Reserach study on SRH needs of men in risk

[Guest guest]

Dear Forum Members

"For a Hijra, sex work is like wage work. So they do not have time to think about small boils and rashes in their private parts. They do sex work all night and sleep during day time. Money is priority for them and not health. So, unless the services are brought to them, they will not avail them", mentioned a Hijra in an interview taken for a research study.

There are ample studies available that talks about the Sexual and Reproductive Health (SRH) needs of women and adolescents. But if you talk about the SRH needs of men that too of marginalised section, there is lack of comprehensive information on their unmet SRH needs. When we say 'marginalised' that means Men who have Sex with Men (MSM), male Injecting Drug Users (IDUs), Hijras, transgenders, migrant workers in slums etc.

In this context, the India HIV/AIDS Alliance in collaboration with community-based and non-governmental organisations conducted a research study, 'Sexual and Reproductive Health of Males-at-risk in India' in five states - Delhi, Manipur, Maharashtra, Tamilnadu and Andhra Pradesh to access the availability of appropriate SRH services; and access to and utilization of existing SRH services for males-at-risk. Every section of these men have their own set of problems.

If we talk about the migrant workers, they face a number of challenges in consistently using condoms with their female, male, and Hijra sexual partners. Condoms are sometimes not accessible due to cessation of funding for free condoms from NGOs.

Migrant workers in slums also reported a variety of reasons for not undergoing a vasectomy: a sterilization operation is seen as a belief that vasectomy is associated with loss of sexual potency and weakens the body; and fear of being belittled by other men.

IDUs have a different story to tell. They feel that there is a complex relationship between sexual drive or performance and drug use. Under the influence of drugs, they face lack of control over sexual impulse, delayed ejaculation, inability to achieve orgasm, and premature ejaculation.

Kothis (men who act as feminine sexual partners in MSM relationship) face stigma and discrimination among the general public and health care providers. Name-calling and teasing by the general public make Kothis feel bad about their sexuality and has a negative impact on their mental and sexual health, reported the study.

Kothis wanted to have the right to marry their Panthi partner and to have legal recognition of that marriage. Some Hijras reported cohabiting with or even getting 'married' to their Panthi, even in the absence of legal recognition. Hijras, irrespective of whether they engage in sex work, experienced difficulties in using condoms consistently with their regular, casual, and paying partners, as well as faced sexual and physical violence from ruffians and police.

The study recommended that males at risk including PLHIV, need to be provided with accurate information and services to preserve and enhance their sexual and reproductive health and to exercise their sexual reproductive rights.

Some of the key recommendations of this study are to promote safer sex behaviour among males-at-risk in a variety of settings. The study recommended to articulate SRH service needs of males-at-risk in national policies, and how those services can best be met through the health care system. There is a need to launch anti-discrimination education campaigns among the general masses to combat stigma and discrimination associated with people living with HIV, same sex attracted people, Hijras/Aravanis and drug users.

The Alliance anticipates that this study will contribute to building an evidence base for designing appropriate policies and programmes to meet the SRH needs of various groups of males-at-risk, and inform the development of improved linkages between broader SRH services and HIV-related services for males-at-risk in India.

To view the detailed study, please visit our Virtual Resource Centre, www.aidsallianceindia.net

Manisha Sharma

Programme Officer-Communications

The India HIV/AIDS Alliance

msharma@...