title: Effects of a health care provider intervention in reduction of sexual risk and related outcomes in economically marginal communities in Mumbai, India.
abstract: BACKGROUND
  The present study assessed the effectiveness of a brief narrative intervention implemented by trained biomedical and Ayurveda, Yoga, Unani, Siddha, Homeopathy (AYUSH) providers from three low-income communities in Mumbai, India.
  
  
  METHODS
  A quasi-experimental research design compared attitudinal and behavioural changes among a cohort of 554 patients presenting gupt rog ('secret sexual illnesses') to biomedical and AYUSH providers who were trained in the narrative intervention model (NIM; referred to as 'narrative prevention counseling' in the intervention manual) with those providing standard care (untrained in NIM). Data were analysed using multivariate and longitudinal statistical models.
  
  
  RESULTS
  Patients who received treatment for gupt rog from trained providers reported receiving a significantly higher number of services than those receiving services from untrained providers (mean 8.9 vs 7.6 services, respectively; P<0.001). In addition, a higher number of patients seeing the trained providers no longer had gupt rog problems than those seeing untrained providers (42% vs 25%, respectively; P<0.001). Patient-reported sex with a partner who was not the wife decreased significantly from baseline to follow-up for the entire sample but was significantly greater among patients receiving treatment from trained AYUSH providers (from 27% at baseline to 2% at follow up) compared with untrained providers (from 18% at baseline to 5% at follow up; P<0.001).
  
  
  CONCLUSIONS
  The results support the effectiveness of brief narrative intervention in primary care settings for reducing sexual risk and associated vulnerabilities among married men.
authors.affiliation: HIV and AIDS Program, Population Council, 142 Golf Links, New Delhi 110 003, India.
authors.forename: Niranjan
authors.initials: N
authors.lastname: Saggurti
authors.forename: Stephen L
authors.initials: SL
authors.lastname: Schensul
authors.forename: Bonnie Kaul
authors.initials: BK
authors.lastname: Nastasi
authors.forename: Rajendra
authors.initials: R
authors.lastname: Singh
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Burleson
authors.forename: Ravi K
authors.initials: RK
authors.lastname: Verma
mesh_terms: D000328:Adult; D003906:Developing Countries; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission; D006266:Health Education; D006282:Health Personnel / Q000193:education; D006801:Humans; D007194:India; D007318:Inservice Training; D008297:Male; D011204:Poverty Areas; D040242:Risk Reduction Behavior; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000517:prevention & control*; D047568:Unsafe Sex / Q000517:prevention & control*