title: Ensuring it works: a community-based approach to HIV prevention intervention development for men who have sex with men in Chennai, India.
abstract: Men who have sex with men (MSM) in India have an HIV seroprevalence 22 times greater than the country's general population and face unique challenges that may hinder the effectiveness of current HIV prevention efforts. To obtain an understanding of the logistical and sociocultural barriers MSM experience while accessing HIV prevention services, focus groups and key informant interviews were conducted with 55 MSM in Chennai, India. Qualitative data were analyzed using descriptive qualitative content analysis. Sixty-five percent of participants identified as kothi (receptive partners), 9% as panthi (insertive partners), 22% as double decker (receptive and insertive), and 4% did not disclose. Themes included: (a) fatigue with current HIV risk reduction messages; (b) increased need for non-judgmental and confidential services; and (c) inclusion of content that acknowledges individual and structural-level determinants of risk such as low self-esteem, depression, and social discrimination. MSM interventions may benefit from approaches that address multilevel psychosocial factors, including skills building and strategies to foster self-acceptance and increased social support.
authors.affiliation: Tuberculosis Research Centre, Indian Council of Medical Research, Chennai, India.
authors.forename: Beena
authors.initials: B
authors.lastname: Thomas
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Mimiaga
authors.forename: Kenneth H
authors.initials: KH
authors.lastname: Mayer
authors.forename: Elizabeth F
authors.initials: EF
authors.lastname: Closson
authors.forename: Carey V
authors.initials: CV
authors.lastname: Johnson
authors.forename: Sunil
authors.initials: S
authors.lastname: Menon
authors.forename: Jamuna
authors.initials: J
authors.lastname: Mani
authors.forename: R
authors.initials: R
authors.lastname: Vijaylakshmi
authors.forename: Meenalochini
authors.initials: M
authors.lastname: Dilip
authors.forename: Theresa
authors.initials: T
authors.lastname: Betancourt
authors.forename: Steven A
authors.initials: SA
authors.lastname: Safren
mesh_terms: D000328:Adult; D055812:Community-Based Participatory Research; D017144:Focus Groups; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D015528:HIV Seroprevalence; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D007194:India / Q000453:epidemiology; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011314:Preventive Health Services / Q000706:statistics & numerical data; D036301:Qualitative Research; D012649:Self Concept; D012747:Sexual Partners; D063508:Social Discrimination; D012944:Social Support; D011795:Surveys and Questionnaires; D055815:Young Adult