Horizons Projects | Reducing HIV Risk Behavior among Key Populations by Strengthening Programs Through Community Involvement

HORIZONS PROJECT
Reducing HIV Risk Behavior Among Key Populations by Strengthening Programs Through Community Involvement

This study is part of a larger research and intervention project entitled the Frontiers Prevention Project (FPP), managed by the International HIV/AIDS Alliance.

In order to empower key populations (i.e., female sex workers, men who have sex with men, and people living with HIV) to protect themselves against HIV, it is necessary to improve their access to services, create an enabling environment free of stigma and discrimination, and build their social capital. Social capital includes civic participation in groups and associations; and trust, solidarity, and reciprocal support within and across key populations and other groups.

Baseline research, conducted by the Horizons program and the Institute of Health Systems, provided information for the development and qualitative evaluation of the FPP.

Key baseline findings include:

Families provide the most support to key population groups, who tend to distrust peers and the larger community.
Family members, however, are major sources of stigma, discrimination, and violence, as are health care workers, the police, and clients.
Respondents find it difficult to cope with stigma, discrimination, and violence, and are wary of seeking support from others, including peer groups and nongovernmental organizations.
Respondents have low levels of self-esteem due to a lack of capacities, self-confidence, and self-worth.
Utilization of health services by key population groups depends on a combination of factors, including accessibility and attitudes of providers.
Condom use is inconsistent among female sex workers and men who have sex with men.

The following recommendations emerged from the study:

Family-level interventions are needed to foster support of key populations.
Strategies to involve clients of sex workers must be part of the overall program.
Awareness raising and sensitization programs with doctors and other health staff are essential.
Peer support groups need to be carefully structured to take into account the challenges and sensitivities of different key populations.
Life skills training and livelihoods development need to be addressed.

Results from the intervention are expected in 2007.

Location

Andhra Pradesh, India

Duration

July 2003–July 2007

Horizons and Population Council researchers

Ravi K. Verma

(For more information about this study, please contact horizons@popcouncil.org.)

Non-Council collaborators

C.K. George (Institute of Health Systems)

Sam McPherson, Fiona Samuels (International HIV/AIDS Alliance)

Donors

US Agency for International Development

Bill & Melinda Gates Foundation

Publications/Resources
Horizons and Population Council researchers' names appear in boldface type.

2006
Samuels, Fiona, Ravi K. Verma, and C.K. George. “Reducing HIV risk behaviors among key populations by increasing community involvement and building social capital: Baseline findings from Andhra Pradesh, India,” Horizons Research Update. New Delhi: Population Council. (PDF)

———. “Stigma, discrimination and violence amongst female sex workers and men who have sex with men in Andhra Pradesh, India," in Anke van der Kwaak and Madeleen Wegelin-Schuringa (guest eds.), Gender and Health: Policy and Practice—A Global Sourcebook, part of Sarah Cummings, Henk van Dam, and Minke Valk (eds.), Gender, Society & Development book series. Netherlands: Royal Tropical Institute, pp. 95–109. (offsite link)