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अत-ranGi (Unique)

Prologue:
They both were working as young barbers during their adolescence when they fell in love. Danish worked in a saloon adjacent to Narender. Danish (Kothi) was 16 years old and Narender (Panthi) was a bit older (18 years) than Danish. As love took over, so did physical intimacy between the two boys. One day as they were watching television together, it happened that Danish explored his feminine side through Narender’s embrace. They soon got married in a temple and Danish moved to Narender’s house as his bride following the hetero-normative societal norms although they were both young men. Danish took over the role of a perfect bride and was also liked by his mother-in-law.

As they grew up, the nuances of social expectations set in. Narender gave in to following the expected social behaviour and got married to a woman. He identifies himself now as a married heterosexual male. His same-sex relationship with Danish gradually dwindled. Danish was taken aback and he too got married to a girl at the age of 22 years but  soon got divorced from his wife. Danish remarried to another woman and has a 3 year old baby. With growing dis-satisfaction in their marriages, both Narender and Danish came together once again. In this story, both Danish, Narender and Danish’s second wife are currently HIV positive. Both Danish and Narender are now married bisexuals and double deckers.

Role of TI NGO in the case-story:
This case has been closely followed by the TI NGO and almost all six components of Targeted Intervention have been effectively covered:Condom promotion, STI management, Enabling Environment, Behaviour Change Communication, Community Mobilization, Referral and Linkage.

The TI established contact with Danish a year back. He was 32 years old and married. The TI services were introduced to him and basic counselling was provided. Screening tests for HIV and Syphilis was done. Narender reported reactive for HIV test. He was brought to drop in centrefor support. Post test counselling was done by the TI counsellor and partner notification was suggested. ORW escorted Narender to ICTC for confirmatory test, and he was confirmed to be HIV positive. Further counselling services at ICTC centre was provided and he was referred/linked to ART centre.

Partner notification and management by the TI had brought to light that along with Danish, his wife and male partner (Narender) were also HIV positive. On counselling it was found that Danish’s wife also had more sexual partners in her hometown and she used to frequently visit her home while being married to Danish. She was also found to be pregnant and tested reactive for syphilis (VDRL). Appropriate services were provided and she was linked to PPTCT. Her newborn baby is HIV negative.

All of them were counselled to take ART however; the trio initially resisted and instead insisted on treatment by a local Godman who is known to cure HIV. ART was not initiated for quite sometime. However, the ORW and Counsellor’s persistent follow up of the trio with situation specific behaviour change counselling finally convinced them to start ART. “Aap devta ke pass jao, lekin medicine bhi lena zaroori hain. Kyonki ye bimaari lakdi mein dimak jaise lag jaye, aisi bimaari hain”(You may go to a Godman if you choose to, but it is also important that you take the medicines).

Both these men are followed up and their adherence to ART is checked. CD4 and Viral Load statuses have slowly bettered than initial. They are frequent members of the DIC and actively participate in supporting the TI NGO’s activities.

Pehle office aane se darta tha, abhi bakayda 4-5 auroko le aatahoon. Saloon mein koi bhi kothi ya double decker ho, le aata hoon”

(Earlier I was scared to visit the office, but now I make sure I get 4-5 more men along with me. If I find any any kothi or double decker in the saloon, I get them along with me)

 – Danish

This is blog is written by theTechnical Support Unit which is being supported by PHFI.

Public Health Foundation of India (PHFI) with support of the National AIDS Control Organization (NACO) is implementing the Technical Support Units (TSUs) in five states of the country namely Jharkhand, Gujarat, Rajasthan, Uttarakhand and Uttar Pradesh since September 2018. The TSUs provide technical assistance to the state HIV/AIDS program to ensure they meet their HIV prevention, care, support and treatment deliverables.