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#AIDS2016 | @AIDS_conference
“MOVING FROM VISIBLE TO VIRTUAL SPACES”: VISIBILITY,
NETWORKING AND MOBILITY AMONG MEN WHO HAVE SEX
WITH MEN FROM GOA STATE: DRAWINGS FROM PRE-
SURVEILLANCE ASSESSMENT OF NATIONAL INTEGRATED
BEHAVIOURAL AND BIOLOGICAL SURVEILLANCE
Sucheta Deshpande1, Pradeep Kumar2, Neelam Joglekar1, Chitra Kadu1,
Neeraj Dhingra2, Raman Gangakhedkar1, Sheela Godbole1
1 National AIDS Research Institute (NARI-ICMR), Pune, India
2 National AIDS Control Programme (NACO), New Delhi, India
Abstract no. TUPED334
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Background
A pre-surveillance assessment (PSA) was done to understand
community concerns for conducting large scale bio-behavioural
surveillance in India.
•Objectives of PSA
–Rough assessment of size of HRG including rural HRG
–Assessment of predominant typologies to ascertain survey
methodologies to be adopted
–Documentation of key patterns, networks & practices of high risk
behaviours in the district & factors that affect them (Qualitative
approach)
–Feasibility assessment for conducting the survey including terms
used, languages spoken, availability of space for interview &
blood collection etc.
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Methods
•PSA was conducted among Men who have Sex with Men (MSM)
in two districts of Goa (South and North Goa) July-September
2013. Five group discussions (GD), (SG=2, NG=3) and 13 in-depth
interviews (IDI) (SG=7, NG=6) were conducted with key
stakeholders and community members. All the GDs and IDIs were
taped after seeking consent.
Domain Summary –extracts from PSA (Primary data
compilation)
North Goa South Goa
1
Reported predominant
typology*
Kothi, Panthi Kothi,
Double-
decker
2
Visibility of MSM at
cruising sites of
congregation
Mostly
hidden
Mostly visible
3
Will mobility patterns of
MSM affect their presence
in hotspot
Yes No
4
Hotspots change
frequently
No No
*Kothi –Predominantly receptive partner, Panthi –predominantly penetrative
partner, Double-decker –at times can be receptive or penetrative
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Research questions and framework for analysis
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Themes and probes used in Qualitative Interviews
•Typology and practice related information
•Different typologies of MSM
•Sexual practices
•Regular partners and relationship stability
•Networking among MSM
•Visibility and places of solicitation among MSMs in the district
•Mobility
•Seasonal variations
•Reasons for variation in size of MSM
•Inter-district or inter-state movement of MSM
•Hotspot and Neighboring districts
–Situations under which the hotspots where MSM congregate, change
•Police related factors
•Seasonal variation
•Fairs and festivals
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Results
Visibility, networking and mobility among MSM
Visibility
–All responses pointed out factors related to reduced visibility of MSM in Goa
•Engaged in commercial sex
“Most of them are commercial and many do it secretly, through internet, and gay websites….”(KII#1,
PM, South Goa)
•Family/Societal pressure
“MSM population is hidden, some are married and continue to engage in MSM activities…”
(KII#2, Doctor, South Goa)
“Majority of the population is hidden….because of fear of discrimination from the society, mindset of
society is such that they don’t want to show they are in this [same sex relations]…” (KII#4, PE, South Goa)
“Most of MSM are from the middle class of the society are not ‘open’ because of the fear of the family
and social prestige.”(GD#1, Stakeholders, North Goa)
•Typology differences
“MSM are mostly hidden. Panthis are hidden due to fear of society and Kothis don’t hide their
identities.College students are hidden due to fear that their college friends may know and tease
them…” (GD#3, Stakeholders, North Goa)
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Results
Urban-Rural difference –MSM are more open in cities
–More openness in Cities (Urban area)
“In rural area MSM are hidden, their way of clothing is very different as compared to city area.In
capital city MSM are of ‘hi-fi’ standard….”(KII#1, PM, North Goa)
“MSM come from village to cities, since they do not find any acceptance in the village, people point
fingers at them as they act feminine and outcast them. “(KII#4, PE, North Goa)
“…lots of people (MSM) from urban areas….there are MSM in rural area as well but usually they hide
their (sexual) activity in the society…” (FGD#2, Community, South Goa)
–Less awareness in rural area
“Maximum population belongs from urban area…rural people (MSM) are not aware about sexual
practices (orientation), or places of their congregation…” (KII#5, PE, South Goa)
“Due to awareness about this (MSM) community they are ‘open’ and most (of MSM) are from cities, but
MSM belonging to rural areas, are more hidden due to fear of the society, family and friends.” (FGD#2,
Non-TI Community, North Goa)
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Mobility among MSM
South Goa
North Goa
Anjuna Beach
Calangute Beach
Baga Beach
Candolim Beach
“This is basically a costal belt..popular beaches are
there…MSM from South Goa frequently goes to these
beaches…” (FGD#1, Community, South Goa)
“Most MSM go to Calangut, Vasco, Mapusa and Panjim…”(KII#3,
Community Health Coordinator, South Goa)
“October to March, is the tourist season, many tourists come
to beaches, all hotels and restaurants are booked in this
season, hotel boys and attendants are engaged in this
activity…so the number of MSM also increase in this period…”
(FGD#2, Community, Non-TI, North Goa)
“ …. maximum MSM are moving from South Goa to North
Goa…” (KII#5, PE, South Goa)
Mobility within Domains –Intrastate mobility
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Mobility among MSM
Interstate mobility –Mobility for MSM activity
“Many (MSM) move to different places
for enjoyment, to enjoy new places
and to search new partner. Many move
to Bombay, Pune, Savantwadi,
Kolhapur and Shirdi etc….” (FGD#3,
Stakeholders, North )
“…mainly for searching new
partners, they move
out….they develop their
contacts during festival and
events…majority of MSM
moved to Maharashtra ,
Karnataka,…” (KII#1, PM,
South Goa)
MSM visit
places
outside
Goa state
Pune
Mumbai
Kolhapur
Sangali
Shirdi
Karwar
Belgaum
Bangalore
Tirupati
Hyderabad
Ajmer
Delhi
Period of Mobility:
Summer & Rains
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Mobility among MSM
MSM come
from
other places
to Goa
Pune
Mumbai
Kolhapur
Sawantwadi
Bagalkot
Belgaum
Mangalore
Hubli
Bijapur
Bangalore
Tirupati
Hyderabad
Kerala
Chennai
Delhi
Chattisgarh
Uttar Pradesh
“Demand for sex work also
make them (MSM) travel
places...” (KII#6, PM, North
Goa)
“For fulfilling the sexual needs
and getting the maximum
satisfaction they move to other
places, they are freely moving to
any places…” (FGD#1,
Stakeholders, North Goa)
Interstate mobility –Mobility of MSM from other states to Goa for MSM activity
Period of Mobility: During
October to March, MSM
from outside Goa visit Goa
[Diwali, Christmas, New
Year]
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Modes of Networking among MSM
Modes of networking cited in GDs & KIIs by Rank
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Conclusion
•Conventional interventions usually target the
more visible, hotspot based MSM. However, in
the current era, movement of MSM from
conventional to virtual spaces is a challenge for
HIV prevention interventions.
•There is an urgent need to identify and develop
approaches for outreach to MSM with higher
mobility but less visibility.
•Non-conventional interventions like web-based
and m-health options for MSM should be a
focus in India.
