Power, pleasure, pain, and shame: Assimilating gender and sexuality into community-centred reproductive health and HIV prevention programmes in India

Abstract

Inspired by the vision of the Millennium Declaration, CARE and ICRW (International Centre for Research on Women) partnered with the Inner Spaces, Outer Faces Initiative (ISOFI) to learn how to more effectively integrate gender and sexuality into CARE's sexual and reproductive health programmes. Drawing from lessons learned from gender mainstreaming, ISOFI focuses initially on fostering personal change among staff, helping them to explore their own gender and sexuality 'baggage' and supporting transformation of their 'inner space'. ISOFI then gradually integrates mechanisms to promote organizational change, and finally extends to community development practice, the 'outer face'. As a system promoting change in organizational culture and practice, ISOFI features structured iterative loops of reflection and learning, action and experimentation, and analysis and assimilation. This article describes the ISOFI Innovation System, and reports on ISOFI-generated learning and innovation in sex positive HIV prevention programming for truckers and reproductive health interventions for women in India.

Gender relations and risks of HIV transmission in South India: the discourse of female sex workers' clients

“…The social taboo around premarital sex (Kakar and Kakar 2007;Nag 1996) is another obstacle for some men to satisfy their sexual desire. However, consistent with some authors (Bhugra et al 2007;Degnan Kambou et al 2007;Poudel et al 2004), the clients interviewed often see sex as a necessity, a primary need to be satisfied. Therefore, turning to female sex workers, who are more open about sexuality, is often a means for clients to come closer to the ideal sexualised male, capable of satisfying a woman.…”

“…Indeed, sexually satisfying a woman, which seems to be important for Indian men, as suggested by some clients interviewed in this study and by Degnan Kambou et al (2007), is apparently difficult within marriage. The inability to be intimate in the house, the repeated absence of the wife for reasons associated with cultural rites, her modesty and the sexual morality expected of her within the conjugal relationship (Kakar and Kakar 2007) represent important barriers for married couples to have a satisfying sex life.…”

“…Moreover, it is widely acknowledged that gender inequalities undermine efforts to prevent HIV in a number of countries, not least in India (Lancet 2006), where the relationship between men and women is recognised as unequal (Kakar and Kakar 2007;Lancet 2006;Steinbrook 2007). In fact, masculine identity, as perceived by clients of female sex workers in India and elsewhere, is linked to domination (Anderson and O'Connell Davidson 2002;Courtenay 2000) and to the capacity to satisfy a woman sexually (Degnan Kambou et al 2007). It is also characterised by an often pressing, even uncontrollable, need to satisfy their urges (Bhugra et al 2007;Poudel et al 2004) or sexual fantasies (Bédard 2005;Bernstein 2001;Bhugra et al 2007;ICHAP 2003).…”

“…Many studies around the world have highlighted the importance of analysing gender to understand the dynamics of, and better prevent, HIV transmission (Anderson and O'Connell Davidson 2002;Bédard 2005;Bernstein 2001;Degnan Kambou et al 2007;Govender 2011;Macia, Maharaj, and Gresh 2011;Rao Gutpa 2000), as the perception of gender roles appears to influence the adoption of certain attitudes and behaviours towards sexuality (Bhugra et al 2007;Macia et al 2011). Moreover, it is widely acknowledged that gender inequalities undermine efforts to prevent HIV in a number of countries, not least in India (Lancet 2006), where the relationship between men and women is recognised as unequal (Kakar and Kakar 2007;Lancet 2006;Steinbrook 2007).…”

Widowhood and HIV: A Narrative of Pain, Illusion and Predicament

“…Poverty can be attributed as another major factor for HIV spread as it increases possibilities of transactional sex and migration (Kambou et al, 2007). Lack of access to resources and awareness are also the byproducts of poverty.…”