provides including free
testing and an escort service to the hospital if a test had come back positive. Topics of
discussion on this session included HIV peer support for youth in different countries, youth
access and obstacles to sexual health and HIV services in different countries and
communication tools used to reach youth to share knowledge and advice. Also discussed
was the youth that are undocumented, illegal or homeless, sex workers, especially those
from migrant families

Narrative of the 2021 sessions

July’s session was Free from Stigma with key commentator, Garry Brough (Positively UK and
Fast Track Cities Initiative-London) and a focus on internalised stigma. Discussion focussed
on how informal and structured support systems can empower people about their issues.
Changes in stigma were identified in South Korea. Stigma in the past was mostly based on a
lack of correct information. Information campaigns reduced stigma. But now incorrect
information and hate speech is being weaponized by right-wing politicians and religious
conservatives and stigma is increasing again. It was also noted that there was a good
balance in this session between talking about problems and talking about the solutions

Narrative of the 2021 sessions

PrEP in the context of Combination Prevention was September’s session. Will Nutland, (co
founder of PrEPSTER) gave an overview of what PrEP is, PrEP options and dosages. People
were encouraged to think of PrEP in the context of combination prevention using PrEP in
combination with other prevention interventions. Active discussion touched on PrEP
availability and legality in Asian countries. Asian activists outlined their projects. Again, the
issues of negotiations for policy change were raised

Narrative of the 2021 sessions

Yasir Ali Khan (Anpud), Rayner Tan (The Greenhouse) and Doan Thanh Tung (Lighthouse
social enterprise) were guest commentators for October’s Chemsex and mental health
issues. They discussed the impact of criminalisation of MSM and drugs in some countries.
They highlighted the need to see HIV, sexual expression and drug use in the context of
sexual health and mental health issues. They addressed the intersecting connections. How
are people vulnerable to HIV acquisition? Were there addiction problems? Childhood
trauma? It was noted that mental health is not a separate issue from chemsex, it should be
part of the same package when it comes to interventions, activities and services that we
should be providing to the chemsex community

Narrative of the 2021 sessions

How to support Peer Supporters, in November, was the final session of the year with guest
commentator, Adam Nathan Schultz. He shared about running and the yoga classes he
provides for gay men. He acknowledged that peer supporters are often dealing with their
own severe health issues. People highlighted the essential need for self-care, the peer
supporter, when aiming to give your energy to the community. Jeff Kong in China shared
that young people living with HIV like to go to dinner parties as a way to support each
other. It was discussed that young people need to talk to other young people to really
relate to what they are saying. Peer support can be structured but also informal. Formal
structures can be obstacles for some people. The session focussed on helping each other
and there was a real sense of connection and vulnerability throughout

Evaluation and next steps

Here is the evaluation report of the 2021 series. Participants agreed they used ideas from
the sessions in their work and they felt less lonely in their work.
Some Series Feedback:
– “I find this series very relevant and much needed in this modern times of a new
epidemic of HIV, chemsex, addiction, and ignorance. Just like the aforementioned
has a domino effect, so does knowledge, sharing, support, and efficacious action
plans for people like us”
– “It provided a good and safe platform for PLHIV”
– “It is firstly an opportunity to learn relevant knowledge pertaining to improving our
own skill sets. Secondly, it is a catalyst to link individuals and organisations to
combine strengths and consolidate efforts. Thirdly, it is a means to identify cross
cutting issues faced by different countries to brainstorm and strategize effective
responses to affect positive change. Fourthly, is allows individuals and organisations
with fewer resources to be heard”

We are using the survey to shape our sessions for 2022. Dr Maha Yewtuck and Chin
Chuanfei from The Greenhouse (Singapore) led our first session, “Talking sex in Asia”, on 5
February. Several times the 2021 training sessions touched on the need for HIV peer
supporters to be “at the table” where decisions get made, with other key stakeholders, to
advocate for policy changes; funding for peer support; LGBTQ, sex work and drug
decriminalisation and treatment and PrEP access. Therefore, we are planning sessions on
negotiations and collaborations and a special series on HIV treatment support