Men behind the menace: An ethnographic study of male clients of female sex workers in the wake of the HIV/AIDS epidemic in India

Sex work, by definition, involves transactions between vendors and purchasers. The latter "clients", often called “grahaks” or “babus” in India, vastly outnumber the women who provide sex for sale. High mobility, invisibility and reluctance to divulge information, keep most clients outside the purview of research and intervention, not only in India but elsewhere as well. The study objectives included estimating the knowledge level of STIs and HIV of clients, their attitude towards sex work, and their risk perception and behaviors. The hypothesis tested was that recent changes in sex trade are primarily driven by changing patterns of client demand and preferences. The present study is based on ongoing research in which a total of 300 ACTUAL male clients of female sex workers were interviewed from over 50 sex access points in Mumbai, India. The research design primarily utilized ethnographic methodology with quantitative measures using Time Location Cluster Sampling Method. Logistic regression and content analysis will be used for hypothesis testing. Preliminary data analysis suggests that the changes in recent years are far more rapid and obscure than expected. A large part of this can be attributed to a coping strategy, on the part of clients, related to stigma and discrimination attached to HIV/AIDS, as well as their changing risk perceptions. This highlights that policies for preventive strategies bereft of clients' perspectives and realities, will not be successful in curbing the growth of the epidemic in India where an estimated number of 5.9 million people are living with the infection.