Why 	
   do 	
   we , 	
   men 	
   who 	
   have 	
   sex 	
   with 	
   men , 	
   not 	
    access 	
   HIV 	
   treatment 	
   services ? 	
   	
    Challenge 	
  	
    The 	
   Karnataka 	
   State 	
   AIDS 	
   Prevention 	
   Society 	
   ( KSAPS ) 	
   is 	
   the 	
   nodal 	
   agency 	
   for 	
    implementing 	
   the 	
   targeted 	
   interventions 	
   National 	
   AIDS 	
   Control 	
   Programme 	
    ( NACP ) 	
   in 	
   the 	
   state 	
   of 	
   Karnataka 	
   in 	
   South 	
   India . 	
   Despite 	
   KSAPS ’s 	
   achievements 	
    in 	
   the 	
   scaling 	
   up 	
   of 	
   HIV 	
   care 	
   and 	
   support 	
   services , 	
   HIV 	
   prevalence 	
   among 	
   the 	
    sexual 	
   minority 	
   group , 	
   men 	
   having 	
   sex 	
   with 	
   men 	
   ( MSM ) , 	
   in 	
   Karnataka 	
    continued 	
   to 	
   show 	
   an 	
   increase . 	
   Prevalence 	
   among 	
   MSM 	
   at 	
   5.4 	
   per 	
   cent 	
   made 	
    Karnataka 	
   one 	
   of 	
   the 	
   nine 	
   states 	
   in 	
   the 	
   country 	
   with 	
   over 	
   five 	
   per 	
   cent 	
    prevalence 	
   in 	
   this 	
   group . 	
   KSAPS 	
   contracted 	
   my 	
   services 	
   to 	
   answer 	
   the 	
   question , 	
    “ How 	
   can 	
   HIV 	
   prevention 	
   and 	
   care 	
   among 	
   MSM 	
   in 	
   the 	
   state 	
   be 	
   made 	
    more 	
   effective ? ” 	
   	
    Selection 	
    Gaining 	
   critical 	
   insights 	
   meant 	
   understanding 	
   the 	
   ecosystem 	
   in 	
   which 	
   the 	
    delivery 	
   of 	
   care 	
   and 	
   services 	
   was 	
   located 	
   and 	
   listening 	
   to 	
   different 	
   stakeholders . 	
    In 	
   particular , 	
   it 	
   was 	
   important 	
   to 	
   understand 	
   why 	
   despite 	
   a 	
   decade 	
   of 	
   stigma 	
    reduction 	
   efforts , 	
   MSM 	
   continued 	
   to 	
   be 	
   hesitant 	
   to 	
   visit 	
   the 	
   testing 	
   and 	
    treatment 	
   centres 	
   located 	
   within 	
   the 	
   government 	
   hospitals . 	
   Journey 	
   Mapping , 	
    mentioned 	
   in 	
   The 	
   Good 	
   Kitchen 	
   story , 	
   along 	
   with 	
   open 	
   ended 	
   discussions 	
    were 	
   used 	
   to 	
   trace 	
   the 	
   experience 	
   of 	
   MSM 	
   trying 	
   to 	
   access 	
   care 	
   and 	
   treatment 	
    services . 	
   However , 	
   the 	
   experience 	
   of 	
   accessing 	
   a 	
   service 	
   was 	
   also 	
   dependent 	
   on 	
    the 	
   way 	
   service 	
   providers 	
   engaged 	
   with 	
   the 	
   care 	
   seekers . 	
   Hence , 	
   discussions 	
    and 	
   dialogues 	
   were 	
   held 	
   with 	
   HIV 	
   testing 	
   centre 	
   counsellors , 	
   peer 	
   and 	
   outreach 	
    workers , 	
   and 	
   laboratory 	
   technicians 	
   and 	
   community 	
   advocates . 	
   Also , 	
   MSM 	
   is 	
   a 	
    diverse 	
   group 	
   in 	
   itself 	
   and 	
   includes 	
   men 	
   who 	
   identify 	
   as 	
   Panthis , 	
   Kothis , 	
   Hijras , 	
    transvestite 	
   and 	
   others . 	
   The 	
   men 	
   are 	
   perceived 	
   and 	
   accepted 	
   differently 	
   in 	
   their 	
    communities 	
   and 	
   their 	
   experience 	
   of 	
   navigating 	
   the 	
   healthcare 	
   system 	
   will 	
   also 	
    differ . 	
  	
   	
    Application 	
  	
    Across 	
   three 	
   districts 	
   in 	
   Karnataka , 	
   MSM 	
   with 	
   different 	
   self-­‐identities 	
   narrated 	
    their 	
   stories 	
   of 	
   accessing 	
   care , 	
   starting 	
   from 	
   the 	
   pre-­‐testing 	
   process 	
   to 	
   accessing 	
    the 	
   HIV 	
   treatment . 	
   As 	
   the 	
   facilitator , 	
   I 	
   used 	
   the 	
   white 	
   board 	
   to 	
   visually 	
   trace 	
    the 	
   journey . 	
   The 	
   group 	
   mapped 	
   the 	
   actions 	
   required 	
   of 	
   them 	
   at 	
   each 	
   step 	
   of 	
    interfacing 	
   with 	
   the 	
   care 	
   and 	
   treatment 	
   service 	
   providers . 	
   We 	
   also 	
   mapped 	
   the 	
    specific 	
   barriers 	
   that 	
   caused 	
   them 	
   concern 	
   and 	
   discouraged 	
   them 	
   from 	
    accessing 	
   the 	
   service . 	
   Finally , 	
   members 	
   from 	
   different 	
   districts 	
   and 	
   groups 	
   did 	
   a 	
    participatory 	
   ranking 	
   exercise , 	
   to 	
   prioritise 	
   the 	
   barriers . 	
   Open 	
   ended 	
    discussions 	
   and 	
   dialogues 	
   with 	
   other 	
   stakeholders 	
   helped 	
   gauge 	
   the 	
   health 	
    system 	
   and 	
   programme 	
   level 	
   barriers . 	
   Mind 	
   Mapping , 	
   which 	
   looked 	
   for 	
    patterns 	
   in 	
   responses 	
   showed 	
   common 	
   barriers 	
   cited 	
   by 	
   different 	
   stakeholders 	
    and 	
   three 	
   levels 	
   at 	
   which 	
   these 	
   stood 	
   – 	
   individual , 	
   programmatic 	
   and 	
   health 	
    system . 	
   Synthesis 	
   of 	
   insights 	
   from 	
   the 	
   diverse 	
   groups 	
   helped 	
   paint 	
   an 	
   overall 

 picture 	
   showing 	
   precisely 	
   at 	
   what 	
   point 	
   and 	
   due 	
   to 	
   what 	
   reason 	
   MSM 	
   tended 	
   to 	
    drop 	
   out 	
   from 	
   the 	
   HIV 	
   treatment 	
   service 	
   access 	
   chain . 	
  	
  	
   	
    Insights 	
    The 	
   following 	
   insights 	
   emerged 	
   from 	
   the 	
   process : 

 Ø Fear 	
   of 	
   being 	
   identified 	
   as 	
   HIV 	
   positive , 	
   unwillingness 	
   to 	
   disclose 	
   HIV 

 positive 	
   status , 	
   a 	
   sense 	
   of 	
   fatalism , 	
   lack 	
   of 	
   faith 	
   in 	
   the 	
   efficacy 	
   of 	
   the 	
    treatment 	
   and 	
   negative 	
   perceptions 	
   about 	
   anti-­‐retroviral 	
   treatment 	
    medication 	
   emerged 	
   as 	
   individual 	
   level 	
   barriers 	
   to 	
   accessing 	
   services 

 Ø Procedural 	
   delays 	
   at 	
   the 	
   hospital , 	
   mandatory 	
   requirement 	
   of 	
   producing 

 an 	
   identify 	
   proof , 	
   having 	
   to 	
   involve 	
   family 	
   to 	
   initiate 	
   treatment 	
   and 	
    discriminatory 	
   treatment 	
   by 	
   the 	
   paramedical 	
   staff 	
   at 	
   the 	
   centre 	
   emerged 	
    as 	
   health 	
   system 	
   barriers . 	
   Most 	
   MSM 	
   were 	
   homeless 	
   or 	
   migrants 	
   and 	
    found 	
   it 	
   difficult 	
   to 	
   produce 	
   proof 	
   of 	
   address . 	
   The 	
   threat 	
   of 	
   their 	
   sexual 	
    identity 	
   and 	
   positive 	
   HIV 	
   status 	
   being 	
   exposed 	
   and 	
   the 	
   resultant 	
   loss 	
   of 	
    social 	
   support 	
   and 	
   potential 	
   stigma 	
   caused 	
   them 	
   to 	
   drop 	
   out 	
   from 	
   the 	
    chain 	
   of 	
   treatment 	
   access 	
   when 	
   family 	
   involvement 	
   was 	
   necessitated . 

 Ø High 	
   workload 	
   of 	
   the 	
   HIV 	
   counsellors 	
   adversely 	
   affecting 	
   the 	
   quality 	
   of 

 engagement 	
   with 	
   the 	
   MSM 	
   as 	
   they 	
   had 	
   to 	
   manage 	
   patients 	
   at 	
   multiple 	
    centres 	
   in 	
   different 	
   locations , 	
   the 	
   merging 	
   of 	
   care 	
   centres 	
   within 	
   the 	
    government 	
   hospitals 	
   that 	
   were 	
   too 	
   far 	
   for 	
   the 	
   MSM 	
   to 	
   access 	
   and 	
   high 	
    attrition 	
   of 	
   counsellors , 	
   who 	
   are 	
   often 	
   the 	
   only 	
   person 	
   to 	
   know 	
   about 	
   the 	
    HIV+ 	
   status 	
   of 	
   the 	
   care 	
   seeker 	
   emerged 	
   as 	
   programmatic 	
   barriers . 

 A 	
   key 	
   insight 	
   from 	
   all 	
   of 	
   this 	
   was 	
   that 	
   the 	
   HIV 	
   treatment 	
   delivery 	
   system 	
    had 	
   not 	
   succeeded 	
   in 	
   ensuring 	
   that 	
   emotional 	
   needs 	
   of 	
   the 	
   care 	
   seekers , 	
    such 	
   as 	
   their 	
   need 	
   to 	
   be 	
   treated 	
   with 	
   respect 	
   and 	
   for 	
   their 	
   identity 	
   to 	
   be 	
   hidden 	
    from 	
   family 	
   and 	
   communities , 	
   are 	
   taken 	
   care 	
   of . 	
   The 	
   fear 	
   of 	
   being 	
   exposed 	
   as 	
    men 	
   who 	
   have 	
   sex 	
   with 	
   other 	
   men 	
   was 	
   an 	
   overpowering 	
   emotion 	
   at 	
   every 	
   step 	
    of 	
   accessing 	
   the 	
   treatment . 	
   In 	
   fact , 	
   the 	
   need 	
   to 	
   protect 	
   their 	
   identity 	
   often 	
    overrode 	
   their 	
   decision 	
   to 	
   access 	
   treatment 	
   even 	
   when 	
   they 	
   understood 	
   the 	
    enormous 	
   costs 	
   involved 	
   in 	
   not 	
   accessing 	
   treatment . 	
  	
  	
   	
    Approach 	
  	
    Looking 	
   at 	
   the 	
   question 	
   through 	
   a 	
   Design 	
   Thinking 	
   lens 	
   persuades 	
   me 	
   that 	
   the 	
    process 	
   would 	
   have 	
   been 	
   more 	
   effective 	
   if 	
   the 	
   policy 	
   makers 	
   and 	
   the 	
   HIV 	
    programme 	
   heads 	
   were 	
   involved 	
   in 	
   the 	
   Journey 	
   Mapping 	
   exercise 	
   and 	
   the 	
    open-­‐ended 	
   discussions 	
   with 	
   the 	
   MSM 	
   and 	
   the 	
   treatment 	
   centre 	
   staff . 	
   This 	
    would 	
   have 	
   allowed 	
   for 	
   visualisation 	
   and 	
   co-­‐creation 	
   of 	
   solutions 	
   by 	
   those 	
   who 	
    design 	
   and 	
   fund 	
   the 	
   programme , 	
   those 	
   who 	
   implement 	
   it 	
   and 	
   finally 	
   those 	
   who 	
    receive 	
   the 	
   treatment . 	
   This 	
   offered 	
   the 	
   possibility 	
   of 	
   generating 	
   empathy 	
   for 	
   the 	
    experience 	
   of 	
   MSM 	
   while 	
   dealing 	
   with 	
   the 	
   health 	
   system 	
   and 	
   ideating 	
   together 	
    with 	
   them 	
   better 	
   and 	
   more 	
   effective 	
   solutions . 	
  	
   	
   	
    Submitted 	
   by : 	
   Jan Miah 	
    Date : 	
   11 	
   July 	
   2016 


EMAIL: 
ID_NUM: 
NAME_STUDENT: Jan Miah
PHONE_NUM: 
STREET_ADDRESS: 
URL_PERSONAL: 
USERNAME: 

### Task: You are a PII (Personal Identity Information) Detection. Given a essays written by students, you have to identify ONLY the following:
NAME_STUDENT - The full or partial name of a student that is not necessarily the author of the essay. This excludes instructors, authors, and other person names.
EMAIL - A student’s email address.
USERNAME - A student's username on any platform.
ID_NUM - A number or sequence of characters that could be used to identify a student, such as a student ID or a social security number.
PHONE_NUM - A phone number associated with a student.
URL_PERSONAL - A URL that might be used to identify a student.
STREET_ADDRESS - A full or partial street address that is associated with the student, such as their home address.
### Input: Why 	
   do 	
   we , 	
   men 	
   who 	
   have 	
   sex 	
   with 	
   men , 	
   not 	
    access 	
   HIV 	
   treatment 	
   services ? 	
   	
    Challenge 	
  	
    The 	
   Karnataka 	
   State 	
   AIDS 	
   Prevention 	
   Society 	
   ( KSAPS ) 	
   is 	
   the 	
   nodal 	
   agency 	
   for 	
    implementing 	
   the 	
   targeted 	
   interventions 	
   National 	
   AIDS 	
   Control 	
   Programme 	
    ( NACP ) 	
   in 	
   the 	
   state 	
   of 	
   Karnataka 	
   in 	
   South 	
   India . 	
   Despite 	
   KSAPS ’s 	
   achievements 	
    in 	
   the 	
   scaling 	
   up 	
   of 	
   HIV 	
   care 	
   and 	
   support 	
   services , 	
   HIV 	
   prevalence 	
   among 	
   the 	
    sexual 	
   minority 	
   group , 	
   men 	
   having 	
   sex 	
   with 	
   men 	
   ( MSM ) , 	
   in 	
   Karnataka 	
    continued 	
   to 	
   show 	
   an 	
   increase . 	
   Prevalence 	
   among 	
   MSM 	
   at 	
   5.4 	
   per 	
   cent 	
   made 	
    Karnataka 	
   one 	
   of 	
   the 	
   nine 	
   states 	
   in 	
   the 	
   country 	
   with 	
   over 	
   five 	
   per 	
   cent 	
    prevalence 	
   in 	
   this 	
   group . 	
   KSAPS 	
   contracted 	
   my 	
   services 	
   to 	
   answer 	
   the 	
   question , 	
    “ How 	
   can 	
   HIV 	
   prevention 	
   and 	
   care 	
   among 	
   MSM 	
   in 	
   the 	
   state 	
   be 	
   made 	
    more 	
   effective ? ” 	
   	
    Selection 	
    Gaining 	
   critical 	
   insights 	
   meant 	
   understanding 	
   the 	
   ecosystem 	
   in 	
   which 	
   the 	
    delivery 	
   of 	
   care 	
   and 	
   services 	
   was 	
   located 	
   and 	
   listening 	
   to 	
   different 	
   stakeholders . 	
    In 	
   particular , 	
   it 	
   was 	
   important 	
   to 	
   understand 	
   why 	
   despite 	
   a 	
   decade 	
   of 	
   stigma 	
    reduction 	
   efforts , 	
   MSM 	
   continued 	
   to 	
   be 	
   hesitant 	
   to 	
   visit 	
   the 	
   testing 	
   and 	
    treatment 	
   centres 	
   located 	
   within 	
   the 	
   government 	
   hospitals . 	
   Journey 	
   Mapping , 	
    mentioned 	
   in 	
   The 	
   Good 	
   Kitchen 	
   story , 	
   along 	
   with 	
   open 	
   ended 	
   discussions 	
    were 	
   used 	
   to 	
   trace 	
   the 	
   experience 	
   of 	
   MSM 	
   trying 	
   to 	
   access 	
   care 	
   and 	
   treatment 	
    services . 	
   However , 	
   the 	
   experience 	
   of 	
   accessing 	
   a 	
   service 	
   was 	
   also 	
   dependent 	
   on 	
    the 	
   way 	
   service 	
   providers 	
   engaged 	
   with 	
   the 	
   care 	
   seekers . 	
   Hence , 	
   discussions 	
    and 	
   dialogues 	
   were 	
   held 	
   with 	
   HIV 	
   testing 	
   centre 	
   counsellors , 	
   peer 	
   and 	
   outreach 	
    workers , 	
   and 	
   laboratory 	
   technicians 	
   and 	
   community 	
   advocates . 	
   Also , 	
   MSM 	
   is 	
   a 	
    diverse 	
   group 	
   in 	
   itself 	
   and 	
   includes 	
   men 	
   who 	
   identify 	
   as 	
   Panthis , 	
   Kothis , 	
   Hijras , 	
    transvestite 	
   and 	
   others . 	
   The 	
   men 	
   are 	
   perceived 	
   and 	
   accepted 	
   differently 	
   in 	
   their 	
    communities 	
   and 	
   their 	
   experience 	
   of 	
   navigating 	
   the 	
   healthcare 	
   system 	
   will 	
   also 	
    differ . 	
  	
   	
    Application 	
  	
    Across 	
   three 	
   districts 	
   in 	
   Karnataka , 	
   MSM 	
   with 	
   different 	
   self-­‐identities 	
   narrated 	
    their 	
   stories 	
   of 	
   accessing 	
   care , 	
   starting 	
   from 	
   the 	
   pre-­‐testing 	
   process 	
   to 	
   accessing 	
    the 	
   HIV 	
   treatment . 	
   As 	
   the 	
   facilitator , 	
   I 	
   used 	
   the 	
   white 	
   board 	
   to 	
   visually 	
   trace 	
    the 	
   journey . 	
   The 	
   group 	
   mapped 	
   the 	
   actions 	
   required 	
   of 	
   them 	
   at 	
   each 	
   step 	
   of 	
    interfacing 	
   with 	
   the 	
   care 	
   and 	
   treatment 	
   service 	
   providers . 	
   We 	
   also 	
   mapped 	
   the 	
    specific 	
   barriers 	
   that 	
   caused 	
   them 	
   concern 	
   and 	
   discouraged 	
   them 	
   from 	
    accessing 	
   the 	
   service . 	
   Finally , 	
   members 	
   from 	
   different 	
   districts 	
   and 	
   groups 	
   did 	
   a 	
    participatory 	
   ranking 	
   exercise , 	
   to 	
   prioritise 	
   the 	
   barriers . 	
   Open 	
   ended 	
    discussions 	
   and 	
   dialogues 	
   with 	
   other 	
   stakeholders 	
   helped 	
   gauge 	
   the 	
   health 	
    system 	
   and 	
   programme 	
   level 	
   barriers . 	
   Mind 	
   Mapping , 	
   which 	
   looked 	
   for 	
    patterns 	
   in 	
   responses 	
   showed 	
   common 	
   barriers 	
   cited 	
   by 	
   different 	
   stakeholders 	
    and 	
   three 	
   levels 	
   at 	
   which 	
   these 	
   stood 	
   – 	
   individual , 	
   programmatic 	
   and 	
   health 	
    system . 	
   Synthesis 	
   of 	
   insights 	
   from 	
   the 	
   diverse 	
   groups 	
   helped 	
   paint 	
   an 	
   overall 

 picture 	
   showing 	
   precisely 	
   at 	
   what 	
   point 	
   and 	
   due 	
   to 	
   what 	
   reason 	
   MSM 	
   tended 	
   to 	
    drop 	
   out 	
   from 	
   the 	
   HIV 	
   treatment 	
   service 	
   access 	
   chain . 	
  	
  	
   	
    Insights 	
    The 	
   following 	
   insights 	
   emerged 	
   from 	
   the 	
   process : 

 Ø Fear 	
   of 	
   being 	
   identified 	
   as 	
   HIV 	
   positive , 	
   unwillingness 	
   to 	
   disclose 	
   HIV 

 positive 	
   status , 	
   a 	
   sense 	
   of 	
   fatalism , 	
   lack 	
   of 	
   faith 	
   in 	
   the 	
   efficacy 	
   of 	
   the 	
    treatment 	
   and 	
   negative 	
   perceptions 	
   about 	
   anti-­‐retroviral 	
   treatment 	
    medication 	
   emerged 	
   as 	
   individual 	
   level 	
   barriers 	
   to 	
   accessing 	
   services 

 Ø Procedural 	
   delays 	
   at 	
   the 	
   hospital , 	
   mandatory 	
   requirement 	
   of 	
   producing 

 an 	
   identify 	
   proof , 	
   having 	
   to 	
   involve 	
   family 	
   to 	
   initiate 	
   treatment 	
   and 	
    discriminatory 	
   treatment 	
   by 	
   the 	
   paramedical 	
   staff 	
   at 	
   the 	
   centre 	
   emerged 	
    as 	
   health 	
   system 	
   barriers . 	
   Most 	
   MSM 	
   were 	
   homeless 	
   or 	
   migrants 	
   and 	
    found 	
   it 	
   difficult 	
   to 	
   produce 	
   proof 	
   of 	
   address . 	
   The 	
   threat 	
   of 	
   their 	
   sexual 	
    identity 	
   and 	
   positive 	
   HIV 	
   status 	
   being 	
   exposed 	
   and 	
   the 	
   resultant 	
   loss 	
   of 	
    social 	
   support 	
   and 	
   potential 	
   stigma 	
   caused 	
   them 	
   to 	
   drop 	
   out 	
   from 	
   the 	
    chain 	
   of 	
   treatment 	
   access 	
   when 	
   family 	
   involvement 	
   was 	
   necessitated . 

 Ø High 	
   workload 	
   of 	
   the 	
   HIV 	
   counsellors 	
   adversely 	
   affecting 	
   the 	
   quality 	
   of 

 engagement 	
   with 	
   the 	
   MSM 	
   as 	
   they 	
   had 	
   to 	
   manage 	
   patients 	
   at 	
   multiple 	
    centres 	
   in 	
   different 	
   locations , 	
   the 	
   merging 	
   of 	
   care 	
   centres 	
   within 	
   the 	
    government 	
   hospitals 	
   that 	
   were 	
   too 	
   far 	
   for 	
   the 	
   MSM 	
   to 	
   access 	
   and 	
   high 	
    attrition 	
   of 	
   counsellors , 	
   who 	
   are 	
   often 	
   the 	
   only 	
   person 	
   to 	
   know 	
   about 	
   the 	
    HIV+ 	
   status 	
   of 	
   the 	
   care 	
   seeker 	
   emerged 	
   as 	
   programmatic 	
   barriers . 

 A 	
   key 	
   insight 	
   from 	
   all 	
   of 	
   this 	
   was 	
   that 	
   the 	
   HIV 	
   treatment 	
   delivery 	
   system 	
    had 	
   not 	
   succeeded 	
   in 	
   ensuring 	
   that 	
   emotional 	
   needs 	
   of 	
   the 	
   care 	
   seekers , 	
    such 	
   as 	
   their 	
   need 	
   to 	
   be 	
   treated 	
   with 	
   respect 	
   and 	
   for 	
   their 	
   identity 	
   to 	
   be 	
   hidden 	
    from 	
   family 	
   and 	
   communities , 	
   are 	
   taken 	
   care 	
   of . 	
   The 	
   fear 	
   of 	
   being 	
   exposed 	
   as 	
    men 	
   who 	
   have 	
   sex 	
   with 	
   other 	
   men 	
   was 	
   an 	
   overpowering 	
   emotion 	
   at 	
   every 	
   step 	
    of 	
   accessing 	
   the 	
   treatment . 	
   In 	
   fact , 	
   the 	
   need 	
   to 	
   protect 	
   their 	
   identity 	
   often 	
    overrode 	
   their 	
   decision 	
   to 	
   access 	
   treatment 	
   even 	
   when 	
   they 	
   understood 	
   the 	
    enormous 	
   costs 	
   involved 	
   in 	
   not 	
   accessing 	
   treatment . 	
  	
  	
   	
    Approach 	
  	
    Looking 	
   at 	
   the 	
   question 	
   through 	
   a 	
   Design 	
   Thinking 	
   lens 	
   persuades 	
   me 	
   that 	
   the 	
    process 	
   would 	
   have 	
   been 	
   more 	
   effective 	
   if 	
   the 	
   policy 	
   makers 	
   and 	
   the 	
   HIV 	
    programme 	
   heads 	
   were 	
   involved 	
   in 	
   the 	
   Journey 	
   Mapping 	
   exercise 	
   and 	
   the 	
    open-­‐ended 	
   discussions 	
   with 	
   the 	
   MSM 	
   and 	
   the 	
   treatment 	
   centre 	
   staff . 	
   This 	
    would 	
   have 	
   allowed 	
   for 	
   visualisation 	
   and 	
   co-­‐creation 	
   of 	
   solutions 	
   by 	
   those 	
   who 	
    design 	
   and 	
   fund 	
   the 	
   programme , 	
   those 	
   who 	
   implement 	
   it 	
   and 	
   finally 	
   those 	
   who 	
    receive 	
   the 	
   treatment . 	
   This 	
   offered 	
   the 	
   possibility 	
   of 	
   generating 	
   empathy 	
   for 	
   the 	
    experience 	
   of 	
   MSM 	
   while 	
   dealing 	
   with 	
   the 	
   health 	
   system 	
   and 	
   ideating 	
   together 	
    with 	
   them 	
   better 	
   and 	
   more 	
   effective 	
   solutions . 	
  	
   	
   	
    Submitted 	
   by : 	
   Jan Miah 	
    Date : 	
   11 	
   July 	
   2016
### Output: 