Re: Targeted intervention in Kerala

[Guest guest]

Dear Forum,

Thank you very much Dr. Prasanna Kumar fopr his very informative write up about

Targeted Intervention (TI) in Kerala. However kindly allow me add my concern to

this.

Right from the beginning of the initiation of TI in Kerala, it has been the

official policy to limit the TI funding to " vulnerable groups " who are

" ECONOMICALY MARGINALISED " as per the conventional definition of " vulnerable

groups " in India.

Inter-alia, has this charecteristic of economic marginalisation, given Kerala's

special educational, econoimic, and HIV prevalence/infection cenario, there may

be a need of having a wider definition of " targeted grous " so that some

" relevant " strata of population may not be exluded in the strategies to

eficiently check the spread of HIV in the State.

As Dr. Prasanna Kumar has rightly pointed out the HIV infection rate among the

" vulnerable groups " such as street based sex workers is lower than the general

population in Kerala.

One has to note that at risk sexual behaviour in Kerala is not an exclusive

phenomenon of " economically marginalised " populations. " Sex industry " is also

socially stratified in Kerala. A new subgroup " high market sex workers " has

evolved over a period of time to " service " the higher strata of the society.

The so called " high market sex workers " and their clients are not included in

the " Targeted Interventions in Kerala due to various reasons including the above

said reason of economic element in the definition of vulnerable groups.

According to the studies done by CSRD among " high market sex workers " and their

clients it was found that the condom use is less prevalent among them due to

the major reason of their " low risk perception " . ( " they are decent parties " )

Sex workers, did not even casually mention about condom to their " high market

clients " .

Kerala HIV prevetion policy may have to bring out measures and means to widen

its prevention intervention net to check the infection in the not so

acknowledged " high risk groups " who are not economically marginalised but are

at risk due to their " low risk perception " or " not at risk conciousness "

Regards

Tito (Advocate)

Director, CSRD

Calicut

E-mail: <titothomas@...>