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Qualitative assessment of HIV risks among MSM in South India
A.K. Srikrishnan, S. Solomon, C.K. Vasudevan, C.J. Sethulakshmi, S. Solomon
Y R Gaitonde Centre for AIDS Research and Education (YRG Care), Research, Chennai, India
Background: Men who have sex with men (MSM) are an evolving risk group for HIV infection in India. Earlier we described high prevalence and correlates of HIV infection among 721 MSM in Tamil Nadu (TN), India. Marriage was strongly associated with HIV, HSV-2 and syphilis. Overall uptake of VCT and health care services were low among this population and the prevalence of unprotected anal intercourse was high. We followed up this quantitative survey with a series of focus groups to identify appropriate acceptable interventions for MSM populations in South India.
Methods: Five focus groups with 12 individuals per group were conducted during the Feb 2009 across South India. These focus groups were aimed at gathering information on reasons for poor health care, VCT access, marriage, sexual risk practices, appropriate interventions, substance abuse patterns and mental health issues.
Results: The participants of the focus groups were both married and unmarried in these focus groups and key findings are: stigma and discrimination were primary reasons for low health care utilization. Social compliance and family situations force marriages on MSM Most married MSM were not open to the option of referring their wives for a HIV test as they were unsure of disclosure processes.. Alcohol consumption to overcome personal frustrations and smoking marijuana was almost universal among the MSM populations. Mental health issues were also identified as a key area requiring intervention. In terms of HIV prevention, almost all MSM felt that sensitization of communities and families of MSM will help reduce stigma/discrimination.
Conclusions: These results clearly indicate the need for interventions to sensitize the communities in India towards MSM-related issues and minimize stigma/ discrimination thus leading to higher off take of VCT by MSM. . Further, interventions to address substance-abuse and mental health issues are also needed in this population.
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