The Hindu Business Line : Barbers talk HIV

Customers of Prem Barsi, 30, a roadside barber in New Delhi's Lajpat Nagar, call him the `Condom Doctor'! "Doctor sahib, yeh aap ki fees," they jest as they pay Barsi.

Barsi is part of a unique HIV/AIDS outreach programme targeting barbers. The programme trains them to dispense condoms to clients, answer simple HIV-related queries, pass on pamphlets and literature on the disease, and even take perturbed customers to an NGO for HIV-testing.

"It feels good that even non-literate people can be of some help to the nation," says Barsi as he skilfully skims lather off a customer's face. The `Barber Intervention Project' launched by Francois Bagnould Xavier (FXB) India, a Swiss NGO that works on HIV/AIDS issues, has been successfully sensitising people about HIV/AIDS in 20 states since 2002.

With the growing realisation that men can play a key role in the prevention and control of HIV/AIDS and sexually transmitted infections (STIs), and the official estimate of the HIV-infected in India crossing 5 million, FXB India has come up with an innovative strategy to reach out to the country's male population. It dispenses information regarding the modes of transmission and prevention of HIV/AIDS in a setting that is predominantly male — barber shops.

With men of all age groups visiting salons regularly, FXB sees barber shops as hubs where men can talk about sex, sexuality, sexual health, HIV/AIDS and STIs without any inhibition. "Ultimately, it's just about pushing the discussion," says Vishwa Deepak, Regional Director, FXB India, "and we found that barbers could perform this role perfectly well."

To begin with, FXB activists approached barbers to sensitise them on HIV/AIDS and then mobilised them to talk on HIV. The NGO also established linkages between barbers and HIV/AIDS and STI management service providers for counselling, testing and treatment. Barbers mobilised by FXB are educated in condom promotion skills and the modes of HIV transmission. They are also coached in referring skills and provided with a list of centres for counselling, HIV testing and treatment of STIs.

Initially, the intervention project was undertaken in 2003 by FXB India's Delhi branch on a pilot basis. For over two years now, the pilot project has been successfully reaching out to a large section of men with information and prevention messages about HIV/AIDS and STIs. The project has spread to cover 10,000 barbers in 20 states.

The FXB team provides continuous support with regular follow-ups and monitoring. It supplies information material (pamphlets, booklets and leaflets) for distribution among the men visiting their salons. Condom depots, for free condom supply, have also been set up at these salons.

Interestingly, rather than a large city-wide initiative, FXB has chosen to work with small groups all over India, dealing with the issue area by area.

In Delhi, the NGO began with Lajpat Nagar three years ago. Though reluctant initially, the barbers were more forthcoming once the volunteers established a rapport with them. About 85 barbers now attend monthly meetings, which update them on HIV/AIDS-related issues. The salon owners even proactively suggest improvements in the programme. FXB now intends to focus on Sangam Vihar in South Delhi.

Says Deepak, "The programme is driven by the main objective of developing barber shops into a hub of information dissemination. We're trying to reach a large section of population with HIV/AIDS control and prevention messages."

The NGO found that initial efforts to control HIV in India were focused largely on commercial sex workers and women in general. "But now, there's growing realisation that cultural attitudes make it inappropriate for women to be fully knowledgeable about sex or to suggest condom use to men," admits Deepak. "On the other hand, it's much harder for men to admit their ignorance about HIV. Hence, initiatives like the barber intervention programme work very well."

According to FXB, low levels of male involvement in sexual health promotion and HIV/AIDS prevention and control efforts, mean that women often have to shoulder most of the responsibilities for both their own and their partner's sexual health. "If men and women understand how their partner's body works, they can understand each other better," says Krishnakant Pandey, Programme Coordinator, FXB. "Many men want to be involved in planning their families and looking after the health of their partners and their children. Hence it is but appropriate to focus on men's knowledge about sex, sexuality and sexual health, including HIV/AIDS and STIs."

"In recent years," says Deepak, "efforts have been made to improve women's health, including sexual and reproductive health. This has challenged the view that women are less important than men, and that inequality between men and women cannot be removed. Most women-oriented AIDS programmes too have been found to be limiting unless they involve men."

FXB's experience is that people learn about their sexuality, and about sex and sexual health, from different sources: parents, friends, teachers, radio, newspapers and television, colleagues and community elders. When people have a concern about sexual health, they go to formal healthcare services, such as clinics or hospitals, or to traditional health healers. Normally, the person that people turn to for advice or treatment is a sexual healthcare giver or educator.

"Our idea," says Deepak, "is to make this source as genuine, effective and user-friendly as feasible."

Women's Feature Service