Harvard Student Collaborates to Address LGBTQ+ Health in Madagascar

ANTANANARIVO, Madagascar — A Harvard student is making strides in addressing urgent health issues in Madagascar, particularly HIV prevention within marginalized communities, after a transformative journey that began in 2016 as a Peace Corps Volunteer.

Rose Service, a Master of Public Health candidate focusing on health and social behavior, returned to Madagascar in January 2023 with the mission of co-creating a sexual health curriculum specifically designed for the island’s LGBTQ+ community. Her initial experience in the country had fostered deep connections with the local population, which ultimately compelled her to tackle pressing health concerns.

Recent research reveals that despite Madagascar’s historical isolation, there is a concerning rise in HIV cases due to a lack of public understanding of prevention methods and significant stigma surrounding LGBTQ+ identities. “I proposed a project to develop a sexual health curriculum tailored to the needs of Madagascar’s LGBTQ+ community,” Service explained.

In collaboration with Rany Ramananantoanina Andrianiaina, a 23-year-old university student and advocate, Service developed a five-module curriculum to educate and empower LGBTQ+ individuals. “Rany’s insights were invaluable in capturing the community’s voice and experiences,” she said.

The curriculum addresses not only sexual health but also sheds light on the historical context of LGBTQ+ identities in Madagascar, which Service believes crucially impacts the current generation. “We took time to highlight Madagascar’s pre-colonial non-binary identities, the Sarimbavy and Sekatra, and their erasure during colonial rule, to empower the current LGBTQ+ community,” she stated.

Legal obstacles further compound the risks, as laws criminalizing same-sex acts with individuals under 21 create a culture of fear and repression. “The stigma leads to severe isolation for LGBTQ+ youth, making our work even more essential,” Service noted.

The project evolved to include participatory workshops, allowing LGBTQ+ community members to engage with the curriculum and provide feedback ahead of its scheduled launch during a pride celebration in April. “This feedback loop is vital; we want to ensure the curriculum reflects the community’s actual needs,” she said.

Reflecting on her experience, Service emphasized the importance of the reciprocal relationship she has developed with the community. “In 2016, I was the teacher, but I learned so much from the resilience and courage of my students,” she recounted. “This time, I returned as a learner, guided by the narratives of those in the LGBTQ+ community.”

With plans to launch the curriculum online, Service hopes it will serve as a resource for broader education in Madagascar and help counteract the stigma faced by LGBTQ+ individuals. “It’s essential to amplify the voices that have been silenced for too long,” she concluded.