Massimo Mirandola, Head of Regional Center for Health Promotion, Verona, Veneto region, Scientific Director of SIALON Project
Massimo Mirandola works as Head of Regional Center for Health Promotion in Verona, Veneto region with 5.5 million inhabitants and is the Scientific Director of SIALON Project. Mr Mirandola is major in Psychotherapy and has a Master Degree in Statistics and Epidemiology and a PhD in Psychiatrist Sciences and Epidemiology. Mr Mirandola paid a visit to the Republic of Moldova during the period of June 14-18, 2010. The consultancy was aimed at providing technical assistance to the national stakeholders involved in the national response to HIV/AIDS in order to enhance programming for HIV prevention among MSM. We are discussing with Massimo Mirandola the results of his mission to Moldova and recommendations for addressing MSM in national programming process.
- 1. Mr Mirandola, could you please explain us more detailed what SIALON represents?
SIALON is a project funded by European Union which aimed at obtaining reliable and valid information on HIV and syphilis prevalence, risk behaviour, and cultural factors among MSM, using a non-invasive outreach testing method based on saliva (oral fluid) samples in countries of Southern and Eastern Europe. The associated partners of the project are: Czech Republic, Greece, Italy, Romania, Slovak Republic, Slovenia, and Spain. The first project targeting MSM community was carried out during 2003-2007, resulting with quantitative and qualitative reports based on a survey implemented among MSM communities within states participants of the project. For the future the next project idea is to carry out a similar survey in cities of Italy, using effective and valid research methods for gathering epidemiological information based on outreach strategies. It is also planned to implement a survey in Eastern Europe, meaning Baltic countries, Bulgaria and Italy in order to estimate the HIV/Syphilis prevalence and risk behaviors among MSM with involvement of UNAIDS.
- 2. Being here, you met representatives of state bodies, UN Agencies and civil society organizations. What can you tell about the HIV response interventions in MSM in Moldova?
I have met indeed different representatives and discussed with them the up-to-date status of interventions among MSM community in Moldova. At this level, these interventions are limited and the BSS survey which takes place now is the most significant step in addressing MSM community and planning evidence based programmes. MSM are underestimated as a number and this underestimation influence the level of interventions and acknowledgment as a vulnerable group. I have also observed the high level of stigma and discrimination and this represents certainly the driver factor of the epidemic.
- 3. MSM represent the group of hard-to-reach-populations? What should the state do to cover this population with appropriate services?
Discrimination is the main issue and the state should fight against this phenomena. Moldova strives to be part of European Union and the criteria in public health area is fight against discrimination. Politicians need to find and build a consensus around this issue and take the leadership in getting the society into the right direction, a state free of stigma and discrimination. Behind the numbers there are lives and the state should take care of these lives – this is the main advocacy message valid not only for MSM but for all groups and populations.
- 4. What should national programmes include as provisions for MSM?
The national programmes should include provisions on providing MSM with more friendly services in order to allow free access and of course there is the need of trained people to perform that. Testing would be an issue as the state might consider implementing oral fluid testing and including it in a framework or providing a legal basis. This prerogative could be assigned to a local accredited NGO which works with LGBT community. It would lead to increase of number of people tested and reliable data on real number of MSM.
- 5. Mr Mirandola, have you met the LGBT community in Moldova? What are your impressions?
I have met the representatives of LGBT community in Moldova. They represent a strong organization with potential which needs to be further developed. LGBT community needs to be listened to and be involved in all national activities of strategic planning and implementation. As I have been told, the representative of LGBT community is member of National Coordination Council on TB/AIDS, this being an important step. Further on, LGBT community needs to be encouraged to be more involved in all planning, implementing and monitoring activities and UNAIDS plays an important role as it tries to get them closer to national stakeholders involved in the national response to HIV/AIDS.
Thanks for your time. Violeta Bunescu, UNAIDS Moldova