Journal Article

Public participation of men who have sex with men in the context of community empowerment in India

Background
Men who have sex with men (MSM) remain a hidden and hard-to-reach high-risk group. MSM experience stigma, discrimination and criminalization in India. The organized participation of MSM in "public spaces"—through which they openly identify themselves as MSM, address social stigma, and demand their rights and entitlements—is an indicator of their empowerment process against structural barriers. This paper assesses MSMs' "public participation" and the contextual factors that influence them.

Method
Data were drawn from a cross-sectional Integrated Behavioral and Biological Assessment survey conducted during 2009–2010 in Tamil Nadu, India. Information was collected on the socio-demographic characteristics, public participation, community mobilization, vulnerability and risk status of 1757 MSM. Two set of measures thought to influence MSMs' public participation were considered—"push" factors and "pull" factors. Pull factors were related to MSMs’ community mobilization status and push factors were related to MSMs’ risk and vulnerability.

Results
Almost half of the MSM (48%) reported public participation in the past six months. Univariate and Multiple regression analysis shows that pull factors [exposure to peer education (OR 8.2 (4.0-16.6); AOR-6.1(1.9-19.4); p<0.05), collective membership (OR 10.2 (6.4-16.3); AOR 9.7 CI 5.9-15.9; P<0.05) and collective agency (OR 3.2 (2.0-5.2); AOR 4.3 (2.3-8.1 P<0.05)] influence MSMs’ likelihood of participating in public spaces. Experience of police arrest was a push factor that influenced MSMs’ likelihood of participating in public places (AOR-3.7 CI 1.6-8.4 P<0.05).

Conclusion
The community mobilization strategy is effective in fostering MSMs’ "public participation;" through this strategy MSM can address structural barriers and the program can be upscale. Public participation of MSM can serve as a key indicator of the empowerment process in a stigmatized society.