Involving non-allopathic providers to reduce sexual risk and HIV/STIs in low income communities in Mumbai, India

This paper reports on a collaborative Indo-US project, entitled Research and Intervention in Sexual Health: Theory to Action (RISHTA) focused on prevention of HIV/STI among married men in three low income communities in Mumbai India. The Paper assesses the effectiveness of a brief intervention based on the narrative intervention model (NIM) an ecologically based, cognitive approach, with trained allopathic providers in a public primary care center and non-allopathic private providers based in the experimental communities. Quasi-experimental research design assessed to a systematic random sample of 2710 and a subset of 910 men was administered STI testing. A patient sample of 537 married men who utilized trained and untrained allopathic and non-allopathic. The results at the community level showed a significant drop from baseline (2004) to follow-up (2006) in gonorrhea (3.9 to 1.2%) and in extramarital sex (12.1 to 1.9%). At the patient level, male patients who went to trained providers showed significant improvement in knowledge about STDs, increased gender equitable attitudes, improved communication with spouse, and reduced extramarital sex, sex with sex worker and alcohol use, compared to those patients who went to untrained providers.