“Facing Our Fears”: Using facilitated film viewings to engage communities in HIV research involving MSM in Kenya

Abstract

Kenya is a generally homophobic country where homosexuality is criminalised and people who engage in same sex sexuality face stigma and discrimination. In 2013, we developed a 16 min documentary entitled “Facing Our Fears” that aimed at sharing information on how and why men who have sex with men (MSM) are involved in on-going KEMRI HIV prevention research, and associated community engagement. To consider the film’s usefulness as a communication tool, and its perceived security risks in case the film was publicly released, we conducted nine facilitated viewings with 122 individuals representing seven different stakeholder groups. The documentary was seen as a strong visual communication tool with potential to reduce stigma related to homosexuality, and facilitated film viewings were identified as platforms with potential to support open dialogue about HIV research involving MSM. Despite the potential, there were concerns over possible risks to LGBT communities and those working with them following public release. We opted—giving emphasis to the “do no harm” principle—to use the film only in facilitated settings where audience knowledge and attitudes can be carefully considered and discussed. The results highlight the importance of carefully assessing the range of possible impacts when using visuals in community engagement.

Keywords:

• HIV
• men who have sex with men
• community engagement
• participatory methods
• visual methods
• Kenya

Public Interest Statement

Men who have sex with other men (MSM) remain a key vulnerable group to new HIV infections. They are a highly stigmatised population in sub-Saharan Africa countries; the stigma has a negative impact on their access to HIV prevention and care. The discriminatory circumstances also affect the implementation of HIV research. For research with MSM to run smoothly, it is important that various other stakeholders are involved. This article shows the potential of using participatory approaches in engaging communities for research involving MSM. The research involved nine focus groups with seven stakeholder groups conducted in coastal Kenya. The findings demonstrate how facilitated film viewings—based on a film called Facing Our Fears—were employed to discuss stigma surrounding homosexuality, vulnerabilities of MSM, and the need for extended health care support for this high-risk population. We found that audio-visuals strategies can support meaningful engagement with communities but should be used in an ethically responsive way.

Competing Interests

The authors declare no competing interest.

Acknowledgements

The authors thank all the different stakeholders for their ongoing support and in particular their participation in the FFVs and their willingness to openly share their views hence making the discussions richer.

Notes

1. Film was funded by USAID through IAVI, and Wellcome Trust. Director was Abisae Maeda and production by Kilimanjaro film institute.

Additional information

Notes on contributors

Bernadette Kombo

This project was initially conceived by Elise van der Elst, Sassy Molyneux and Eduard Sanders, who designed it together with Evans Gichuru, and Salla Sariola. Bernadette Kombo and SS conducted the FGDs, analyzed the data and wrote the first draft of the manuscript. EvdE’s research has produced new thinking, evidence and recommendations around strengthening key players’ involvement in health service delivery for key populations in general and MSM specifically. SS’s work has focused on social studies of biomedicine and bioethics as well as gender, sexuality and marginality. All authors have been a part of the community engagement efforts for the HIV vaccine preparatory research at the Kenyan coast that is led by Dr Sanders as the principal investigator. Together, we represent researchers and public health professionals dedicated to ethically responsive conduct of HIV research, and more importantly to the control of HIV infections including among disproportionately affected communities.