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‘Gender paradox’ in Kerala refers to the ‘contradiction’ whereby women’s high showing in socio-demographic indicators of development exists simultaneously with their low public participation and the increasing incidence of violence upon them. Given that ‘gender paradox’ has become the overwhelming context for imagining women in Kerala today, this paper seeks to examine its anatomy. The paper argues that there are two divergent descriptions of contemporary Kerala which circulate with comparable energy – Kerala as utopia and as dystopia. Theorisations of paradox bring these two worlds together, but without having sufficiently reckoned with their internal dynamics. Consequently, the paper explores the interiors of these worlds. It examines utopia through two discrete, yet intersecting social discourses – (a) the Kerala model of development and (b) tourism. It then proceeds to examine dystopia through the discourses around AIDS and sexual violence, which tend to be configured in analogous ways. The paper focuses on how women are gendered in these two worlds and concludes that they evoke two very different kinds of women. In the light of these explorations the paper goes on to lay out some of the implications and inadequacies of using gender paradox as the condition for speaking about women in Kerala. It argues that, instead of serving as a site for radical critique and productive feminist politics, gender paradox often become an occasion for conservative re-telling. [ABSTRACT FROM AUTHOR]

The public works program (PWP), the Mahatma Gandhi National Rural Employment Guarantee Act (MNREGA) in India, opened a new chapter in rural governance, signifying transformative potential for enhancing economic and social security. Despite the aim of this social protection scheme to enhance the "livelihood security of the household", provide employment to landless labourers, and encourage sustainable development, young men still opt to be migrant labourers in Bombay, many of whom become infected with AIDS and subsequently die. Often economic returns outweigh social risks and the new channels of disempowerment it reopens for women and children who are dependent on the income of these migrant men. We draw on ethnographic research conducted in Udaisarai (Gram Panchayat), Bhitaura block in Fatehpur District (Uttar Pradesh), to uncover rural-to-urban migration to Bombay, for better employment opportunities, and AIDS as one of the fallouts of the poor implementation of MNREGA. These pressing concerns need to be critically evaluated. [ABSTRACT FROM AUTHOR]

Increasing emphasis is being placed on the need for 'structural interventions' (SIs) in HIV prevention internationally. There is great variation in how the concept of SI is defined and operationalised, however, and this has potentially problematic implications for their likely success. In this paper, we clarify and elucidate what constitutes a SI with particular reference to the structured distribution of power and to the role of communities. We summarise the background to the growing emphasis being placed on the concept of SIs in HIV prevention policy, and present ethnographic case-study material from a sex worker's HIV project in Kolkata, India, to illustrate the nature of HIV vulnerability and its implications for the design and targeting of successful SIs. The paper draws attention to the dual importance of (1) attending to local complexities in the micro and macro-level structures that produce vulnerability; and (2) clarifying the meaning and role of communities within SIs. [ABSTRACT FROM AUTHOR]

Three-hundred and eighty-five social work students enrolled in 11 colleges in India were surveyed. Overall, the students demonstrated a moderate degree of knowledge about HIV/AIDS. However, they were generally unconcerned about the contagion. Three-fourths admitted to their lack of competence to deal with HIV+ patients. Regression analyses identified the positive effect of AIDS knowledge in combination with variables ‘actual contact with AIDS patients’ and ‘sense of competence’ on attitude toward PHWA. The paper discusses a curriculum strategy aimed at gender sensitive content and recommends behavior change as the best approach to reverse the tide of the contagion. [ABSTRACT FROM AUTHOR]

This paper sets out to describe the characteristics of HIV/AIDS in India, especially in the western Indian state of Maharashtra, and how Australian technology is being transferred to India to assist with the control of this epidemic. Specifically, the paper looks at Australian involvement in the Ansell-Raymonds joint venture, which manufactures the Kamasutra condom. To begin with, however, the problem of HIV/AIDS and its control in India is set into a broader cultural framework that looks at why HIV/AIDS in India has been so prolific and spread so quickly. By what means might the spread of HIV/Aids be controlled? The article questions the adequacy of the responses to HIV/AIDS in India, given the failure to identify men having sex with men as a major source of risky behaviour. We assess the contribution that the Kamasutra condom might make in the light of this broader discussion about the culture of sex and sexually transmitted diseases in India. Clearly the response of the private and public sectors in India have been far from adequate; perhaps as many as four million people in India now have HIV infection. Given the absence of any cure, and the lack of cheap medicines to delay the onset of death, the majority of HIV-infected people in India are likely to die. The HIV/AIDS epidemic is emerging as possibly India's greatest public-policy failure since independence. [ABSTRACT FROM AUTHOR]

Sexual health is a prime concern whether it is population control or HIV/AIDS. Population controls as well as the HIV/AIDS campaigns have repeatedly focused on the sexual practices of the poor and the sub-altern population of the developing nations. The campaigns employed have somewhat socially constructed the normative sexual health practices for the population at large. It has in some sense, 'dictated' the population about the 'correct' sexual behaviour. A glance at the population as well as HIV/AIDS programmes flag a common agenda. It can also be observed that the developing countries have depended on the expertise of the developed nations for the programmes. Thus, the developed nations had an upper hand in 'dictating' the normative sexual health behaviour for population in the developing nations based on their own understanding of sexual health practices. It can also be observed that most of the campaigns tend to speak down to the masses rather than considering their culture. This paper attempts to understand the basic tenets of the concepts of sexual health and tries to relate it to the population and HIV/AIDS programmes in India. [ABSTRACT FROM AUTHOR]

India has the second-largest population living with HIV/AIDS in the world. Although the exact number of HIV positive people is contested, it is predicted that the current numbers are likely to grow at a rapid rate in the next decade if the epidemic goes unchecked. This paper explores the HIV/AIDS epidemic in India through the perspective of two non-governmental organisations (NGOs) whose roles have become critical in the fight against the disease. Specifically, it identifies the challenges faced by these NGOs such as lack of government responsiveness, funding-related problems, corruption, donor accountability, and cultural attitudes to HIV/AIDS, while exploring the theoretical implications of NGOs playing a greater role in providing programming and services to those living with, and affected by, the epidemic. [ABSTRACT FROM AUTHOR]

With 3.1 million people estimated to be living with HIV/AIDS in India and 39.5 million people globally, the epidemic has posed academics the challenge of identifying behaviours and their underlying beliefs in the effort to reduce the risk of HIV transmission. The Health Belief Model (HBM) is frequently used to identify risk behaviours and adherence behaviour in the field of HIV/AIDS. Risk behaviour studies that apply HBM have been largely quantitative and use of qualitative methodology is rare. The marriage of qualitative and quantitative methods has never been easy. The challenge is in triangulating the methods. Method triangulation has been largely used to combine insights from the qualitative and quantitative methods but not to link both the methods. In this paper we suggest a linked trajectory of method triangulation (LTMT). The linked trajectory aims to first gather individual level information through in-depth interviews and then to present the information as vignettes in focus group discussions. We thus validate information obtained from in-depth interviews and gather emic concepts that arise from the interaction. We thus capture both the interpretation and the interaction angles of the qualitative method. Further, using the qualitative information gained, a survey is designed. In doing so, the survey questions are grounded and contextualized. We employed this linked trajectory of method triangulation in a study on the risk assessment of HIV/AIDS among migrant and mobile men. Fieldwork was carried out in Goa, India. Data come from two waves of studies, first an explorative qualitative study (2003), second a larger study (2004-2005), including in-depth interviews (25), focus group discussions (21) and a survey (n=1259). By employing the qualitative to quantitative LTMT we can not only contextualize the existing concepts of the HBM, but also validate new concepts and identify new risk groups. [ABSTRACT FROM AUTHOR]

With access to prevention of parent-to-child transmission (PPTCT) and antiretroviral therapy (ARV), people living with HIV/AIDS are better able to consider childbearing and parenthood. However, there is limited understanding of the reproductive healthcare needs and the impact of infection on the fertility desires of women living with HIV/AIDS. Research on the relationship between fertility and HIV/AIDS has been largely clinical, focusing on the ability of women living with HIV/AIDS (WLHA) to conceive or their pregnancy outcomes. This paper describes the findings of a qualitative study undertaken in Namakkal district, Tamil Nadu, India that aimed to explore fertility desires, intentions and fertility decision-making in WLHA and the barriers they face in fulfilling these desires. In-depth interviews were held with selected 43 currently married WLHA aged 18-35 years and 10 key informants. The women were classified according to whether or not they had living children and, within that, whether they had experienced abortion, wanted more or any children or were pregnant. The main factors distinguishing women who wanted to have a child and those who did not were their levels of anxiety about the future and available family support. Women who indicated that they did not have family support and were stigmatised by the family were reluctant to opt for a pregnancy as they were not sure of the future, including child care in event of parental death. In contrast, those women who decided to have a child did so based on family support, especially when family members offered to take care of the child in the future in the event of parental death. Awareness and access to PPTCT and ARV was another key factor guiding the final decision on child bearing. Findings highlight the need for further research on issues faced by WLHA in fulfilling their fertility desires and intentions and for programmes that both enable WLHA to exercise informed choice in meeting their fertility desires and sensitise healthcare providers about these needs. [ABSTRACT FROM AUTHOR]

This paper evaluates the role of female sex worker (FSW) collectives in the state of Karnataka, India, regarding their facilitating effect in increasing knowledge and promoting change towards safer sexual behaviour. In 2002 a state-wide survey of FSWs was administered to a stratified sample of 1,512 women. Following the survey, a collectivization index was developed to measure the degree of involvement of FSWs in collective-related activities. The results indicate that a higher degree of collectivization was associated with increased knowledge and higher reported condom use. Reported condom use was higher with commercial clients than with regular partners or husbands among all women and a gradient was observed in most outcome variables between women with low, medium and high collectivization index scores. Collectivization seems to have a positive impact in increasing knowledge and in empowering FSWs in Karnataka to adopt safer sex practices, particularly with commercial clients. While these results are encouraging, they may be confounded by social desirability, selection and other biases. More longitudinal and qualitative studies are required to better understand the nature of sex worker collectives and the benefits that they can provide. [ABSTRACT FROM AUTHOR]

Copyright of Culture, Health & Sexuality is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This paper examines the effects of current policies intended to liberalize the Indian economy and facilitate globalization on women close to poverty. The New Economic Policy of 1991 included standard structural adjustment measures including the devaluation of the rupee, increase in interest rates, reduction in public investment and expenditure, reduction in public sector food and fertilizer subsidies, increase in imports and foreign investment in capital-intensive and high-tech activities, and abolition of the cash compensatory support for exports. These policies have resulted in increased urbanization, and fewer job opportunities for women in the formal sector. Such conditions increase poverty for women in particular. As a result, many women flow into cities looking for work in the informal sector. This may have increased numbers of women in sex work, for lack of better economic opportunity. Sufficient data are not available to confirm whether HIV infection rates have risen as a result; however, the evidence suggests there may be a relationship between macroeconomic policies and health outcomes. [ABSTRACT FROM AUTHOR]

How households and families respond to AIDS is of fundamental importance when it comes to designing programmes and interventions to provide support and care to people living with HIV disease. Where household and family responses are negative, different kinds of interventions may be needed from those where responses are more supportive. This paper reports on findings from an in-depth study of household and family responses to HIV and AIDS in India. Using individual and couple interviews, data were collected on the ways in which care and support were offered (or denied) to people living with HIV and AIDS. Findings show that responses are greatly influenced by prevailing gender relations, with men being responded to more positively than women, as well as other variables such as social status. The quality of responses is also influenced by pre-existing patterns of support and discord within the family. Where trust is high and spousal conflict slight, for example, HIV and AIDS are reacted to more positively than when there is mistrust and inter-spousal conflict. Suggestions are made concerning programme and intervention development so as to strengthen existing responses, and to maximize the success of home-based care. [ABSTRACT FROM AUTHOR]

United Nations' agencies are reporting that India will become the world center for AIDS and HIV-related illnesses by the end of the century (Pais, 1996). It is predicted that in the year 2000, India will have the highest rate of infected individuals and new infections (Panday et al ., 1997). This information is daunting. AIDS and HIV-related illnesses have proven to be challenging for all nations that have had to face both the widespread epidemic and, frequently, highly infected epicenters or populations at high risk. The epidemic has seriously taxed the health systems in technologically advanced countries such as the USA. A cursory examination of this impending problem in India might lead to the obvious conclusion that it is going to be devastating. One also might speculate that there would be very little that could be done, and finally conclude that the die are cast, so that acceptance and managing the consequences are all that is left to India at this point in time. This paper explores trauma, HIV and India, and in this context addresses the impact of a traumatizing event, the HIV epidemic, on a nation and its children. [ABSTRACT FROM AUTHOR]

Purpose: To characterize the presenting features of cytomegalovirus (CMV) retinitis in HIV-positive patients in a developing country in the HAART era.Methods: Retrospective chart review of all patients with CMV retinitis seen at a tertiary-care referral center between January 2006 to June 2017. Demographic and clinical data were collected to study the presenting features and risk factors for blindness.Results: Fifty-five patients with treatment-naïve CMV retinitis were enrolled; 75% were males. CD4 counts were below 50 cells/µL in 51.1%. Bilateral presentation was seen in 61.5%. Half (50.6%) of the eyes were blind at first examination. Zone 1 involvement was present in 46% of the eyes. Retinal area involvement > 25% was the only factor associated significantly with higher incidence of blindness (p = 0.016).Conclusions: There was extensive and bilateral presentation of CMV retinitis due to delayed presentation. Screening for CMV retinitis, irrespective of CD4 counts, may help in developing nations. [ABSTRACT FROM AUTHOR]

Client-provider relationships have significant effects on how individuals comprehend their life situation during chronic disease and illness. Yet, little is known about how frontline health care providers (HCPs) influence client's identity formation through meaning-making with clients such as HIV-positive women living in poverty. This requires ethical consideration of the meanings made between clients and providers about client's health and well-being, both individually and in the larger society. Health care providers (N = 15) and married women living with HIV (N = 33) in north-central India engaged in separate intensive interviews providing narrative data which were analysed using a conceptual framework crossing Lipsky's street-level bureaucracy theory (Lipsky 2010) with meaning-making processes. HCPs and women construct meanings of women's role as caregivers that impact women's sense of identity, health, and well-being. Findings indicate that despite being well-intentioned, HCPs inadvertently reinforce rigid gender norms and convey that women's worth is tied to their familial caregiving role. HCPs' discretionary advocacy may also reinforce societal images of women as incapable and needy, thereby harming them more generally. Attention to the gender-sensitive training of HIV health care providers may assure that discretion is ethically interrogated to promote gender equity and enhance women's access to social welfare services. [ABSTRACT FROM AUTHOR]

Purpose: To compare changes in the demographic profile and ocular manifestations in patients with HIV in the pre-HAART and HAART era in North India.Methods: In this single-center cross-sectional study, 100 HIV patients receiving HAART and 96 HIV patients in the pre-HAART era were enrolled. Prevalence of ocular manifestations of HIV was calculated for both cohorts.Results: The prevalence of ocular manifestations was not statistically different in the two eras (38%, SE: 4.85% in HAART era; 41.67%, SE: 5% in pre-HAART era) (p = 0.60). Mean CD4 counts were lower in the pre-HAART era compared with the HAART era (p < 0.001). In the HAART era, cytomegalovirus (CMV) retinitis and HIV retinopathy continued to remain the most common infectious and non-infectious cause of visual morbidity.Conclusions: While the introduction of HAART has resulted in a major impact on the overall health of patients with HIV, the spectrum of ocular disease remains largely unchanged in developing countries such as India. [ABSTRACT FROM AUTHOR]

In this study, focus groups were conducted with 16 rural women living with AIDS (WLA) from Andhra Pradesh, India, who had previously participated in a clinical trial wherein 68 WLA were randomized into either an Accredited Social Health Activists (ASHA)-Life (AL) intervention or a usual care program. Findings are discussed in terms of (a) mental health issues, (b) perceived stressors, (c) individual resources for coping with mental health issues, and (d) role of ASHA support in coping with mental health issues. These findings highlight the salience of mental health issues in the lives of WLA and the role played by ASHA in addressing some of these issues. The discussion section makes a case for increased emphasis on mental health care in future community-based interventions for this population. [ABSTRACT FROM AUTHOR]

Copyright of Annals of the Association of American Geographers is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This article is an attempt to present and elaborate the HIV/AIDS scenario in Jharkhand state of India, services available, key issues, challenges, and concerns at various levels to mitigate the epidemic. It also examines the role of different stakeholders and agencies in halting and reversing the epidemic. The findings show that there are various challenges that need immediate attention. The article critically examines these issues in detail and suggests the approach to address the epidemic. [ABSTRACT FROM AUTHOR]

HIV/AIDS stigma can severely compromise the quality of life of people living with HIV/AIDS (PLHA) by reducing access and quality of care, adherence to therapy, and disclosure of HIV status, thereby potentially increasing transmission. The objective of this study was to develop and psychometrically test three parallel scales measuring self, experienced, and perceived stigma among PLHA (n=188) in Chennai, India. Exploratory factor analysis (EFA), which was used to facilitate item reduction and assess construct validity, confirmed the presence of three underlying theoretical domains. The final number of items and Cronbach's Alpha for each scale were: 8 items, Alpha of 0.84, for self stigma; 7 items, Alpha of 0.86, for experienced stigma; and 7 items, Alpha of 0.83, for perceived stigma. External validity was ascertained by confirming a significant positive association between the measure of each type of stigma and depression (measured using CES-D), using structural equation modeling (SEM). Therefore, scales were parsimonious, reliable, and were found to be valid measures of HIV/AIDS stigma. Using these validated scales, researchers can accurately collect data to inform the design of stigma reduction programs and interventions and enable subsequent evaluation of their effectiveness. [ABSTRACT FROM AUTHOR]

The past decade has witnessed a tremendous growth in the scale and policy influence of civil society in global health governance. The AIDS ‘industry’ in particular opens up spaces for active mobilisation and participation of non-state actors, which further crystallise with an ever-increasing dominance of global health initiatives. While country evaluations of global initiatives call for a greater participation of ‘civil society’, the evidence base examining the organisation, nature and operation of ‘civil society’ and its claims to legitimacy is very thin. Drawing on the case of one of the most visible players in the global response to HIV epidemic, the Global Fund to Fight AIDS, Tuberculosis and Malaria, this article seeks to highlight the complex micropolitics of its interactions with civil society. It examines the nature of civil society actors involved in the Fund projects and the processes through which they gain credibility. We argue that the imposition of global structures and principles facilitates a reconfiguration of actors around newer forms of expertise and power centres. In this context, the notion of ‘civil society’ underplays differences and power dynamics between various institutions and conceals the agency of outsiders under the guise of autonomy of the state and people. [ABSTRACT FROM PUBLISHER]

Although depression may be commonly experienced by persons living with AIDS, it may be challenging for health care providers to identify persons who are suffering from depression symptoms, particularly if they are living in the more isolated rural areas of India. The purpose of this study is to assess correlates of depression among women living with AIDS in rural Andhra Pradesh, India. A total of 68 rural women living with AIDS (WLA) completed baseline data and were assessed by means of structured instruments. Regression modeling revealed that disclosure avoidance and making at least six health care visits in the last six months were all associated with depression. Further, living with a spouse was associated with lower depressive symptom scores. Stigma was not found to be associated with depression. Understanding correlates of depression can lead the way toward designing culturally-tailored interventions that can mitigate disclosure avoidance and improve the health of women. A more comprehensive health focus may be needed to empower the women to seek quality care for both physical health, as well as mental health, symptomatology. [ABSTRACT FROM AUTHOR]

This article highlights potential public health effects of India's Patents Act of 2005, which was implemented to conform to the requirements of the World Trade Organisation's Trade-Related Aspects of Intellectual Property Agreement (TRIPS), a new legal regime that will likely have a significant impact on access to HIV/AIDS medications in much of the world. This new patent law may play a role in keeping new antiretroviral (ARV) medications, including improved first-line medications and second-line drugs that are being developed for first-line drug resistant HIV, financially out of reach for many people living with HIV/AIDS in poor countries. India's drug industry, which had thrived under earlier patent laws that protected processes but not products in the case of medications, had brought down the price of ARV drugs in South Asia and Africa by more than 90%. While most existing drugs are grandfathered under the new patent laws, newer ARV medications may be barred from manufacture by Indian companies. This article analyses the effects of the coming together of this new legal regime, the global political economy and emerging resistance to HIV/AIDS medications, and evaluates efforts to mitigate the negative public health effects of the new patent laws. [ABSTRACT FROM AUTHOR]

Caring for a family member with HIV/AIDS presents multiple challenges that strain a family's physical, economic and emotional resources. Family carers provide physical care and financial support and deal with changes in family relationships and roles, often with little support from outside of the family. Carers in developing countries face even greater challenges, due to lack of medical and support services, poverty and widespread discrimination against those with HIV/AIDS. Little is known about how family carers cope with these challenges or about the ways that development impacts on the process of coping. The current study explored coping strategies used by family carers in two contexts, Kerala, India and Scotland, UK. As part of a larger study, 28 family carers of persons living with HIV/AIDS were interviewed -23 in Kerala and 5 in Scotland. A modified version of the Ways of Coping scale was used to assess coping strategies. Responses were compared on the total number of coping responses used as well as on selected subscales of the WOC. Differences were assessed using the Mann-Whitney U-test. The two cohorts differed significantly in terms of the coping strategies used. The carers from Scotland used a larger number of different coping strategies and scored higher on measures of problem focused coping, positive reappraisal, seeking social support, self-controlling and distancing/detachment. Respondents from Kerala scored higher on a measure of self-blame. Results are discussed in terms of the impact of community resources on coping strategies. [ABSTRACT FROM AUTHOR]

This study compared evidence from two low caste labouring communities in India: a relatively modernized urban group and a rural group in a backward region. It explored their levels of ill health, their capacities to respond to adult illness and the support they received. In each region, a baseline survey of approximately 1,000 households provided background quantitative evidence with qualitative evidence was collected from about 55 families. HIV infection and AIDS deaths were found to occur in the 'less poor' segments of the study group in both regions. In keeping with the official data, they formed a small proportion of the overall mortality and morbidity in this group. Stigma and discrimination were found to be low but fear of stigma was high, generated by the medical response to AIDS and used opportunistically for personal gains. The study provides insights into the structural determinants of health and coping mechanisms in these communities. The best conditions for a healthy life were found in the group that had a rooted community setting, collective political power, migrant economic support and improved working conditions - the less poor rural group. While improved economic status was associated with better health status, this relationship was stronger when combined with the presence of improved working conditions, with social cohesion at family and community levels and with political power as indicated by levels of organized collective representation and identity formation in workplace, local- and state-level politics. However, the traditional forms of social cohesion are under stress and new forms, moderated by commercial relations, are proving inadequate to meet major household shocks, like adult mortality. [ABSTRACT FROM AUTHOR]

This is the second in a series of two articles (the first appeared in Contemporary South Asia, 10:1) on HIV/AIDS in India and the transfer of Australian technology to assist with bringing the epidemic under control. It is estimated that between five and eight percent of India's HIV infections have occurred through contaminated blood supplies. Australian blood technology has been identified as international best practice, and this article examines the transfer of this technology to the Mumbai Red Cross Blood Bank. This examination is preceded by an exposition of the cultural context within which India's blood supply has developed, including the 'cultural metaphor of blood', how blood has been regarded in the long run of Indian history, and how colonialism changed the metaphor from a polluting and horrific fluid to a lifesaving substance. This is followed by an account of the evolution of India's modern blood supply, the current problems with the infrastructure that seeks to deliver more blood to an ever-expanding demand, and how improvements might be made to both the quality and quantity of blood available, with special emphasis on the role of 'replacement blood donors' in the Indian system. [ABSTRACT FROM AUTHOR]

To successfully stall the spread of HIV/AIDS among the ethnic minorities in India, it is imperative that we not only understand the complexity of issues in India with regard to HIV spread among ethnic groups but also comprehend that straightforward measures that might have worked in the context of other countries may not work in the Indian context. The authors present field work data and the results of interviews with 635 opinion leaders from eight 'tribal groups' from the north eastern border state of Manipur in India where a high rate of HIV infection is reported among the IDUs (intravenous drug users). The study found community support for AIDS, sex and drug education, along with an increasing perception of social vulnerability. Even though respondents perceive the threat of infection, few feel that they are personally susceptible. As HIV/AIDS prevention programmes compete with other socioeconomic conditions, the prevention blue print must be tailored to meet diverse demands in the study area and of the ethnic minorities in India. [ABSTRACT FROM AUTHOR]

Abstract A survey conducted among the lower-class urban population of Delhi, India to describe the heterosexual behaviour, condom usage and awareness about STDs/AIDS revealed that 4.4% respondents had sex outside/before marriage. Female commercial sex workers, friends and neighbours were the important sexual partners. Heterosexual activity was significantly higher among males, unmarried, literates and middle/higher income groups. Almost half of those who had sex before/outside marriage never used a condom during the sexual encounter. Though only a small fraction of the population was found to be engaged in extra-/pre-marital sex, the overall impact of this may be multifold, given the nature and modes of HIV transmission. The superficial and inadequate knowledge regarding STDs/AIDS among this population, especially among those having extra-/premarital sex, indicates an urgent need for appropriately targeted health education and condom promotion activities in the community with an endeavour to increase awareness about STDs and HIV/AIDS and motivate people towards healthy sexual lifestyles. [ABSTRACT FROM AUTHOR]