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Sunday, Dec 15, 2019

How poverty leads to unprotected sex, HIV

Seven-year study in city slums reveals how urban poor are vulnerable to infection; project model to be adopted nationally, reports Aditya Ghosh.

india Updated: Aug 16, 2008 00:56 IST
Aditya Ghosh
Aditya Ghosh
Hindustan Times

This is no glamorous sex survey, but it could rewrite the country’s campaign against HIV. Because the details revealed here have never been acknowledged earlier.

Like one in every three teenagers had active sex lives and their partners were often married women, living with or without their husbands. Unprotected sex for majority of teens was fine but masturbation was not. Over 60 per cent men had sex for the first time with unmarried neighbours and friends. And more than half of them never used a condom.

The project of which the survey was a part has other firsts to its credit: starting a unique sex education and counselling unit for men and involving ayurvedic doctors in awareness campaigns, many of whom would otherwise double up as quacks.

Impressed with the success of the project that concluded in July — after running for seven years in which data was collected and analysed — the country’s apex body of HIV prevention, National AIDS Control Organisation (NACO), has decided to reproduce this model of intervention for men across the country.

The survey was carried out from a male sex clinic in Shivaji Nagar, Govandi between 2000 and 2008 by TN Medical College, Indian Institute of Population Sciences (IIPS), Connecticut University, US, Population Council of India and Walden University, US.

The clinic’s clients are slum dwellers.

Experts said sexually transmitted infections and HIV in these pockets could easily spread to other sections of society.

“Many men and women work as maids in local households, as labourers in factories and construction industry,” said IIPS professor T.V. Shekhar, the study’s principle investigator. “Poverty leads them to unsafe sex and risk of sexually transmitted diseases because they have little idea about facts of sex.”

Married women were most vulnerable. Over 65 per cent of them had more than one partners. One in four men involved in sex outside relationships had an unmarried female partner. About 2.5 per cent men had sex with men.

The clinic intervened with an unconventional approach, functioning in the afternoon to make it convenient for men to visit the clinic after work and before they would seek sex. “In India almost all the health projects and interventions are targeted at women and children, which is why this clinic was significant,” said Radha Aras, head of community and preventive medicine, TN Medical College, which ran the clinic. “By operating it between 4 and 8 pm we got so many more males coming to the clinic to discuss their problems and misconceptions.”

The project, for the first time in any health campaign, successfully used ayurvedic doctors for imparting sex education. “This was an invaluable experience and now such clinics will come up across the country, starting with Andhra Pradesh and Karnataka,” said K. Sujatha Rao, director general, NACO.

The survey also showed that older people hardly used condoms. “This is a dangerous practice and we did not have a clue that it was so,” said Aras.