Authors: Shiva S. Halli, Shajy Isac, Parinita Bhattacharjee, Sumit Dutta, B. M. Ramesh, Robert Lorway, James Blanchard
It is argued that Indian gender minorities displayed differential mental health problems and suicide attempts. Hence, the study was intended to understand the prevalence of anxiety, depression and suicidality among this group, specifically those living in a metropolitan city in South India.
The data was generated from a cross-sectional study that employed a structured questionnaire to collect information about experiences of anxiety, depression and suicidal behavior among gender-diverse individuals in Bangalore, the capital city of Karnataka state. The study used stratified simple random sampling of eligible individuals who were 18 years of age and older and who were enrolled in an HIV prevention program implemented for gender-diverse individuals run by the Karnataka Health Promotion Trust and the University of Manitoba at the time of the study (2012). Bivariate and multivariate analyses were used to assess the relative contribution of various factors that affect suicide ideation or actual attempts among the gender diverse participants.
Results showed that 62% whose main source of income was Basti (socially sanctioned practice of begging), 52% of Hijras, 56% who lived with their Gurus, 58% who were not happy with their physical appearance, 55% who consumed alcohol daily, and 63% who experienced high depression had ever thought of or attempted suicide in the month prior to the survey. However, multivariate analysis showed that respondents who were not happy with their physical appearance and thought of changing it had significantly higher odds (AOR = 2.861; CI 1.468,5.576; p = 0.002) of either having thoughts that it was better being dead or wished they died. Similarly, those who experienced high depression, their odds of either having had thoughts of or having attempted suicide increased by three times (AOR = 3.997; CI 1.976, 8.071; p < 0.000).
It is observed that a high percentage of gender minorities had attempted suicide or thought of suicide during the month preceding the data collection. The findings bring new insights on the proximate determinant of physical appearance on the suicidality of gender minorities assigned male at birth and appropriate to account for this while addressing the mental health issues.
Citation: Halli, S.S., Isac, S., Bhattacharjee, P. et al. Suicidality among gender minorities in Karnataka, South India. BMC Psychiatry 21, 25 (2021). https://doi.org/10.1186/s12888-021-03043-2
With the evolution of sex work patterns, newer physical places like Spas and Massage Parlours are emerging as new venues for sex work. The traditional peer-educator based Targeted Interventions reach out to the Key Population at geographical hotspots. However, these new venues are often unreached. DL TSU, in collaboration with DSACS, identified this implementation gap and supported DSACS to design this intervention to reach out and provide HIV services to the FSWs and MSMs who engage in sex work through Spas and Massage Parlours in Delhi.
The expansion of mobile technology and use of mobile phones have led to changes in the patterns of sex work solicitation among female sex workers (FSWs). FSWs have also increased their dependence on mediators termed ‘Network Operators’ (NWOs) for client solicitation. This Implementation Brief describes the NWO approach that the Targeted Interventions in Delhi adopted in order to reach out and facilitate linkage to HIV services for this hidden FSW population. The DL TSU technically supported the DSACS to design, train implementers and evaluate this strategy.
Virtual Interventions are a promising innovation to reach out and link MSMs who operate via virtual platforms to HIV services. The DL TSU supported the DSACS to implement virtual interventions for MSM using the Map, Adapt, Digitize and Evaluate (MADE model). This note describes the detailed implementation process of the MADE Model of implementation in Delhi.