Effects of a health care provider intervention in reduction of sexual risk and related outcomes in economically marginal communities in Mumbai, India
Niranjan Saggurti A F , Stephen L. Schensul B , Bonnie Kaul Nastasi C , Rajendra Singh D , Joseph A. Burleson B and Ravi K. Verma EA HIV and AIDS Program, Population Council, 142 Golf Links, New Delhi 110 003, India.
B Department of Community Medicine and Health Care, University of Connecticut School of Medicine, Farmington, CT 06030-6325, USA.
C Department of Psychology, Tulane University, New Orleans, LA 70118, USA.
D International Center for Research on Women, Mankhurd, Mumbai 400043, India.
E International Center for Research on Women, C-139, Defence Colony, New Delhi 110024, India.
F Corresponding author. Email: nsaggurti@popcouncil.org
Sexual Health 10(6) 502-511 https://doi.org/10.1071/SH13076
Submitted: 11 March 2013 Accepted: 4 August 2013 Published: 25 October 2013
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.
Additional keywords: clinic-based intervention, health services, HIV prevention, men, sexual behaviours, sexual health, traditional doctors.
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