Responding to Men's Sexual Concerns: Research and Intervention in Slum Communities in Mumbai, India

Much of the responsibility for the transmission of HIV/STD lies with men involved in sexually risky behavior. While there are many programs aimed at reducing men’s risky behavior, insufficient attention has been paid to men’s perspectives on sexual health and the cultural context within which men engage in risky behavior. This paper reports on a multi-year, multi-level research and intervention project to assess men’s culturally based sexual health concerns and to utilize those concerns in the development of HIV/STD risk reduction and treatment programs in urban poor communities in Mumbai (Bombay), India. The intervention approach consists of community-level education, training of both public allopathic and private nonallopathic providers and a treatment modality that centers on syndromic diagnosis and management, behavioral change, and a therapeutic approach based on narrative and cognitive therapy termed the “narrative intervention model.” The project’s pre-post, control, and experimental design allows evaluation of impact at each intervention level.