The Implementation of Multilevel Approach for the Prevention of HIV/STI Transmission from Husbands to Wives and Promoting Sexual Health in a Low Income Community in Mumbai

Women in India are at risk for HIV/STI primarily through the behavior of their spouse. This paper will describes, a multilevel intervention involving individual women, wives and husbands, the health system and the community that is aimed at prevention of HIV/STI transmission within marriage and reduction of sexual risk behavior. A Women’s Health Clinic was organized at the primary care center to treat women’s gynecological and STI related problems. Individual women presenting with the culturally based symptoms of vaginal discharge (safed pani) and related problems to the WHC are randomized into receiving treatment plus individual counseling (IC), group couples intervention (CI), both IC and CI and a control receiving standard care. The Women’s Structured Survey (WSS) was administered to assess women at baseline, six-month and one-year post intervention from 2009-2012. HLM model was used for data analysis and preliminary analysis comparing WSS baseline with WSS 6-month follow-up (N=886) and one year follow-up WSS (N=-866) comparing those involved in the intervention against the control. On the major outcome variables have shown that the intervention group shows better Sexual Health (p <.001), greater knowledge about STIs (p <.001), less sexual problems, (p <.001) better treatment seeking in health problems (p <.001).