Research

India has one of the highest adult HIV incidence in Asia (0.75 per cent) with about 85 per cent of the infections occurring through sexual route (NACO, 2003). Since 1986, when the first six Commercial Sex Workers (C.S.W.s) were identified in Madras (now Chennai), AIDS has become a visible threat to Indian society. High risk groups like Intravenous Drug Users (I.D.U.s), Men having Sex with Men (M.S.M.s), and Commercial Sex Workers were the first ones to be massively infected. HIV/AIDS is now spreading in the cities and in some parts of rural India to persons not belonging to high risk groups.

India has also high rates of both internal and external migrations, either on a seasonal or on a long-term basis; and empirical evidence shows that migration is a phenomenon on the rise.

Free from the traditional social restrictions and taboos of their communities of origin, and taking advantage from the anonymity of the cities, migrants adopt generally a more liberal sexual behavior at the place of destination. They are also more subject to external influences driving them to adopt new behavior / practices (like drug use). This increased vulnerability makes them the ideal transmitter of STIs and HIV/AIDS to their families and communities back home. In Tamil Nadu, migration is the main link between HIV/AIDS high risk groups and the population at large.

Although all indicators point at the importance of a coordinated prevention policy for migrants on HIV/AIDS, research on the subject has been minimum and inter-state cooperation has been restricted to some isolated activities, and has failed short of a comprehensive policy on the subject. It is hoped that the present research will contribute to fill this gap.

The methodology of the present research is cross-sectional including literature review and detailed schedules for 1,009 respondents (slum dwellers) aged between 18 to 49 years. Participatory sessions for additional qualitative data include 20 focus group discussions with different groups of concern like women and children. The study also included interviews of key informants like health officials, field practitioners, and policy makers.

Data collection was completed by June 2004. Preliminary results were available by December 2004. As the study is not supported by any sponsor, considerable in-kind support has been generated from local NGOs. It is proposed to organize the dissemination of research findings through an interstate workshop involving policy makers and practitioners for the set-up of a Tamil Nadu Plan of Action on HIV/AIDS among Migrants. It will be proposed for sponsoring to external donors or depending on available resources.

The findings of the present thesis are analyzed and presented in seven chapters. The first chapter contain an introduction with a/ a statement of the problem and b/ a literature review on definitions, theories about poverty, migration and HIV/AIDS, c/ general and specific objectives and d/ background research questions. The second chapter focuses on the methodology of the research including a/ sampling methods, b/various qualitative and quantitative data collection methods, c/ ethical aspects, d/ benefits for the respondents, e/ field test of methodology and f/ duration of the study. The third chapter describes the household characteristics and the structure of the studied population with marital and migratory status of the respondents. The poverty status of the studied population is presented in the fourth chapter including a/ hunger status, food habit, staple food; b/ access and control over water and sanitation, electricity, telephone, fuel, shelter, education and health; c/ access to assets; d/ social control mechanism in the slums and e/ health seeking behavior. The fifth chapter describes the migration status of the studied population with details on remittances and impact of migration. The sixth chapter describes the understanding of the HIV/AIDS and STIs and the related attitudes and practices that has the studied population, including a/ sexual behavior aspects, b/ knowledge, attitude and practice of HIV/AIDS and condom use; c/ stigma and discrimination of HIV positive people. The summary of the study is presented in the last seventh chapter with conclusions and policy recommendations for international, national institutions, INGOs, NGOs and CBOs. Findings will also be made available on a web site.