16th International AIDS Conference Toronto, Canada - August 13 - 18, 2006

SEXUAL NETWORKING AND HIV RISK IN MIGRANT WORKERS IN INDIA

Int Conf AIDS. 2006 Aug 13-18;16 Abstract No. MoAc0304

Gelmon L.¹, Singh K.², Singh P.², Bhattacharjee P.³, Moses S.⁴, Costigan A.², Blanchard J.^5
1Univ. Nairobi/Univ Manitoba, Medical Microbioloy, Nairobi, Kenya, ²ICHAP Project, Jaipur, Rajasthan, India, ³ICHAP Project, Bangalore, India, ⁴Univ Manitoba, ICHAP project, Medical Microbioloy, Winnipeg, Canada, ⁵Univ Manitoba, ICHAP project, Medical Microbioloy, Bangalore, India

BACKGROUND: The Hamara sub-project is part of the India-Canada HIV/AIDS Project (ICHAP), working with rural migrants from Rajasthan, providing prevention/care from places of origin, while in transit, and in destination places. A biological baseline in fifteen villages in 2004 revealed high levels of medically-confirmed STIs with HIV prevalences of approximately 1% (four times the state average) in migrants, non-migrants and their spouses. Further, there was evidence of high rates of sexual networking. A follow-up study documented the sexual behavior of migrants (actual, potential, returned, visiting), their spouses, sex workers and MSMs.

METHODS: All 133 villages in three districts of Shekhawati Region were canvassed, primary and secondary stakeholders identified, and detailed questionnaires developed, enquiring into perceptions of what was occurring in the villages. Data was collected through key informants (793), focus groups (318) and “polling booth” questionnaires (3,166).

RESULTS: There are high levels of sexual networking in the home villages as well as the places of destination, with 40%-70% of the respondents acknowledging evidence of premarital and extramarital sex by both women and men, the presence of village sex workers and MSMs. Married and unmarried migrant workers visit sex workers and/or have liaisons with local women both at home and at their places of destination. There is a relatively high rate of knowledge of STIs and HIV/AIDS but a low rate of condom utilization.

CONCLUSIONS: Migration intensifies risk for contracting HIV/STIs, but the key finding is that the determinant of risk for migrant workers is prior behaviour. Migrating does not change sexual behavior, migrants take their established behavior into an environment where there is a higher rate of HIV/STIs. This is different from the commonly-accepted wisdom that being a migrant leads one to assume high-risk behaviour. Therefore migration programming has to address both the points of origin as well as the points of destination.

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2006-08-13
MoAc0304

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