Response to HKCASO’s Comment and WUestions on the Mid-term Review of the Recommended HIV AIDS Strategies

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• Publié par: Asli
• Nombre de lectures: 28
• Langue: English

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(CFA Paper 12/2008-2011)
Community Forum on AIDS
Response to HKCASO’s Comments and Questions on the Mid-term Review of
the Recommended HIV/AIDS Strategies for Hong Kong 2007 – 2011

Purpose
This paper summarizes the responses with input from relevant parties to the
comments and questions raised by the HKCASO in relation to the mid-term review of
the recommended HIV / AIDS strategies for Hong Kong 2007 – 2011 that was
thpresented in the 15 Meeting of the Community Forum on AIDS. The responses are
put under corresponding comments and questions (in italic) for ease of reference.

Overall Comments
 The NGOs and the communities concerned, including HKCASO, have not been
involved and their views were therefore not included in the review.
 The focus of the paper was very government oriented and the roles of the NGOs
or community-based groups were not highlighted sufficiently.
 The perspective of the paper was not comprehensive to reflect what
efforts/responses actually took place in the past two years.

2. The mid-term review serves a start to gather information relevant to the
eight targets, for discussion and inviting feedback, comments and inputs. It is by no
means a comprehensive account of what has been done towards the targets. The
paper resented and discussed at the CFA meeting aims to invite views and inputs from
NGOs and community workers, work of which is of paramount importance to the
local AIDS response. This paper serves as a framework to facilitate members’
discussion on the eight targets. Before the end-period of the current Strategies, ACA
would actively seek input from community and other stakeholders on progress of the
eight targets.

Comments/Questions on the Eight Targets of the Recommended Strategies
Target 1 – Increase condom use of MSM, sex workers and their clients to > 80%
 The possession of condoms and lubricants has been continuously used as
supporting evidence for arresting and prosecuting sex workers. It is an act that
undermines the effectiveness of the safer sex campaign and could very probably
bring severe damages to public health. Have any efforts been made to initiate a
cross-bureau investigation aiming to review the law enforcers’ practices and its
impact on the violation of human rights and public health?
(CFA Paper 12/2008-2011)
3. The issue of confiscating condoms had been discussed at the Hong Kong
Advisory Council on AIDS (ACA) meetings on 10 July 2009 and 15 January 2010 at
which the FHB's representative was present. We have enlisted the assistance from an
ACA member, Mr Charles Wong, to look into the matter and liaise with the Police.
As reported by Charles Wong at the ACA meeting on 15.1.10, he suggested the
NGOs to record down the incidents of confiscation of condoms. In case there is
prima-facie evidence of abuse by Police on confiscating fronts, they could make a
formal complaint to the Police for independent investigation.

4. In addition, ACA Chairman wrote a letter to the Commissioner of Police on
the same issue. An extract of the reply from the Commissioner of Police has been sent
to Mid-night Blue, the coordinator of the four NGOs which wrote the joint letter to
ACA. It is noted that a mechanism has already been in place for regular dialogue with
NGOs and sex workers. The Police stepped up liaison with the NGOs and the no. of
meetings increased from two in 2008 to six in 2009. The ACA Secretariat has also
explored the possibility of delivering talk on HIV prevention to the Judiciary but no
suitable opportunities were identified yet.

 What was the population size for evaluating condom use specifically among
young people who are MSM, sex workers or clients of sex workers and what
were the findings?

5. Population size was not estimated in evaluating condom use among
different target groups. Instead, the evaluation was done by carrying out specially
conducted projects, which are given in the table below –

Survey Survey sample size response Age range Condom use rate
rate (median age)
MSM: PRISM (08/09) 843 44.8% 15-83 Use condom with
(94.4% have ever had anal (31) non-regular sex partner:
sex with another man) More than half in the past 6
months: 96%
Every time: 75%
ACTS (2008) 1349 Attendances - 18-64 Adult MSM:
(including 334 adult MSM) (30) Use condom with casual sex
partner*:
More than half in last year:
82%
#At last sex : 16%
At last anal sex: 71%
AIDS Concern 985 MSM cases - Median age group: Use condom more than
for anal sex in last 3 (2008) 26-30 half
months: 82%
At last anal sex: 72% (CFA Paper 12/2008-2011)
Sex workers CRISP (2009) 986 71.8% 17-60 Use condom more than half in
(female) (34) the past 1 week: 95.1%
Every time 91.1%
CSD (2008) 476 Females - CSW: CSW: use condom more than
(including 195 commercial 18-55 half in the past 1 week: 42%
sex workers) (33) Every time: 22%
SHS (2008) 400 Females - CSW: CSW: use condom more than
(including 22 commercial 17-46 half in the past 3 months: 95%
sex workers) (33) Every time: 73%
Clients of sex CSD (2008) 500 Males - Clients of sex worker: Clients of sex worker:
workers (male) (including 220 ever visited a 15-65 Use condom more than half in
commercial sex worker in (34) the past 1 year: 81%
the past one year) Every time: 63%
SKC (2008) 1489 Males - Client of sex worker Client of sex worker
(including 577 ever visited a 22-65 Use condom during the last
commercial sex worker in (39) sex contact: 82%
the past half year)
ACTS (2008) 1349 Attendances - Adult heterosexual Adult heterosexual male:
(including 792 adult males: Condom use more than half
Heterosexual males) 18-80 in last year: 90%
(32) Condom use at last sex: 50%
SHC (2008) 1141 new cases - Adult heterosexual Adult heterosexual males:
(including 552 adult males: Condom use more than half in
heterosexual males those 18-89 the past 3 months: 63%
ever had casual sex including (36) Condom use at last sex:
commercial sex) 61%
* casual sex partner: including commercial sex partner and non-regular non-commercial sex partner.
#
last sex including vaginal sex, anal sex and oral sex.

 As various local researches showed that there was a big gap between knowledge
and actual practice of safer sex among the MSM community, ATF should scale
up the funding support (both programme expenses and manpower) for
programmes which are labor-intensive but could have a more sustainable impact
on behavioral changes.

6. Funding applications of programme or project under ATF would be
considered on a case-by-case basis according to a structured technical review and
vetting process. Approval for extension of project or programme is given on their
own merit based on supporting evidence. The existing mechanism allows
accountability on one hand, and flexibility to adapt the evolving epidemic on the
other.

Target 3 – Develop one or more resource allocation plans to guide programme
funding
 Apart from the resource allocation plan for the years 2005 – 2008 (para 11), is
there any projection of resource allocation for different target groups from
2009/10 onwards? Also, what are the targets of the projects under Category B (CFA Paper 12/2008-2011)
(predefined areas) and do they include young people?

7. The resource allocation of ATF is echoing to "Recommended HIV/AIDS
Strategies for Hong Kong 2007 to 2011" by ACA. AIDS Trust Fund will accord
higher funding priorities to programmes targeted at the high risk groups, until further
recommendations from ACA. Targets, other than high risk groups, which fit in
predefined areas, will be regarded as Category B.

 In response to para 11, does it mean that the resource allocation of ATF will be
based on annual reported statistics and will there be any adjustment?

8. According to ATF Guidelines, in order to target efforts and resources more
efficiently and effectively, programme funded by the ATF should be targeting high
risk groups. A relatively greater proportion of funds should be channelled to areas
where most of the infection occurs.

Target 4 – Review ATF funding mechanism to improve effective funding of
community based response
 Whether the ATF has any stock taking on the effectiveness of : (a) individual
programme/project, (b) overall response as a result of the ATF funds, and (c)
service gaps for the GO and NGOs to take proper actions to fill such gaps?

Individual project / programme
9. According to the ATF application guidelines, an applicant must set out in
the application form the monitoring and evaluation plan for achieving the specific
targets of the programme/ project. The applicant should specify the quantifiable
method to evaluate the effectiveness (outcome indicator) of the programme / project.
The applicant needs to indicate their achievement in the interim and final report.
Failure to submit a satisfactory evaluation report may result in deferral or termination
of the programme / project funding. Furthermore, the effectiveness of the current
study not only affect the funding support of current programme / proje