Violence Report Final2_AP Alliance

Acronyms
AAA Alliance for AIDS Action
ANM Auxiliary Nurse Midwife
AIAP Alliance India Andhra Pradesh Office
AIDS Acquired Immune Deficiency Syndrome
BMGF Bill & Melinda Gates Foundation
CAG Core Advocacy Group
CBO Community Based Organization
CERA Centre For Rural Action
CERDS Chaitanya Educational and Rural Development Society
CRT Crisis Response Team
FGD Focus Group Discussion
FHI Family Health International
FIR First Information Report
FSW Female Sex Workers
HB Home Based
HIV Human Immune Deficiency Virus
IDI In-Depth Interviews
IHAA International HIV/AIDS Alliance
iNGO Implementing Non Governmental Organization
MIS Management Information System
MSM Men having Sex with Men
NGO Non Governmental Organization
ORW Out Reach Worker
PE Peer Educators
RAT Rapid Action Team
SB Street Based
SYO Sarvodaya Youth Organization
S&D Stigma and Discrimination
STI Sexually Transmitted Infections

CONTENTS
EXECUTIVE SUMMARY
BACK GROUND
2-4
RESEARCH OBJECTIVES
5
METHODOLOGY
6-13
RESULTS
14-33
CONCLUSION AND RECOMMENDATION
34-35
ANNEXURE

Executive Summary
Back Ground
Alliance India is part of the International Secretariat of International HIV/AIDS
Alliance. Set up in 1999, Alliance India office aims at expanding and intensifying
International HIV/AIDS Alliance global strategy of supporting community action to
reduce the spread of the HIV and mitigate harm of AIDS. The Alliance existence in
India comprises five linking organizations. Alliance for AIDS Action (AAA) (Andhra
Pradesh) is one of the linking organizations. AAA implemented Avahan programme
in 14 districts of Telangana and Rayalaseema regions. The programme is managed
in partnerships with 36 iNGOs in 140 sites across14 districts.
Research Objectives
The objectives of the research study are:
 To identify and assess the various forms of violence on the lives of the FSWs
and MSMs in the project and non project districts
a. Who are the culprits
b. Do they live with violence and harassment or it happens
occasionally
c. How is harassment different from violence
d. What are the various types of violence
e. Is there any difference of degree in project areas/non project areas
 To identify the “Triggering Factors” of the violence
a. What irks the partner and makes him react violently
 To assess the types, utility and effectiveness of violence response
mechanisms currently in practice in both project and non project districts.
a. How violence is being tackled by the community
b. How well placed is the response mechanism
c. Response time
d. Has the mechanism mitigated violence and harm
 To document the lessons emerging from the above and measures for
sustainability.

Research Technique
To understand the violence faced by FSW and MSM and their vulnerability to
HIV/AIDS a qualitative research technique was considered appropriate. The
information was collated extensively and exclusively through Focus Groups
Discussions (FGDs) and In-Depth Interviews (IDIs).
The information on violence and vulnerability to HIV was gathered from community
members. These included:
 Female Sex Workers
 Men who have sex with Men
 Out Reach Workers
 Peer Educators
 Project Staff ofi NGO
Sampling Frame
Sampling Technique:
Selection of Districts
A multistage sampling frame was adopted to reach the target groups. The selection
of the districts and the iNGOs therein is based on a criterion i.e.
The criterion:
Criteria I: Districts with high FSW population and low MSM population
Criteria II: Districts with high MSM population and low FSW population
The criterion aimed to represent and reflect the disparities within the two regions.
Districts and the iNGOs were purposively sampled based on the criterion and target
respondents, within each of the iNGO served areas were selected at random.
Selection of iNGOs
Purposive based on the sampling criterion and also to get representation of old and
new iNGOs,

Selection of Target Respondents
Target respondents were selected randomly and those who gave their oral consent
were taken as participants.
Sample Size
In all 319 FSWs and MSMs participated in the study through 32 FGDs and 97 IDIs .
Findings
Profile : Study population
Typology of the Study participants: FSW
A total of 263 FSWs participated in the study. Of them 53 percent are home based
(140/263). Street based are 37 percent (89/263). Remaining 10 percent (34/263)
are brothel based.
Typology of the Study participants: MSM
MSM comprised 18 percent (56/319; 263+56) of the total study participants. Majority
82 percent (46/56) are “KOTHI”.
Community and Violence
Incidence of Violence
About two-fifths of the home based and street based FSW informed facing violence
from non-regular partners, harassment is more by the family members. Importantly,
most of the brothel based workers informed facing only harassment from the
partners.
A total of 208 FSWs (121 home based and 87 street based FSW) informed Slapping
as the commonest form of violence. This is more common in Telangana vis-à-vis
Rayalaseema. In Rayalaseema, majority (53/89) of the street and brothel based
FSWs informed snatching away of money and non-payment post sex as very
common form of violence. MSMs in both the regions informed snatching away of
money and other belongings and torturing body with lighted cigarette stubs as the
common forms violence faced by them.

Types of Violence
Slapping “is the commonest violent act reported by both home based and street
based sex workers. Other acts termed as violence or harassments are mentioned
below.
Acts termed as Violence: FSW
 Beating/Slapping
 Biting
 Taking/Snatching away Money
 Tearing Clothes
 Non-payment post sex
 Pinching
 Torturing with lighted cigarette stubs
Acts termed as Violence: MSM
 Beating/Beating with Sticks
 Torturing with lighted cigarette
 Hurling Stones
 Blackmailing
 Verbal Abuses
Acted termed as Harassment: FSW and MSM
 Threatening
 Demanding Free Sex
 Verbal Abuse
 Ill-treating children ( FSW)
 Arrest / Lock up with out reason
Violence: Culprits
In both Telangana and Rayalaseema, almost all the home based FSWs informed
family members as the perpetrators of violence against them. Street based face
violence from police personnel, while brothel based face harassment from police
personnel. This was reported from both the regions.
Interestingly FSWs, react differently to the acts committed by a regular partner from
that committed by a non-regular partner. The acts of violence committed by regular
partner are tolerated and not reported. While the acts of violence committed by a

non-regular partner are not tolerated and immediately reported to the community
members.
Brothels based sex workers experience less violence as against violence faced by
sex workers of other typologies. They face more harassment from police personnel.
Around 2 percent of female sex workers informed during discussion experiencing
both violence and harassment.
Almost all the “Kothi” informed experiencing violence and harassment. A few of the
Panthi participants identified themselves as perpetrators of violence and harassment.
Torturing partner with lighted cigarette stubs is most common form of violence
informed all the participants.
Auto drivers, were mentioned as major offenders by both FSWs and MSMs.
Triggering Factors of Violence
Chief Triggering factors: Regular/Non Regular Partners
 Refusal to unsafe sex
o Implications
 Non-payment post sex: When sex workers insist on condom
use, the client expects free sex. If the partner uses condom,
post sex no money is paid.
 Physical abuse: Most of the time a non-regular partner is
under inebriated state when he seeks sexual services, at such
times, if penetration without condom is refused and insistence
is on oral sex than client turns violent.
 Loss of maintenance allowance: “Kothi” receives
maintenance allowance from Panthi as “regular partner”,
however, insistence on safe sex has led to sharp rise in Panthi
withdrawing the maintenance paid.. This has resulted in loss of
this allowance. Withdrawal of maintenance allowance is also
reported by Home based FSWs however, there is no
retaliation as in case of MSMs.

 Refusal to use premises and loss of income: This is
particular to the brothel based FSWs. Most of them
mention if acquaintance of the police personnel or “special
clients are not entertained without condoms then “aunty”
(pimp) refuses the premises to be used for the services to be
provided by the FSW which means loss of income, while the
police threaten to arrests.
 Other Triggering Factors : Regular Partners ( Home, Street and
brothel)
 Taking calls of other clients/ Talking in hushed voice over
the phone: As these acts are discreet, taking calls of other
clients in the presence over the phone; leads to suspicion.
ORWs do not come and attend meetings organized by the
iNGOs , if there regular partner is at home./ in town
 Comes to know of sex worker status (Home and Street
based): As mentioned, as these acts are discreet, if the
partners come to know of the status, it leads to violence.
 Group Sex without consent
Very common amongst MSM, refusal to unsafe sex or free sex , often leads
to forceful group sex by Panthi’s.
Vulnerability to HIV/AIDS
The following reasons make them vulnerable to HIV:
a) Capacity to Negotiate for safe sex not uniform: Those who shared their
safe sex negotiating skills, most of them are ORWs and PEs. However,
many others participants were uncomfortable and avoided any discussion on
condoms, there by casting doubts over the safe sex negotiating capacity.
Few admitted giving into the client demands.
b) Economic considerations and fear of violence and harassments
preventing safe sex: Brothel based FSWs; informed pimp did not permit
condom usage. Interactions with pimp revealed, that each sex work is paid a
salary, insistence on use of condom is not economically viable, as it would
shoo away the client; secondly, any violence due to condom usage may invite

harassment from police personnel who are on look out demand for sexual
favours. A few home based and street based FSWs also admitted, they give
into client demands for non- usage of condom, if on the day of the establish
client the economic condition is bad.
c) Non-usage of condom with regular partner puts them at risk: All the
MSM and FSW mentioned not using condoms with the regular partner. For
both fear loss of maintenance allowance and also acts of violence by the
partners.
d) Bi-sexual puts partners at risk : MSMs, admitted dislike for condom use.
A participant identifying himself as bi-sexual informed that he does not allow
either of the partners to use condoms. There by putting lives of all at risk.
Mechanisms to address Violence:
a. Institutionalized Mechanisms and its Effectiveness:
Crisis Response Team (CRT)
 In Warangal still evolving, but community members nominated to respond to
crisis.
 In Khammam and Kadapa it is known as Core Advocacy Group (CAG),
registration of CBOs is in process, but CAG is operational.
 In Anantapur, it is known as Rapid Action Team ( RAT)
b. Other Mechanisms in Practice
No other mechanisms exist in any of the intervention and non-intervention sites. In
intervention areas, AAA- iNGOs bring together the community by way of meetings, it
gives them a platform to share and support, in non project sites this facility does not
exist.
Effectiveness and Utility of the CRT
The CRT is able to handle crisis. Help of iNGOs is being sought only when for case a
police complaint or FIR needs to be lodged or in case of medico-legal battles or for
settlement claims.

Intervention sites vis-à-vis Non-Intervention Sites
AAA-iNGOs have successfully brought around 70,000 key populations in their areas
of work together and mobilized them to form CBOs. In each of the iNGOs
intervention sites, CBO process initiation is in progress, but most impressive is its
effectiveness, regardless of the fact; it is yet to take full shape. CBOs which will
formally become part of the CAG, has presently, been able to amicably settle many
cases of violence and harassment, which hitherto required, support of the iNGOs.
In non-intervention sites, no such support system exists as a result; key population
faces violence and harassment from various stakeholders, few of the participants
from the non-intervention site informed, refusal to sex proves fatal, as there have
been instances where by key population has lost life.
Conclusion and Recommendations
Violence and harassment are wide speared and common. Crisis Response Team is
in place and proving effective. The retaliation by MSM is worrying. It can at any time
escalate into a major social issue and disturb the peace.
Recommendations
 Scaling up of the project to non- intervention sites: In the absence of
existence of any kind support, the non-intervention sites witness more
violence and harassment.
 Providing legal counseling: In the wake of retaliations by MSM’s it is
important to provide on the legal aspects, how and why not to take law into
hands.
 Enhancing capacities of CBOs for greater role in violence mitigation
All the acts violence should be brought to the notice of CBOs and through
them to iNGOs
 Increased Advocacy: No advocacy is taking place in Telangana region,
where as advocacy is intensive in Rayalasema. Where as advocacy needs
to be intensified at all levels across stakeholders.

A Study on Impact of Violence faced by FSW and MSM and their Vulnerability to HIV/AIDS
- Amoghah Research Study – 2009. 2
1Background
1.0 Alliance India
Alliance India is part of the International Secretariat of International HIV/AIDS
Alliance. Set up in 1999, Alliance India office aims at expanding and intensifying
International HIV/AIDS Alliance global strategy of supporting community action to
reduce the spread of the HIV and mitigate harm of AIDS.
The Delhi office serves as the national secretariat and works towards contributing to
national programmes by focusing on impact at state and district level, which further
contributes to universal access targets for specific groups at risk1
.
The Alliance existence in India comprises five linking organizations. Alliance for
AIDS Action (AAA) (Andhra Pradesh) is one of the linking organization. AAA
implemented Avahan programme in 14 districts of Telangana and Rayalaseema
regions. The programme is managed in partnerships with 36 iNGOs in 140 sites
across14 districts.
Alliance India in Andhra Pradesh is providing strategic and programmatic leadership
for the community of key population through creating enabling environment. The
programme covers over 70,000 key populations in 140 mandals 2
. The main
programmatic interventions include:3
 STI Treatment through Mythri Clinics: AIAP through these clinics achieves
the objectives of addressing the sexually transmitted infection, promoting safe
sex practices through counseling services; and imparting the knowledge to
identify and seek health care; and effective referrals for higher levels of health
care.
 Advocacy initiatives at various levels: Alliance designed and developed
with community participation a sustainable structure for advocacy. The
1
http://www.aidsalliance.org/linkingorganisationdetails.
2
India HIV/AIDS Alliance Research Brief
3
Information booklet “ Avahan” : AIAP.

AIAP Intervention Regions:
Telangana Rayalseema
Respect, Recognition
and Reliance are the
core values that
govern community –
centric approach
AIAP covers over
70,000 key populations
in 140 Mandals
community members are trained in practical advocacy to deal with various
stakeholders to address their issues.
 Promotion of condom usage: For
preventing spread of HIV/AIDS, Alliance is
marketing its own brand of Mythri Condom
for high-risk groups. Mythri brand has two
packs one pack with two pieces of condoms
and another pack with two pouches of lubricant which are water based. At
few intervention sites through social marketing it has launched Female
Condoms.
 BCC through Out Reach Workers (ORWs) and Peer Educators (PE):
Through outreach activities commodities like condoms, lubes and IEC
materials are supplied to the key communities. Information on the services
within and outside the project is also given
Figure 1
Community is nucleus of Avahan, and all
interventions revolve around it. Working with the
community, i.e. mobilizing and involving them at
every step is crucial principle and methodology of
Alliance.
Respect,
Recognition and
Reliance are the
core values that
rule the community
centric approach of
Avahan AP4
. These values helps a) build and own
mechanism and systems to sustain change; b) build
a greater understanding through the sharing and pooling of knowledge that
empowers community members and fosters solidarity ;c) facilitates changes in social
and community structures and norms in order to achieve equitable access to
information and services; and d) increases community members awareness of their
4
Information booklet “ Avahan” : AIAP.

right to basic social and economic services and can strengthen their ability to claim
these rights.
1.1 Research Hypothesis
This research study is based on the premise that the FSW and MSM face violence
from various stakeholders, through rights violation, physical and psychological
abuse, coercion, harassment, extortion and rape especially from partners, which
makes them vulnerable to being infected by HIV.
1.2 Purpose of Research
The purpose of the research is to study the violence faced by the FSW’s and MSM’s
and their vulnerability to HIV/AIDS. This research report is an attempt to understand
the types of violence faced by FSW and MSM how it makes them vulnerable to HIV.
It also describes the objectives of the research study, methodology adopted to
collate information, how the study sites were identified and reached. Preliminary
results, learning and suggests the future course of action,

2 Objectives
2.1 Specific Research Objectives
The objectives of the research study are:
1. To identify and assess the various forms of violence on the lives of the FSWs
and MSMs in the project and non project districts, i.e. to find out who are the
culprits, do they live with violence and harassment or it happens
occasionally; how is harassment different from violence; what are the various
types of violence ; Is there any difference of degree in project areas/non
project areas.
2. To identify the “Triggering Factors” of the violence i.e. what irks the partner
and makes him react violently.
3. To assess the types, utility and effectiveness of violence response
mechanisms currently in practice in both project and non project districts, i.e.
how violence is being tackled by the community; how well placed is the
response mechanism; response time; has the mechanism mitigated violence
and harm.
4. To document the lessons emerging from the above and measures for
sustainability.

3Methodology
3.1 Approach Followed
To understand the violence faced by FSW and MSM and their vulnerability to
HIV/AIDS a qualitative research technique was considered appropriate. The
information was collated extensively and exclusively through Focus Groups
Discussions (FGDs) and In-Depth Interviews (IDIs).
The information on violence and vulnerability to HIV was gathered from community
members. These included:
 Female Sex Workers
 Men who have sex with Men
 Out Reach Workers
 Peer Educators
 Project Staff of NGO
3.2 Sampling Frame
A multistage sampling frame was adopted to reach the target groups. The selection
of the districts and the NGOs therein is based on a criterion i.e.
The criterion:
Criteria I: Districts with high FSW population and low MSM population
Criteria II: Districts with high MSM population and low FSW population
The criterion aimed to represent and reflect the disparities within the two regions.
Districts and the NGOs were purposively sampled based on the criterion and target
respondents, within each of the NGO served areas were selected at random.
3.2.1 Identification and selection of the Study Districts
Study districts in Telangana and Rayalaseema regions were identified and selected
on the basis of the above – mentioned criteria. On that basis following four study
districts were identified and selected.

Telangana Region
 Khammam : Has most number of FSWs in the region
 Warangal : Has most number of MSMs in the region
Rayalaseema Region
 Anantapur : Has most number of FSWs in the region
 Kadapa : Has low MSM population in the region
.2. 2 Identification and selection of the iNGOs, Project Intervention and
Non Project Intervention sites
3.2.2.i Selection of iNGOs
In the region i.e. Telangana and Rayalaseema, AAA is working with 36 iNGOs all
these iNGOs are involved under Avahan. Around three–quarters of the iNGOs are
associates of India HIV/AIDS Alliance (IHAA) since 2004, while 13 iNGOs got linked
as recently as year. 20075
.
Within a district, iNGOs were identified and selected keeping in view the criteria
herein, another dimension i.e. old iNGO and new iNGO were also considered and
applied wherever, possible. Among the two new iNGOs in Warangal, SYO and
Pragathi, SYO was chosen as it had lower MSM population compared to Pragathi.
Jagruthi (Khammam) and CERA (Anantapur) and CERDS (Kadapa) were identified
from Telangana and Rayalaseema regions respectively. All the iNGOS were
selected purposively.
5
Based on AIAP data.

Table1a: Distribution of Key Population of iNGOs within identified and
Selected Districts of Telangana
Districts iNGOs Intervention Sites Distribution of Key Population
FSW MSM
Khammam
Jagruthi
Khammam 1369 1962
Yellandu 525 837
Thirumalayyapalem 159 0
Enkoor 168 0
Total 2221 2799
Secure Kothagudem 579 143
Palvancha 541 72
Bhadrachalam 141 130
Sarapaka 222 154
Dummugudem 194 82
Burgampad 249 12
Mulakpalle 195 3
Total 2121 596
Siri Aswapuram 185 61
Manuguru 261 145
Pinapaka 277 92
Total 723 298
Warangal
Mari Mahabubabad 583 600
Jangaon 640 496
Parakal 506 544
Warangal 0 1171
Bhopalapally 685 451
Kuravi 78 124
Total 2492 3386
Pragathi Kesamudram 287 256
Narasamet 267 229
Nekonda 263 279
Total 817 764
SYO Maripeda 263 173
Thorur 266 259
Wardhannapeta 260 263
Total 789 695
Source: India HIV/AiDS Alliance Data
3.2.2 .ii Selection of Project Intervention sites
In each of the selected iNGO, two intervention sites were selected on the basis of
afore-mentioned criteria.

Table1b: Distribution of Key Population of iNGOs within identified and
Selected Districts of Rayalaseema
Districts iNGOs Intervention Sites Distribution of Key Population
FSW MSM
Anantapur
CERA
Kalluru 172 142
Anantapur 719 590
Graladinne 193 0
Tadipatri 458 233
Peddavaduguru 359 50
Total 1901 1015
Chaitnaya Dhramavaram 844 354
Hindupur 1202 373
Total 2046 727
FORD Agali Mandal 264 303
Gudibanda 304 0
Rolla 313 0
Total 881 303
HANDS_ATP Gooty 741 138
Guntakal 1506 236
Total 2247 347
JJ Amadaguru 275 0
Gandlapenta 235 0
Kadiri 499 135
Nallamada 327 0
Talupula 292 0
Total 1628 135
KERDS Bukkapatnam 244 51
Penukonda 303 53
Roddam 442 59
Total 989 163
MEDS Beluguppa 463 130
Bommanamahal 287 164
Brahmasamudaram 331 189
D.hirehal 306 77
Gummagatta 182 133
Total 1569 693
RIDS Kambaduru 223 0
Kundurpi 288 0
Setturu 527 0
Total 1038 0
Kadapa
CERDS_KDP Proddutur 840 0
Mydukuru 267 0
PAID Kadapa 0 635
Rajampet 345 179
Total 1452 814
Source: India HIV/AiDS Alliance Data

3.2.2 .iii Selection of Non Project Intervention sites
In each of the selected iNGO, one non project intervention site was selected on the
basis of afore-mentioned criteria with the help of the iNGOs. (Table 2)
Table 2 Study sites in Telangana and Rayalaseema
Region Districts iNGOs Project Intervention sites Non project sites
Telangana Khammam Jagruthi Khammam, Yellandu Kharepalli
Warangal SYO Thorur, Maripeda Nallikuduru
Rayalaseema Anantapur CERA Anantapur,
Peddavaduguru
Bukkarayasamudram
Kadapa CERDS_KDP Proddutur, Mydukuru Jammalamadugu
Source: Primary Field Data
3.2.2.iv Sample Size
In each of the iNGO sites the number of FGDs and IDIs were planned in
proportionate to the population of the sample served.
Table 2: Sample Size Proposed
District Type of Site FGD IDIs
FSW MSM FSW MSM ORW NGO
Khammam Intervention(Jagruthi) 6 3 7 7 2 1
Non-Intervention 2 1 2 1 - -
Warangal Intervention (SYO) 3 2 2 2 2 1
Non-Intervention 1 1 1 1 - 1
Telangana Total 12 7 12 11 4 2
Anantapur Intervention (CERA) 6 3 4 4 2 1
Non-Intervention 1 1 2 1 - -
Kadapa Intervention
CERDS_KDP
5 - 5 - 2 1
Non Intervention 1 - 4 - - -
Rayalaseema Total 13 4 15 5 4 2
Source : Worked out based on the Data provided by AIAP

Table3: Sample size achieved Number and Participants
Districts iNGOS FGDs** IDIs*
FSW MSM FSW MSM
OR
W
NGO
No. Participants No. Participants
Khamma
m
Intervention
(Jagaruthi)
4 6 *4 =24 1 6*1= 6
11 13 2 1
Non Intervention 1 6*1= 6 - - 1 1 - -
Warangal Intervention
(SYO)
7 8*7 = 56 1 6*1= 6 4 6 1 1
Non Intervention - - - - 3 - - -
Telangana Total 12 86 2 12 19 20 3 2
Anantapur Intervention
(CERA)
6 6*6 = 36 3 6*3= 18 18 5 3 1
Non-Intervention 1 1*6 = 6 - - 2 1
Kadapa CERDS_KDP 7 7*8= 56 - - 30 - 2 1
Non- Intervention 1 1*8 = 8 - - 2 - - -
Rayalseema Total 15 106 3 18 52 6 5 4
Total
(Telangana+Rayalaseema) 27 192 5 30 71 26 8 6
*20 IDIs were incomplete as participants left in between and they have not been
taken account.
**In each FGD more than 10 participants came, only those who did not leave the
group even once, were considered as participants.
Table 4: Typology wise sample Size achieved FGDs and IDIs
FSW MSM
HB SB Brothel Total Kothi Panthi TG Mixed* Total
FGDs 15 9 3 27 2 1 - 2 5
IDIs 28 35 8 71 16 8 2 - 26
*Participants included both Kothi, and Panthi

3.3 Interview Guides
Information on violence faced by the key population was gathered with the help of
moderation guides. The moderation guides (Annexure A) were designed to get
information on the objectives listed out under section 2.2 of this report. The
moderation guides developed served as check-list for the FGD and IDIs. The
moderation guides were translated in Telugu prior to administration.
3.4 Data Collection Schedule
The data was collected from 5th November to 15th
November 2009. At each site 2
days of actual data collection and I reserve day was planned. The actual days
required on field was finalized in consultation with iNGOS. The research team was
trained by the principal investigator at Warangal on 4th
November. The training
focused on:
 Study background
 Objectives of the study
 Discussion on the Moderation Guides
3.5 Limitations
Sensitivity of the issue made setting up interaction sessions with the key population a
serious challenge. It is to the credit of the young researchers that they overcame all
the challenges posed and completed the task on time. The challenges faced by the
study team are listed below:
 At many places MSMs were not comfortable talking in the presence of female
investigators.
 MSMs were reluctant to participate in FGDs but were comfortable with one-
on-one IDIs, therefore, at all such places IDIs were conducted. It was vice-
versa with FSWs
 At two non-intervention study area participants and the study team were
dispersed by police who came on routine raids.
 After incidence of police raid, key population in non- intervention areas
refused to speak or give time to research team.
 Key population in Telangana region’s non intervention did not give permission
for face to face in person interview, but were willing to speak over the phone,
whoso ever agreed, with them telephonic interview was conducted.

 Many interviews and discussions were carried out at “HOTSPOTS” and late
in the evenings at intervention sites.
 Interactive sessions were frequently interrupted as the participants received
calls from clients.
 Participants gave very limited time for discussions, as they had to attend to
their customers.

4Findings
4.1 Understanding the community in the Regions
4.1 Spread of the Community
By the end of the Phase –I, Avahan had reached 72331(Telangana
35900+Rayalaseema 36431) community members. Female sex workers comprise
nearly seventy percent of the community (69 percent; 49733/72331).
4.1.1 Overall
In the interior districts served by India HIV/AIDS Alliance
under Avahan, the key population distribution is not
even, with in a region and district as well. In around 30
Avahan sites MSM do not exist, while only 7 sites do not
report of any FSW. There are high and low pockets of
FSW and MSM. The iNGOs selected for the study
together cover 75046
(5221FSW+2283 MSM) community members which is little over
ten percent of the total Avahan population. Of them more than half are from
Telangana region (55 percent; 4124/ 7504) the remaining from Rayalaseema. This
by no means reflects the reach. Evident difference of 10 percent coverage in
Rayalaseema is due to the non-existence of MSM population in areas served by
iNGO -CERDS_KDPS.
4.1.1,i Telangana Region
The region has a total of 35900 (FSW 23598+ MSM 12302) community members. A
shade under half (49.6 percent; 35900/72331) of the project7
population resides in
this region. Nearly a quarter (24.8 percent; 8906/35900) of the community
members, are from the Warangal district of the region. Followed by 19.1 percent
(6864/35900) and 16.06 percent (5767/35900) in Khammam and Medak
respectively.
6
based on the data of typology wise KP by iNGOs SYO, Jagaruthi, CERA and CERDS_KDP
7
Programme refers to “AVAHAN”.
65 percent of the
Female sex workers
are home based.
Kothi comprise 49
percent of the MSM.

Warangal with 40 percent; (4945/12302) of MSM population has the largest
concentration of MSMs in the region. The rest are spread over other districts of the
region, except Hyderabad which does not have MSM.
Similarly there are pockets of FSW populations in the region, however, when
compared with MSM concentric pockets, these are much smaller. Little over 21
percent (5065/12302) of the FSW are in Khammam, followed by 16.7percent
(3961/23598) in Warangal.
Within the selected iNGOs8
intervention sites, the spread of the population is more
uniform in SYO served areas vis-à-vis Jagruthi areas. In iNGO Jagruthi areas,
majority of the community members are in Khammam and Yellandu. (Table 1a)
Non Project Intervention Sites: Nallikuduru and Kharepalli
Discussion with the iNGOs personnel revealed existence of large number of key
populations at these non-intervention sites; however, the exact figures were not
available. During discussion with a FSW at Nallikuduru, it came to light the large
number of FSWs do not reside in the village due to stigma; but visit the village to
meet the client and provide services to them. Thereafter, they go back to their
respective villages. Nallikuduru is more of a meeting point.
4.1.1. ii Rayalaseema Region
This region has a total of 36431 (FSW 26135+ MSM 10296) community members.
Little over half (50.3 percent; 36431/72331) of the project9
population resides in this
region. Over two-fifths (41.7 percent; 15208/36431) of the community members are
in Anantapur district of the region. Followed by 31.1 percent (11348/36431) and
20.89 percent (7609/36431) in Chittoor and Kurnool respectively.
As against Telangana region MSM population is more uniformly spread in
Rayalaseema. Highest percentage i.e.34.1percent (3516/10296) in Chittoor, followed
by 30 percent (3107/ 10296) in Anantapur, and 27.7 percent (2859/10296) in Kurnool
districts of the region.
8
iNGO sites herein refers to the intervention study sites as mentioned in table 3
9
Programme refers to “AVAHAN”.

The FSW population is concentrated in Anantapur district where in resides 46
percent (12101/26135) of the region’s FSW population. Chittoor district with 29.9
percent (7832/26135) is the next concentric FSW pocket.
Within the selected iNGOs intervention sites, MSM population is present in CERA
served areas, whereas, in CERDS sites only FSW are present. (Table 1b).
Non Project Intervention Sites: Bukkarayasamudram and Jammalamadugu
Discussion with the iNGOs personnel revealed existence of large number of key
populations at the non-intervention sites; however, the exact figures were not
available.
4.2 Profile of the Community
Typology: Female Sex Worker (FSW)
Overall
Home based female sex workers and Kothi are the majority community under the
programme. 10
Lodged based sex workers and transgender consist of 1 and 2
percent respectively of the key population. In Rayalaseema, almost three-fourths
(74 percent;1819/2469) of the female sex workers are home based vis-à-vis
Telangana where in around two-fifths of female sex workers are street based (44
percent;1217/2752) and home based (42 percent; 1151/2752). Around 30 percent
(390/1304) of female sex workers are brothel based in iNGO-CER.A areas.
4.2.1.i Telangana Region
In the region 2286 (iNGO Jagruthi 1894+iNGO SYO 392) are FSWs. Like the spread
of the population, the typology in the study sites is lopsided. Almost 60 percent
(1365/2286) of the FSW are street based. Nearly one-third (32.1 percent; 735/2286)
are home based. Brothel and Lodged base comprise less than 5 percent of the
population in the study areas. In iNGO Jagruthi area 62 percent (1183/1894) of the
10
based on India HIV/AIDS Alliance –Andhra Pradesh Office District wise working population
September 2009 Data

FSW’s are street based. Where as in SYO areas equal percentage of FSW’s
operate from home and street.
4.2.1.ii Rayalaseema Region
iNGOs CERA and CERDS_KDP together are serving a population of 2185 FSWs .
Majority (71.6 percent; 1566/2185) FSW are home based. More than half (58.5
percent; 631/1078) in Anantapur and 84.5 percent in Kadapa are home based
FSWs’. A sizeable percent (35.1 percent; 378/1078) of FSW’s in Anantapur are
brothel based. Interestingly, in Telangana region against less than 5 percent FSWs
are brothel based.
Figure 2: Typology Based Distribution of Female Sex Worker
Source: India HIV/AIDS-AIAP data
7 percent of the
Female sex workers
in Khammam and 35
percent of Female sex
workers in Anantapur
are brothel based.
0
10
20
30
40
50
60
70
80
90
Street Home Brothel Lodge
46.4 46.1
0
7.3
62.4
29.2
6
2.2
5.8
58.5
35
0.6
12.2
84.5
0.7 2.6
%
Type:FSW
SYO Jagruthi CERA CERDS_KDP

4.2.1 iii Typology of the Study participants : FSW
A total of 263 FSWs participated in the study. Of them 53 percent are home based
(140/263). Street based are 37 percent (89/263). Remaining 10 percent (34/263)
are brothel based. (Table 6)
Table 5: Typology wise Distribution of number of participants
FSW MSM
iNGO HB SB Brothel Total Kothi Panthi DD TG Total
Warangal 63 0 0 63 12 0 0 0 12
Khammam 26 8 8 42 16 1 0 3 20
Anantapur 25 19 18 62 18 6 0 0 24
Kadapa 26 70 0 96 - - - - -
140 97 26 263 46 7 - 3 56
4.2.2 Typology: Men who have sex with Men (MSM)
Overall, little less than half (49 percent; 11147/72331) of the MSM population in
interior districts of Avahan are “KOTHI”. The spread of MSM is more uneven than
FSW. Amongst the two regions i.e. Telangana and Rayalseema, in about 30 percent
of Rayalseema sites vis-à-vis in only13 percent of sites in Telangana MSM do not
exists
Over two- fifths (45 percent; 1021/2239) of the MSM contacted for the study are in
Anantapur. Interestingly, bi-sexual comprises a quarter (25 percent; 576/2239) of
the study population. In the study areas, Anantapur has highest percentage of bi-
sexual, they consists of 59 percent of the bi-sexual population included in the study.
4.2.2.i Telangana Region
In this study region there are 1599 MSMs’, Out of them ‘KOTHI’ comprise 46
percent of the population (742/1599). Within iNGO districts, in SYO served areas
48.3 percent (336/695) are ‘KOTHI”. In Jagruthi 26 percent are ‘Panthi and Bi-
sexual.

4.2.2.ii Rayalaseema Region
In this study region there are 640 MSMs’, Out of them ‘KOTHI’ comprise 43.5
percent of the population (279/640) and 45.9 percent (294/640) are Bi-sexual. Within
iNGO districts, there are no MSMs in CERDS served areas.
Table 6: Typology Based Distribution of Men Who Have Sex with Men
District iNGO Kothi Panthi Double
Decker
Transgender Total
Warangal SYO 48.3(336) 45.8(219) 5.7(40) (0) 695
Khammam Jagaruthi 44.9(406) 26.3(238) 26.7(242) 1.9(18) 904
Anantapur CERA 43.5(279) 10.4(67) 45.9(294) 0(0) 640
Kadapa CERDS_KDP 0 (0) 0(0) (0) 0 (0) 0
Total 1021 624 576 18 2239
Source: India HIV/AIDS-AIAP data
4.2.2. iii Typology of the Study participants : MSM
MSM comprised 18 percent (56/319; 263+56) of the total study participants. Majority
82 percent (46/56) are “KOTHI”.
Source: Primary Field Survey N= 56
82%
13%
5%
Figure 3 :Distribution of Study participants: MSMs
Kothi Panthi TG

4.3 Community and Violence
4.3.1 i Various forms of violence
Overall
To identify and assess the various forms of violence it is necessary to understand the
distinction between violence and harassment. Dourjanyam as violence is termed in
Telugu was defined as “Sharirakam ga peedinchadamu (physical abuse). Himsa
or Harassment means “Manasikamu ga peedinchadamu”(Mental Torture)
Discussions with FSWs and MSMs at both intervention sites and non intervention
sites reveal that violence is experienced by each and every participant at some point
of time. .For all of them “Dourjanyam” (Violence) and Himsa (Harassment) every
day is common and acceptable.
Some of the participants
experience both harassment and
violence. Moreover, participants
at all sites were able to
distinguish between violence and
harassment. However, the
various forms of violence as
defined in PWDV act 2005, and
as understood especially by FSWs’ differ. Both FSWs’ and MSMs’ face violence;
significantly, retaliation is higher amongst MSMs’ vis-à-vis FSWs”.
4.3.1.ii FSWs and Violence : Typology based
FSWs’ understands violence as any form of physical abuse and harassment means
verbal abuses. Interestingly, they face and both violence and harassment everyday,
however, for them it is common and acceptable, one of the participants remarks
sums their attitude towards violence and harassment “Maa vrutti lo ivanni aoutune
untayi”(this common in/part of our profession). Interestingly, about two-fifth of
the home based and street based FSW informed facing violence from non-regular
partners, harassment is more by the family members. Importantly, most of the
brothel based workers informed facing only harassment from the partners.
Violence is termed as Dourjanyam
and is defined as “Sharirakam ga
peedinchadamu and Harassment
is termed as Himsa and is defined
as “Manasikamu ga
peedinchadamu”(Mental Torture).

Acts of violence acts such as: “Oka Debba Kottadamu” (Slapping), korkadamu
(biting); “Dabbu lagadamu (Snatching money and extortion), “Battalu
chimpadamu” (tearing of clothes) Sex chesi dabbu iyyaka podam (Non-payment
post sex), Gichadam (Pinching) Cigarette toh Vollu Kalchadm (Torturing with
burning cigarette stubs) are common and almost all the FSWs mentioned
experiencing them often.
Source : Primary Field Survey N= 263
Despite high incidence of violence faced by FSWS, the help of the community is
sought only in extreme situations i.e.
“Severely beaten” (Bagga Kotute). i.e
“Netira karadamu, leda telivi
tappipodamu” (When person bleeds
profusely or becomes unconscious),
However, they were quick to add such
incidents are rare.
0
20
40
60
80
100
120
140
HB SB Brothel
121
87
26
60
14
16
47
35
26
15
42
22
22
30
15
46
18
10
62
37
22
N
u
m
b
e
r
FSW Typology
Figure 4 : Acts of Violence : FSWs
Slapping Biting
Snatching Money Tearing of clothes
Nonpayment Post Sex Pinching
Torturing with lighted cigarette stubs
“Slapping” is the commonest
form of violence faced by Home
based and Street Based FSWs
and Torturing body with
lighted cigarette buds is
common form of violence faced
by “Kothi”.

“Slapping “is the commonest violent act reported by both home based and street
based sex workers. Interestingly FSWs, react differently to the acts committed by a
regular partner from that committed by a non-regular partner.
Violence committed by regular partner is mostly ignored, as it is viwed as differences
between couples, like any other couple. “ Inti lo mougudu Pelam lo ivanni
aatohne untayi” (Arguments and fights happen in every family), hence do not
report. This was corroborated by the iNGOs as well. However, violence committed
by non-regular partner is not tolerated and is immediately brought to the notice of the
community members.
Brothels based sex workers experience less violence as against violence faced by
sex workers of other typology. This is because of the security provided by the head ,
popularly known as “aunty” to female sex workers from violence “Oka saari na
pillanu yavarena ante leda kodate vadini nenu malla ra neeya nu” (Entry for
troubleshooters/makers is barred) informed brothel head at Khammam. A fact
confirmed by FSWs during group and one on one interviews
When asked to describe harassment, there was lot debate amongst the participants
on categorizing the acts as violence or harassment. Majority of participants identified
the acts “Bedharinchadam”(threatening), “Free sex adagadam”(Demanding free
Sex), Thittadamu (Verbal abuse), Pillalu nu school lo chulakanaga chustaru (Ill-
treating children in schools and else where) as harassment
Ill-treatment of children or rather discrimination against them is painful and
depressing “Maa Pillalu ku memu yemi chestamo teliyadu, yavarena me amma
pani yenti ani vallanu adiginappudu badha ga untudi” (when some one teases
our children or discriminates because we are sex workers it hurts) shared an FGD
participant in Anantapur.
Importantly, participants informed both extortion and snatching away of money is
common, when asked to elaborate to gain insights into the understanding of the
distinction between extortion and snatching a participant said “ikkada khaki dresslo
appudappudu vochi ma daggara nenchi dabbu adagadam jarugutundi, inka

Box 1
Violence is very dangerous .We (MSM)
face often. Police take away mobiles
and money whenever they cross us.
They also do not mind abusing “Lanja
Koduka”.
If a client is violent and we try to lodge a
complaint at police station, police
personnel pressurize for free sex.
road meeda vellutunte dabbu lagadamu jarugutundi.” (People in uniform extort
money at times, while some men snatch away money when we go out for work).
It is significant to note that all acts of violence at times invite retaliation. Interestingly,
there was lot of argument during the group discussions as to how one can retaliate
against regular partner “ Mogunni yela kottadamu” (You can’t hit husband) said
one , while other retorted “Vadu nalugu sarlu nannu maatalu ante, nenu kuda
rendu sarlu antanu.” (Once in a while, I also give back). However, at intervention
sites retaliation is common, and it happens against regular partner. Amongst FSWs
retaliation, is limited to verbal abuse only. Around 2 percent of female sex workers
informed during discussion experiencing both violence and harassment.
4.3.iii MSMs and Violence : Typology Based
Majority of MSMs cannot differentiate
violence and harassment. It came out
during interactions that violence and
harassment happens mostly at same
time. (Box 1).However, a few reported
“Kottadamu” (beating) Cigarette toh
Vollu Kalchadm (Torturing with burning
cigarette stubs), “Raallu Visaradamu”
(Hurling stones) and “Karratoh
Kottadamu”(hitting with sticks) as violence and “Blackmail cheyadamu
“(blackmailing), “Thittadamu” (Verbal abuses,) “Lock up lo pettadamu” (Detention
with out rhyme or reason) as harassment. Almost all the “Kothi” informed
experiencing violence and harassment. A few of the Panthi participants identified
themselves perpetrators of violence and harassment. Torturing partner with lighted
cigarette stubs is most common form of violence informed all the participants.

Table 7 : Violence faced by MSM
Type of Violence Kothi Panthi TG
Beating 7 4 1
Torturing with lighted cigarette 30 7 2
Hurling Stones 17 5 -
Blackmailing 10 6 -
Hitting with sticks 20 4 -
Verbal abuses 12 7 -
46 7 3
Source: Primary Field survey
4.3.2 Violence: The Culprits
Overall
Regular instances of violence and harassment, lead to an obvious question, who are
the perpetrators of violence and harassment? The culprits, during discussions
victims disclosed, include regular and non regular partners, police personnel, family
members and acquaintances.
Majority of the home based FSWs mentioned family members as the people
instigating violence. Violence by family members has come to light more in
Rayalaseema region vis-à-vis Telangana region.
Source: Primary Field Survey N=319
0
20
40
60
80
HB SB Brothel Kothi Panthi
10
70
2020
40 40
20
0
60 60
50
60
80
10
%
a
g
e
Typology
Figure 5: Violence and Harassment :
Culprits
Regular Non Regular Police Family Members
Home based FSWs face
violence from family
members. Street and
Brothel based and MSM
face violence and
harassment from police
personnel.

4.3.2.i Violence Culprits :Typology based
Family members are the perpetrators of violence and harassment against home
based female sex workers. Poor financial situations forces women to look for
substitute income more so,
when men go for work to
far away places and are
away from home for a long
time. 11
Men folk in the
family (father, brother or
brother-in-law) encourage
income substitution by
providing sexual services
and also seek sexual
favours. More often than not, such acts have approval of the female members of the
family. For female members also fear violence against them. (Box 3 ).
Brothel based Female sex workers, and MSMs face harassment from police
personnel. Who seek free sex, from them in lieu of protection and non- arrests.
4.3.2.ii Violence Culprits :Occupation based
Among MSMs, auto drivers were identified as the perpetrators of violence and
harassment. Discussions
revealed in both the regions
the community dreads auto
drivers. Although some of
them are community
members, yet they do not
hesitate indulging in violence
and harassing their own
community fellows. (Box 2
(a) and (b))
11
In Rayalaseema, men go to Middle East for work
Box 2 a
A tribal women (Lambadi) working as sex worker,.
known to oblige who so ever paid her more.
During Dasara festivities, her regular partner, not
finding her at home, started search operations. Her
body was fished out of the drain.
Enquiry by police led to the suspects: a group of auto
drivers. They had plotted her death as they were
unable to bear her repeated rejection to their sexual
advances.
Box 2 b
Most of the MSMs, informed reaching the client site
in an AUTO. Most of the MSMs have tied with AUTO
DRIVER to take them to client site regularly as it
helps in keeping secrecy. However, as discussion
revealed, many a times, AUTO DRIVERS turn out to
be a “PIMP” and on pretext of taking them to the client
site, takes them to secluded spot and forces them for
group sex. A few such incidents had come to light in
the recent months in both Telangana and
Rayalaseema

4.3.3 Violence: The triggering factors
Overall
4.3.3 i Condom use and violence
Sex workers, irrespective of the typology, see the insistence on use of condom, as
the chief triggering factor of violence. Avahan has raised the awareness levels for
safe sex and
alongside build the
capacity for
negotiating skills for
safe sex. The
impression one
gathered after month
long interaction ‘Say,
yes to safe sex”
At many sites,
participants were
amused as how they
initially treated
“Buddagulu”
condom as balloons
and gave it away to children. Giving a very animated display a participant said
“intaka mundu, condoms ni balloon laga oodhi, water posi danitho pillalu
aadukonevaru.” (It was used as water balloons by children). But not now, they know
the importance and hence buy it from market if, exhausted. “bayata Kottulo
kontamu”. (If exhausted with the supplies of condoms they buy from the market).
FSWs, prefer male condom over female condom, for it is free where as female
condom is to be purchased @ Rs 2 per pack. Female condom is used in an
emergency situation, when client refuses to use condom and insists on penetration.
At such time almost all the participants at all intervention areas informed using
female condom. (Box 3).
It is noteworthy, MSMs prefer condom supplied by iNGOs, than to buy from market
because it is more lubricated. “Samstha iche dantlo Nune untundi.” informed an
Box 3
Mustering courage, she said she shared, she was bold enough
to share her plight and that of many others like her ………..
Her husband, left for Dubai three years ago. She along her
kids lives with her parents-in-law.
Head of the family works as daily wage earner nearby and
income earned is insufficient for family of six
The onus of substituting family income lies on her. She started
working as FSW.
Ever since it has come to the knowledge of her father –in-law,
he has started demanding sexual favours, and her mother –in –
law approves of it. Refusal for such favours are always met
with rejoinders” Inti poru kosam” . “ inti izzat baita pettaku”
(For the honour of the family, satisfy family members)

MSM at Peddavaduguru. MSM and FSW at non – intervention sites also mentioned
buying condoms or collecting from iNGO run drop in centres.
The sharp increase in awareness about the diseases especially, the impact it has on
the social life, i.e. stigma and discrimination and subsequent economic implications
has resulted in enhanced
negotiating skills and
empowered them to “ SAY NO
TO UNSAFE SEX”.
The community has developed
the capability to negotiate.
Majority of the FSWs be it
Home-based or street based
have no “nonsense attitude
towards unsafe sex.” The
communication to the
prospective client as
mentioned by FSW is clear and
simple, “ Vaste ra leka pote
poh”(Get lost ! if you want to have sex without condoms);” Poh ra nuvvu kaka
pote unkodu” (No sex with out condoms, if you are not interested in sex with
condoms, there may be other clients who want safe sex). Even MSMs informed
refusing clients desirous of unsafe sex. An FGD a participant said “if I need money
on a day and client is not willing for safe sex, I tell him “Thodala madyaga sex
chestanu, back dvara sex cheyanu.” (Indulge only in foreplay, no penetration).
However, this awareness and knowledge, about HIV/AIDS is proving to be an
adversary. At all sites, FSW and MSM informed a regular partner turns violent, as
insistence of use irks him.
1: Chief Triggering Factor: Refusal to unsafe Sex
At all sites the fallout of refusal to unsafe sex as FSWs and MSMs informed are:
 Non –Payment post sex: When sex workers insist on condom use, the
client expects free sex. Cases of non-payment post sex are on increase.
Box 3
Negotiating for safe sex is not easy, informs FSW. I try all
methods, to ensure clients use condoms
“ Noti tho condom vestanu” (make him wear the condom,
indulging in oral sex), “Cheti tho rub chesi condom
thoduguthanu” ( indulge in foreplay and make client wear
the condom); “light off chesi thodugutanu.” (Make client
wear condom under dim lights or by switching off lights) If all
these methods fail, then she added further “ Paasu ki veli
vasta ani cheppi female condom pettukuni vastanu.” (I
excuse myself on the pretext of answering nature’s call, and
insert female condom). I never have sex without condoms
with non –regular customers.

Such cases and incidences are on rise was confirmed by member of
response team, “ nenu roju ki oka solve non payment case de solve
chestanu,” ( daily, solve at least one case of non –payment).
 Physical abuse : Most of the time a non-regular partner is under
inebriated state when he seeks sexual services, at such times, if
penetration without condom is refused and insistence is on oral sex than
client turns violent. Client abuses verbally and gets physical by slapping or
biting or tears away clothes or tortures body with lighted cigarette stubs
inform home based and street based female sex workers. Such incidences
have become a routine. A participant stated ,” Sara thagi vachinappudu
condom thodugu ko mante godava chestaru” (When Partner is under the
influence of liquor, and we insist on use of condom, partner turns violent);
 Refusal to use premises and loss of income: Most of the brothel based
mention refusal to entertain acquaintance of the police personnel or “special
clients without condoms is inviting trouble both from “aunty” (pimp) and the
police. Pimp refuses the premises to be used for the services to be
provided by the FSW which means loss of income, while the police threaten
to arrests.
 Loss of Maintenance allowance: This has come to light during discussion
with MSMs. “Kothi” received maintenance allowance from Panthi as “regular
partner”, however, insistence on safe sex has led to sharp rise in Panthi
withdrawing the maintenance paid. The resultant loss of this allowance, more
often than not leads to violence, as Kothi and Panthi retaliate to acts of
violence. Withdrawal of maintenance allowance is also reported by Home
based FSWs however, there is no retaliation as in case of MSMs.
 In eye of Suspicion of Regular Partners: The regular partner views use of
condom as a “breach of trust”, He almost always reacts with verbal abuses
“Lanja munda, neeku nenu tapinchi yavurena unnara” (Who else is your
partner) and gets physical)

 Other triggering factors: This is more with regular partners, when any of the
acts committed in their presence:
a) Taking calls from other client
b) Talking in hushed voice in “his” presence over the phone;
c) Refusal to entertain, even at mid night;
d) Comes to know of their identity as sex worker.
In fact, if the regular
partners are around
iNGOs informed, key
population do not
come and attend
meetings, leave
alone key population,
even ORW will give a
miss. (Box 4) As
key population hide
their status from their partners.
2. Group sex with out consent
Refusal to free sex or unsafe sex by an MSM many a times results in a forceful
group sex by the PANTHI especially if Kothi is in inebriated states.. Rejection
of group sex leads to violence by both parties. The participants informed ,
during violent acts, Kothi’s clothes are torn and he is beaten up.
4.3.3.ii Implications of Violence
Violence and Mental Torture
Discussions with the key population, especially FSWS at all sites revealed, that
they live under a constant fear, Most of them mentioned being blackmailed on
refusal to advances or favours, as sexual activity is discreet, family members
especially, children coming to know of it worries them more than anything else.
Box 4
This is an incident during data collection at SYO.
A FSW had agreed to take us to HOTSPOT and also
give interview. When the team reached next day, there
was no sight of her, as we waited tirelessly for her all
through after noon, We came to know of her inability to
make to the SYO office and lead us to HOTSPOT.
The reason, her husband (regular partner) had arrived at
night hence, she would not be coming. She is an ORW,
her husband is not aware of her activity.

MSMs mentioned living under the constant fear of running into police personnel and
spending time behind the lock up for any minor or trivial offence.
Discrimination and Violence
The key populations face discrimination from all quarters. Their presence in the
neighborhood is not
tolerated and which often
leads to violence as the
key population,
especially, MSM and
Transgender retaliate (
Box 5)
4.3.4 Violence: The
Crisis Response
Team
Overall
FSWs and MSMs often face violence and harassment. To mitigate the harm, Avahan
build the capacity of the community to help each other and stand united against
violence.. In Project intervention areas the crisis response teams active, useful and
effective.
4.3.5.i The Crisis Response Team: Type
Telangana region
iNGO : SYO site
The question, “have you heard of Crisis Response Team “drew blank faces. When
asked, do you seek any help in case of violence or harassment” the response was
near unanimous and chorus, giving out names of few people who rush to help. It
was understood: that CRT as “team” in its strictest sense is evolving and presently,
the iNGO has deputed few individuals who are the members of the groups who are
reaching out as soon as they get an SOS.
Box 5
This incidence happened in Khammam district,
wherein a transgender, was forced to vacate and
move out of the area, as the neighbourhood had
complaint their activities as nuisance to the police.
The police forced the TG to leave the locality.
The TG house is lying vacant as neighbourhood is not
allowing any one take it on rent nor is it allowing the
TG to sell off the property. The prospective buyers
are revealed the owners identity.

The iNGO staff requesting anonymity informed, we are in process of developing
CBOs. CRT which will be part of the Core Advocacy Group, will be in place as soon
as CBOs get registered , till then we have circulated the names of individuals to the
key population, who can be contacted in the case of emergency .
iNGO: Jagaruthi
In Khammam area CRT, is popular as Rapid Action Team and its response time is
quick and almost immediate, divulged the participants. The formal registration of the
CBOs is near completion and but it is already operational.
Rayalaseema
iNGO :CERA
The participants know about CRT. They informed, it is a team which solves problems
and its members are alert and eager to help. Here in, the CBOs though formed
recently have completed the process of registration and formed CAG. A lot of
advocacy work has already been undertaken.
iNGO : CERDS_KDP
The CRT is known here as part of Core Advocacy Group (CAG), like elsewhere it is
known to the community members as place to turn to incase of an emergency, The
CAG here has helped in solving 2-3 case.
4.3.5.ii The Crisis Response Team: Utility and effectiveness
Telangana Region
Despite the
absence of the
formal CRT, the
iNGOs individuals
ORWs/PE’s
entrusted with
responsibility of
responding to crisis
is quiet effective. At
all places
Box 6
Daughter of sex worker, a 14 year old girl was raped by forest guard
when she had gone to collect firewood. The rapists threaten the girl of
dire consequences, if she informed,
The victim developed fever and infection, doctors on examination
confirmed pregnancy. The issue came to the notice of iNGO recently,
Pregnancy has been terminated. iNGO has been successful in getting
rapist to admit crime and dole out compensation of Rs 20,000. So far
victim has received only Rs 5000. iNGO is still engaged in a legal
battle for the remaining amount.

participants expressed happiness over response to crisis. Be it harassment or
violence, support of the community members has given confidence. A participant
sharing her experience about Crisis Response Team, said , “I just happened to
mention my problem to my friend , she in turn informed Sanjay ( Name
Changed) I do not what Sanjay said to them, they never harassed me again”
Exhibiting new found confidence, FGD participants at Thorur informed “
Intakamundu memu Police ante Bayam, ippudu police ke antamu po raa nuvvu
yavaru”( Earlier we shivered at the sight of Police , not any more, we now challenge
him , you dare to harm us)
Rayalaseema Region
On receiving a call from the victim or in person complaint from the victim, the
response team tries to help out victim as soon as possible. Time taken to reach to
victim depends on the location of the victim.
Despite violence being common, very few incidences of violence and harassment
come to the notice of the iNGO partner. This is because the crisis response team is
able to handle majority of cases. Help of the iNGO is sought when Crisis response
team is unable to deal with the situation. The iNGO is at third level of violence
information flow system. INGO gets to know of only very serious violence cases.
(Box 6) During discussion it came to light the numbers of the CRT members are
displayed at drop-in-centres or one comes to know through word of mouth.
CRT in Non Intervention sites
At non-intervention sites Nallikuduru and Kharepalli (Telangana Region) and
Bukkarayasamudram and Jammalamadugu (Rayalaseema Region) No mechanisms
were found working in non- CRT sites At Naillikuduru, a FSW, got irked and lost
temper at SYO, out reach work for not extending support to their village. She was
overheard saying, during informal chat between them, “I have requested you many
times for organizing camp here, but you don’t listen.”

Figure 6 - Violence Information Flow
PROBLEM SOLVED
VICTIM INFORMS
FRIENDS
FRIENDS SENSTISIZE
CULPRIT
FRIENDS INFORM OTHER
MEMBERS
iNGO Reaches
out to the Victim
Members inform iNGO

Box 7
This happened during data collection at Maripeda.
(Warangal) A FSWs participating in the discussion
on the issue of condom usage sat through out the
discussion, without making any eye contact and was
very uncomfortable at the mention of word
CONDOM.
Though she informed, after lot of cajoling using
condoms. When asked whether there are condoms
in the room (place where group was conducted).
Without lifting her head she pointed in the direction
where the box was kept. Thus casting doubts on
her safe sex negotiating abilities.
4.3.5 Findings: Community and Vulnerability to HIV/AIDS
Community at both sites, despite heightened awareness and increased usage of
condoms is still at risk. The factors responsible for vulnerability are based on trends
emerging from the discussion from both regions, and hold good for both.
a) Negotiating capacity for safe sex not uniform; Those who shared their safe
sex negotiating skills, most of
them are ORWs and PEs.
However, many others
participants in the group and
individuals were not
comfortable in making even
eye contact and too shy to join
discussion, on the issue of
condom usage, casting doubts
over the safe sex negotiating
capacity. (Box 7)
b) Economic considerations and fear of violence and harassments preventing
safe sex : During groups with brothel based FSWs, it came to light, that pimp did
not permit condom usage. Interactions with them revealed, that each sex work is
paid a salary, insistence on use of condom is not economically viable, as it would
shoo away the client; secondly, any violence due to condom usage may invite
harassment from police personnel who are on look out for sexual favours. “I have
to pay to each worker, if I insist on use of condoms, we will not get customers,
most customers do not want to use condoms, I give them choice: not to use
c) Non –usage of condom with regular partner puts them at risk:
All the MSM and FSW mentioned not using condoms with the regular partner. For
MSM the fear of loosing regular income and inviting violence are paramount. FSWs’
reasons for not using condoms with regular partner are i) the fear of loosing partner’s
confidence; as these acts are discreet. ii) Female Sex Workers wishes to raise
family, hence they do not like to use condom “ Maaku Kooda ani pistundi, yavvaru
toh aina family undali” ( we also feel to lead a family life with some one) Although
the community acknowledges, that their “regular partner” might be having multiple

partners and they are not aware of his condom use age behaviour, and there fore by
not using condom they are at risk
d) Bisexual put partners at risk: Majority of MSM, admitted dislike for condom use.
a MSM who identified himself as bi-sexual, during discussion mentioned , dislike for
condoms and he does not allow either of his partners use it.. There by putting lives
of all at risk.

5.0 Conclusion and Recommendations
Violence and harassment are wide spread and common. Crisis Response Team is
in place and proving effective. The retaliation by MSM is worrying. It can at any time
escalate into a major social issue and disturb the peace.
Recommendations
 Scaling up of the project to non- intervention sites: In the wake non
existence of any kind support, the non-intervention sites witness more
violence and harassment. The formation of CRT and its usefulness and
effectiveness is having a ripple effect in non-intervention sites. At all sites, the
participants and ORWs were overheard discussing about the recent
incidences handled by them. The project can periodically organize meetings
with the KPs and help their capacity to form CBOs and take charge of their
lives against violence.
 Providing legal counseling: In the wake of retaliations by MSM’s it is
important to provide on the legal counseling to them: How and why not to
take law into hands. At least one or two sessions on legal counseling should
be provided; conducting VERBAL AUTOPSY with legal experts will prove
effective.
 Enhancing capacities of CBOs for greater role in violence mitigation:
At present, CBO formation is a nascent stage at all sites, though the process
has already begun, but it has to pick pace. Currently, for all medico-legal
cases the community is depending on NGOs. For sustainability of the CRT
and bring down incidences of violence, strengthening of CBO is important,
through hand holding for all types of cases, till CBO grows into a independent
unit.
 Increased Advocacy: No advocacy is taking place in Telangana region,
where as advocacy is intensive in Rayalaseema. The iNGOs in
Rayalaseema regions work with very high energy levels and are serious
about advocacy. Despite the fact, that all the iNGOs practically started off
CBO formation initiation process around same time, in Telangana region the

CBO formation process is at various levels and generally, the enthusiasm
towards work is very low. The iNGO attitude has a rub off effect on the
community, hence it is vital, for sustainability of the CRT that AIAP fixes a
target i.e. formation of CBOs ( deadline date and number of to be formed),

Glossary
Community: Female Sex Workers and Men having sex with men together represent
community and referred as such in the report.
Home based: Female Sex Workers providing establishes clients from home and
providing services from there.
Old iNGOs : Associated with AlAP since 2004.
New iNGOs: Associated with AIAP since 2007.
Region: Intervention areas Telangana and Rayalaseema are referred as region in
the report.
Regular Partner : One who visits more than once in a week.
Street Based: Female sex workers establishing client and providing services
(sexual) at secluded public places.
Verbal Autopsy: is a technique of communicating and assessing where in the
participants are shown a real life scenario and related it with actual incident. When
used as communication tool is helps in informing and educating on the following:
 What Happened
 Why it Happened
 Who did it
 When in happened
 How it can be prevented
 Where to go for counseling/help
 Whom to contact

Violence Report Final2_AP Alliance

Recommended

Recommended

More Related Content

What's hot

What's hot (18)

Similar to Violence Report Final2_AP Alliance

Similar to Violence Report Final2_AP Alliance (20)

Violence Report Final2_AP Alliance