Inner Spaces, Outer Faces Toolkit: Practical Steps to Integrating Sexuality into International Health/HIV Programs

Issues: There is growing recognition that international health programs must expand traditional public health interventions to address social factors driving the HIV/AIDS epidemic. Behaviour change models can be more effective by addressing the variety of social and personal meanings that sex has, including pleasure, power, intimacy and/or shame. People implementing HIV prevention projects need skills to adequately understand and address social constructs of sexuality and gender, as well as a rights framework, in order to more effectively plan and implement programs.

Description: CARE and ICRW implemented a project focused on fostering personal change among staff, and then assisting them to apply the learning in their own health/HIV projects. The “Inner Spaces Outer Faces Initiative (ISOFI) helped staff to explore personal definitions of gender and sexuality (their ‘inner space'), and then supported staff to promote organizational change, including their own professional practice (the ‘outer face'). The specific steps of ISOFI, collected in the “ISOFI Toolkit,” feature structured iterative loops of reflection and learning, action and experimentation, and analysis and assimilation.

Lessons Learned: Evaluation data showed measureable improvement in staff capacity of staff to integrate sexual pleasure as well gender equity and other rights into health/HIV programs. Organizational commitment to building staff capacity and to human rights is critical.

Recommendations: More research on effectiveness of interventions is needed; CARE and ICRW are currently implementing a quasi-experimental operations research design to test the influence of the ISOFI interventions on health outcomes.