Effects of a health care provider intervention in reduction of sexual risk and related outcomes in economically marginal communities in Mumbai, India

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Article (peer-reviewed)

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Background: The present study assessed the effectiveness of a brief narrative intervention implemented by trained biomedical and Ayurveda, Yoga, Unani, Siddha, Homeopathy (AYUSH) providers from three low-income communities in Mumbai, India. Methods: A quasi-experimental research design compared attitudinal and behavioural changes among a cohort of 554 patients presenting gupt rog (‘secret sexual illnesses’) to biomedical and AYUSH providers who were trained in the narrative intervention model (NIM; referred to as ‘narrative prevention counseling’ in the intervention manual) with those providing standard care (untrained in NIM). Data were analysed using multivariate and longitudinal statistical models. Results: Patients who received treatment for gupt rog from trained providers reported receiving a significantly higher number of services than those receiving services from untrained providers (mean 8.9 vs 7.6 services, respectively; P < 0.001). In addition, a higher number of patients seeing the trained providers no longer had gupt rog problems than those seeing untrained providers (42% vs 25%, respectively; P < 0.001). Patient-reported sex with a partner who was not the wife decreased significantly from baseline to follow-up for the entire sample but was significantly greater among patients receiving treatment from trained AYUSH providers (from 27% at baseline to 2% at follow up) compared with untrained providers (from 18% at baseline to 5% at follow up; P < 0.001). Conclusions: The results support the effectiveness of brief narrative intervention in primary care settings for reducing sexual risk and associated vulnerabilities among married men.