Revista de SIDA e investigación clínica

Public Participation of Men Who Have Sex with Men in the Context of Community Empowerment in India

Abstract

Karikalan Nagarajan, Seema Sahay, Deepika Ganju and Ramesh S Paranjape

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.