Asia

Community-led efforts to reduce HIV-related stigma and discrimination can achieve a great deal with relatively small investments, according to a new report by the International Center for Research on Women (ICRW) and the World Bank.

The report, “Tackling HIV-Related Stigma and Discrimination in South Asia,” synthesizes lessons from a World Bank regional competition to find innovative, grassroots programs that reduce stigma and discrimination. The grants program totaled $1 million and funded 26 projects in Afghanistan, Bangladesh, India, Nepal, Pakistan and Sri Lanka; the maximum grant size was $40,000. ICRW’s team of experts collaborated with grantees to design and evaluate the programs, and analyze their outcomes.

Grantees embraced many approaches to address stigma, ranging from training for radio journalists to food and catering services for people living with HIV. Each effort was led by or engaged key populations at risk, including sex workers, injecting drug users, men who have sex with men and transgender communities. In South Asia, the prevalence of HIV is low overall but the epidemic is growing among high-risk groups, partly due to the failure to respond to HIV stigma and discrimination.

One intervention, Project Baduku in Bangalore, India, led a series of more than 200 campaigns to sensitize the public about the issues female sex workers and people living with HIV face and to encourage change in societal attitudes and biases. As a result, sex workers living with HIV reported that they felt more confident after participating in the campaigns.

 “Being a part of Project Baduku gave me the mental stamina I needed to resist stigma and discrimination and deal with my disease,” one woman said. “It made me strong. When you are better mentally, you are better physically.” Additionally, the percentage of sex workers living with HIV who regularly sought care and treatment at antiretroviral therapy centers increased from 30 percent before the project to 60 percent after.

“These results suggest that minimal investments in stigma reduction can maximize investments in HIV prevention, treatment and care,” said Anne Stangl, behavioral scientist and stigma specialist at ICRW and lead author of the report. “This report provides lessons for AIDS funders and community groups to replicate and scale up similar initiatives.”

Sandy Won is ICRW's strategic communications manager.

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ICRW program gives young Indian man the confidence to speak up about violence against women.

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MUMBAI, India – On a sweltering Saturday in the Shivaji Nagar slum, women in jewel-toned saris squat in the narrow entrances of their homes, washing clothes between their feet. Others bend to place dal papads – a type of flatbread – on baskets to dry in the sun. Meanwhile, countless children run barefoot, their playful giggles filling the humid air.

The children’s melodies mix with the noise of blowing aluminum strips that hang above some of the community’s skinny walkways. The strips are leftover decorations from Eid, a Muslim celebration. When an occasional breeze hits them, they produce a symphony of sound, much like a rainstorm on a tin roof.

One of the walkways here leads to 20-year-old Rajesh Jadhav’s house. A plaque on his family’s front door reading “God Bless Our Home,” greets guests, as does a handshake from Rajesh. The cane stalk-thin young man with soft eyes and a wide smile is part of the International Center for Research on Women’s (ICRW) “Parivartan” program.

As he settles in a chair inside the small square space that he, his parents and his younger brother share, Rajesh describes how certain interactions he observed between boys and girls stung him inside. How they made him feel helpless.

Like that one time on the train.

As is custom, Rajesh explains that women stood in a compartment relegated for them. But the train was packed on this day, so some women were in the general area, alongside men. That’s when Rajesh saw a few men deliberately brush up against women. His eyes caught the pained looks on women’s faces.

Another time – actually, many other times – Rajesh says he was with friends when they harassed girls with lewd comments. He says he’s seen friends do so if they thought a girl was too tall. If they thought her skin was too dark. If she was with her boyfriend, they’d comment about what she did with him sexually.

In India, such behavior by Rajesh’s friends is called “eve teasing.” It runs the gamut, from making suggestive remarks to groping women, and is relatively common in public settings.

“I always used to feel … that we look at women and girls from a narrow perspective, and we make fun of their existence,” says Rajesh, who is pursing a bachelor’s degree in commerce at a nearby college – a rare opportunity in his community. “I’ve seen girls break down and cry and I couldn’t do anything.”

Until now.

These days, Rajesh has the confidence to speak out against mistreating women and girls. Sometimes, he even intervenes to stop it. He admits to being pressured to harass girls, too – and has in the past – but no more. “I know now that is harming someone’s dignity.”

As a participant in ICRW’s Parivartan program, Rajesh has become an ambassador of sorts, preaching to his peers that women shouldn’t be controlled, and that men need to learn how to handle problems without using violence.

Parivartan – which means “change for the better” – helps boys and young men see women and girls as equals, and treat them respectfully. The program attracts participants through the popular sport of cricket. It challenges them to question traditional beliefs around manhood – for instance, that men don’t do housework and they never cry – as well as notions about women’s roles in society.

Rajesh serves as a Parivartan mentor to a cricket team of 10- to 16-year-olds called the New Generation Sports Club. Like Rajesh, the young athletes hail from Shivaji Nagar, which has some 600,000 residents, most of them Muslim.

Through a series of workshops, Rajesh is learning how to pass on the messages of Parivartan to young cricketers. A set of 12 training cards offers some guidance. Each card addresses a certain subject, provides sample language to spur a discussion, questions for players and guidance on how to wrap up discussions. The cards explore topics such as the affects of using insulting language, social expectations for men and the harm men can cause by bragging about their sexual relationships with women.

Rajesh has started talking to his athletes about some of the program’s principles. He thinks it’s making a difference – evident, Rajesh says, by how his team behaved during a recent cricket tournament sponsored by Apnalaya, an organization that partners with ICRW on Parivartan.

“None of my boys uttered a bad word during the match,” Rajesh beams. “I’m so proud to be there to see some changes in them.”

They’re not the only ones experiencing a transformation.

Before Parivartan, Rajesh seldom helped around the house and didn’t listen to anyone, says his mother, Shanta, as she sits on the floor of their home where framed pictures of Jesus and Mary hang. “I can’t tell you how much he’s improved,” she says. “Now he tries to listen, tries to understand and resolve the situation in a much more peaceful way.”

“He’s has become more loving and caring.”

Rajesh’s 17-year-old brother, Rahul, agrees. He says they’re much closer now. They talk more. “He’s become more respectful,” Rahul says. “I want to be like him.”

Rajesh says he feels he now has a role to play in his community, particularly as it relates to preventing violence against women. He feels a responsibility to talk to his friends about how they treat and view women, even if much of what he says may go against what is socially expected of Indian men.

“It will be a struggle,” Rajesh says. “But I believe there will be a break in it, and my friends will come to understand me and why I respect girls and women.”

“I have a strong feeling,” he says, “that I can change them.”

Gillian Gaynair is ICRW's writer/editor.