Hidden psychiatric morbidities and general health status among men who have sex with men and other clients of a sexually transmitted disease clinic of Kolkata: A comparative study

Abstract

Next to South Africa, India has the second largest number of persons living with HIV/AIDS in the world. According to the data on the National AIDS Control Organization till 7th July, 2008, adult HIV prevalence in India is approximately 0.36%, amounting to between 2 and 3.1 million people. It is also estimated that 85% of HIV transmission is sexual. Though the contribution of MSM to the HIV/AIDS epidemic in India was officially set at 1% in 2001,(1) it is felt by the researchers that this Figure underestimates the impact of unsafe sexual practice of the MSM on the epidemic of HIV/AIDS in India, especially since global estimates suggest that 5 to 10% of HIV prevalence is attributable to sexual transmission between men.(2) The frameworks of male-to-male sex are substantially divergent and inclusive. It includes normative males (panthis) who desire to penetrate as the only signifier, feminized males (kothis) who desire to be penetrated, males who have partners of both sex (duplis) along with hijras, who desire to be penetrated by other males, and adolescent and other males who desire to experiment for fun. Men Who Have Sex with Men (MSM) are a unique group of people who live in a world of utopia. They feel and believe they will face hardships in society once their identity is disclosed but this does not deter them from dressing and behaving like the opposite sex in public life or fighting for their rights. Not to forget they are humans, many a times they are taunted by common man in the street. The more they are treated like social outcaste, the more they will try to conceal their feelings and perception, the net result this population will remain on the fringes of the society. Ultimately, they will remain unaware about them being a very high risk vulnerable group in the recent upsurge in HIV/AIDS transmission and their ignorance will help in spreading of the disease further in the community. No wonder, the inner conflicts in a MSM grows day by day and it takes a toll on their social life and hurts their mind. As a result, psychiatric morbidities like depression, anxiety, psychotic disorders and even suicidal tendencies are common in this group. With this in backdrop, the researchers decided to conduct a study in a MSM clinic of central Kolkata. The clinic is run under the auspices of an NGO, Manas Bangla, which provides care and treatment to the MSM in eastern India especially West Bengal.