Reducing HIV Risk Behavior Among Key Populations by Strengthening Programs Through Community Involvement
Council researchers explored issues of social capital, stigma and discrimination, HIV knowledge and behaviors, self-esteem, and service delivery among three key populations (female sex workers, men who have sex with men, and people living with HIV) in Andhra Pradesh, India, before and after exposure to interventions designed to empower them to practice HIV prevention behaviors.
This study was 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.
Stigma, discrimination and violence against female sex workers and men who have sex with men in Andhra Pradesh, India (PDF)
Samuels,Fiona; Verma,Ravi K.; George,C.K.; van der Kwaak,Anke; Wegelin-Schuringa,Madeleen; Cummings,Sarah; van Dam,Henk; Valk,Minke
Gender, Society & Development book series, pp. 95-109
Publication date: 2006
Project Stats
Location: India (Andhra Pradesh)
Program(s):
HIV and AIDS
Topic(s):
Behavior change
Men who have sex with men
People living with HIV
Sex workers
Stigma and discrimination
Duration: 7/2003 - 7/2007
Non-Council collaborators:
C.K. George (Institute of Health Systems)
Sam McPherson (International HIV/AIDS Alliance)
Donors:
Bill & Melinda Gates Foundation
US Agency for International Development
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