FHI - Fun and Fashion Define Cambodia’s MStyle

DECEMBER 2009 — Just over a year ago FHI and its partners launched MStyle, a USAID-supported project in Cambodia to improve the sexual health of men who have sex with men (MSM). MStyle is a peer-led social network that takes a holistic approach to reducing the risk of transmission of HIV and other sexually transmitted infections (STIs).

Because of the stigma and discrimination MSM often face, they may be reluctant to seek health and support services. The MStyle program helps MSM overcome this reluctance by providing high-quality and confidential services. It does so by creating an environment that is not just supportive but also engaging: music and fashion are important elements. The program has far surpassed its initial goal to reach 2,500 MSM. To date, nearly 6,000 of the 9,900 visible MSM in Cambodia have been reached. On average, each individual was reached seven times with HIV prevention messages, health services, and referrals. This figure represents 59 percent coverage, nearly the 60 percent UNAIDS deems to be universal coverage.

Because many Cambodian MSM also have female sexual partners, MStyle works in tandem with FHI's SMARTgirl program, which targets Cambodia's female entertainment service workers and their male clients. This harmonization of efforts means that those most vulnerable to HIV receive consistent, clear messages through multiple channels.

Reaching Out to MSM

Facilitator's Guide In collaboration with its partners and community-based organizations, FHI supports MStyle in implementing behavior-change approaches that emphasize risk reduction and safer sexual practices. Community and peer facilitators from FHI's partners reach out to MSM through one-on-one and group interactions. Using MStyle risk assessment cards (PDF, 107KB) and guides (PDF, 251KB), facilitators help MSM assess their risks in different situations and learn how to protect their health. Outreach sessions aim to go beyond discussion of STIs and HIV to address other risks MSM may face, from disclosure of their sexual practices to drug use to sexual violence.

MStyle promotional materials incorporate colorful designs and an appealing sense of fashion and style. Outreach workers from FHI's partners distribute the materials along with condoms, lubricants, and referral cards for HIV counseling and testing, treatment for STIs, and other health services.

The cards are later collected, and the information they contain—referral types, facilities referred, and names of outreach workers providing the referrals—is entered into a database that is used to measure and improve the program's effectiveness. FHI also supports local partners to refer HIV-positive MSM to care and treatment services and make follow-up home visits.

During 2009, five MStyle partners collected over 6,100 of the referral slips provided to MSM clients and nearly 4,000 referral slips for HIV counseling and testing, representing 31 percent and 21 percent of total service uptake, respectively. The data suggest that 100 percent of MSM reached have accessed STI services at least once, and 67 percent received counseling and testing. (Some of these may be repeat clients.)

Additional outreach sessions are held weekly at five MStyle clubs located in Phnom Penh and Banteay Meanchey. The clubs are safe places where MSM can meet with friends, watch TV, join in karaoke, and at the same time learn about healthy sexual practices and choices. So far, 45 percent of MSM reached through MStyle have become members of these clubs and they average 12 visits per year.

With technical support from FHI, partners provide addiction counseling, support groups at the clubs, and referrals to drug-use services. In addition, from January through September nearly 168,000 condoms and lubricants were distributed for HIV prevention through these venues.

Changing a Culture
FHI and its partners are encouraging bar and club owners, healthcare providers, and others to build a supportive environment where the health and wellbeing of young men and the wider community are protected. To foster sustainability, FHI is also developing the capacity of local partners and stakeholders to plan, implement, and monitor program activities when the project ends.

The new, branded MStyle approach has proven popular with MSM, and with club and outreach staff. The program is poised to play an important, long-term role in addressing sexual health and MSM issues in Cambodia.

PHOTOS: (Top) Visible MSM serve as positive role models and convey key messages about the importance of developing responsible sexual attitudes and practices. These men use their image to promote an MStyle website, which offers a chat room, quizzes, and sexual health information that members can access confidentially. (Bottom) The cover of the Facilitator's Guide provides an example of the colorful and engaging artwork used in the campaign. (FHI/Cambodia)