STI-HIV-AIDS Vulnerability Research GUNTUR

Vulnerabilities of Young Women
Against STI/ HIV/ AIDS
Guntur District Situational Assessment
November 2002
For
Co-ordinated HIV/AIDS/STI Response through

Capacity Building and Awareness (CHARCA)
District Situational Analysis – CHARCA, Guntur
Draft Report – 18 Dec 2002
The Research Team
Dr. T.L.N. Prasad Asst. Professor of STD, Research Co-ordinator

HIV/AIDS Medicine, Guntur
Medical College & Guntur
General Hospital, Guntur
Dr. Sk. Subhani SEEDS Senior Researcher
Mr. B. Adam SEEDS Senior Researcher
Mr. D. Joseph SEEDS Senior Researcher
Ms. D. Nirmala Rani Kothapeta Mahila Mandal Senior Researcher
Ms. K. Kalavathi CRDS Senior Researcher
Ms. S. Varalaxmi CRDS Senior Researcher
Mr.Y. Moshe SEEDS Junior Researcher
Mr. D. Venkateshwara Rao Nehru Yuvak Kendra Junior Researcher
Mr. J. Siva Krishna SEEDS Junior Researcher
Ms. G. Vijayalakshmi SEEDS Junior Researcher
Ms. G. Malleshwari Kothapeta Mahila Mandal Junior Researcher
Ms. Sk. Shakeela Student, KSHEMA Junior Researcher
The Research Sub-Committee
Prof. M. Laxmi Pathi Raju Prof. & HOD of Social work , Nagarjuna University, Guntur
Mr. D. Roshan Kumar Project Director, SEEDS, Guntur
Mr. P. Ranjan Babu Project Director, CARDS, Guntur
Dr. T. Seva Kumar Project Director , SHO, Guntur
Dr. T.L.N. Prasad Asst. Professor of STD, HIV/AIDS Medicine, Guntur Medical
College & Guntur General Hospital, Guntur
Facilitators
M/s Catalyst Management Services Pvt. Ltd.

Development Management Consultants
Bangalore
1
CHARCA – Guntur
The Core Group for Project Planning
Dr. P. Uma Devi District Leprosy Officer (DLO) & convener of CHARCA
Mr. M. Caleb CEO, Scheduled Caste Corporation (SC Corporation)
Mr. D. Venkateshwar Rao District Education Officer (DEO)
Mr. G.Sudershan CEO, STEP
Dr. C. Vasanth Kumar Professor & HOD of OBG, Guntur Medical College
Dr. G. Babu Rao Superintendent of Govt. Fever Hospital, Guntur
Prof. M. Laxmi Pathi Raju Professor & HOD of Social work , Nagarjuna University
Dr. T.L.N. Prasad Asst. Professor, Guntur Medical College
Mr. D. Roshan Kumar SEEDS
Mr. P. Ranjan Babu CARDS
Dr. T. Seva Kumar SHO
Ms. Vasantha Laxmi MDO
Ms. J. Rani Community Representative, Sharada Colony
Ms. K. Lakshmirajyam PLWH
Ms. Pankajakshi Primary stake holder nominated by PD DRDA, Sai Yuva
Shakti
SNO Name Organisation/ Profession DESIGNATION
1 Sri. Heeralal Samaria, IAS District collector & Magistrate , Guntur Chairman
2 Sri. Rama Krishna Rao, IAS District collector & Magistrate, Guntur Chairman
3 Dr. P. Uma Devi District Leprosy Officer, Guntur Convenor
4 Mr. J. Murali Project Director, DRDA, Guntur Member
5 Mr. M. Caleb Chief executive officer, SC corporation, Member

Guntur
6 Mr. G. Sudarshan Youth welfare Officer, Guntur Member
7 Prof. C. Vasantha Kumar Head of Obstetrics & Gynecology Member

Department, Guntur Medical college,
2
Guntur
8 Prof. G. Babu Rao Superintendent, Fever Hospital, Guntur Member
9 Dr. T.L.N. Prasad Assistant Professor of STD, HIV/AIDS Member

medicine, Guntur Medical College,
Guntur
10 Dr. T. Seva Kumar President Service Health Organization, Member

Guntur
11 Prof. M. Laxmipathi Raju HOD Social work, Nagarjuna University, Member

Guntur
12 Mr. D. Roshan Kumar Project Director SEEDS, Guntur Member
13 Mr. T. Ranjan Babu Project Director CARDS, Guntur Member
14 Dr. D. Madhavi Medical Officer PHC, Pedakakani Member
15 Ms. Vasantha Laxmi Rural MDO, Guntur Member
16 Ms. K. Laxmirajyam PLWH Member
17 Mr. D. venkateswara Rao Youth Leader Member
18 Miss. J. Swarupa Rani Primary Stake holder nominated by ED Member

SC corporation
19 Ms. Pankajakshi Primary stake holder nominated by PD Member

DRDA, Sai Yuva Shakti
3
PREFACE
Ms. K. DAMAYANTHI, IAS

PROJECT DIRECTOR, APSACS
4
ACKNOWLEDGEMENTS
We express our deepest regards to Madam Damayanthi, IAS Project director, Andhra
Pradesh State AIDS Control Society, and to the core committee members for giving us this noble
opportunity of studying the vulnerabilities of women under CHARCA project in Guntur District.
There are no words from our side to express our feelings for their continuous monitoring,
suggestions, and directions which helped us immensely during the study.
We wish to place on record the valuable help rendered by Mr. M. Caleb, Mr. G.
Sudarshan, Prof. C. Vasantha Kumar, Prof. G. Baburao, and Mr. D. Roshan Kumar during our
study.
We are thankful to UNAIDS, for giving us this opportunity and to catalyst management
services who coordinated and catalysed the entire issue, and for being partners with us from
inception to conception to delivery.
Last but not the least we are grateful to all those three thousand and odd citizens of
Guntur district who participated in our study willingly, voluntarily, and enthusiastically.
We also thank individuals and agencies – governmental, non-governmental, community

based and private organisations in Guntur District – for their excellent co-operation, support, time
and invaluable inputs to the study.
On behalf of the research sub committee & research team,
Dr. T.L.N. Prasad, M.D., D.N.B Dr. P. Uma Devi, M.B.B.S, DPH
Research coordinator, Convenor,
CHARCA project CHARCA project
Guntur Guntur
5
ABBREVIATIONS USED IN THE DOCUMENT
AH Area hospital
AIDS Acquired Immune Deficiency Syndrome
ANC Ante-natal Clinic s
ANM Auxiliary Nurse Midwife
APMO Assistant Para Medical Officer
APSACS Andhra Pradesh State AIDS Control Society
APVVP Andhra Pradesh Vaidya Vidhan Parishad
AWW Anganwadi worker
BPL Below Poverty Line
BWW Balwadi worker
CBO Community Based Organization
CEO Chief Executive Officer
CHARCA Co-coordinated HIV/AIDS Response through capacity building And awareness.
CHC Community health centre
CMS Catalyst Management Services
CRDS Community Rural Development Society
CSW Commercial Sex Worker
DI Depth Interview
DLO District Leprosy Officer
DM&HO District Medical and Health Officer
DPMO Deputy Para Medical Officer
DRDA District Rural Development Authority
DSA District Situational Assessment
DSP District Strategic Plan
FGD Focus group discussion
FHAC Family Health Awareness Campaign
GGH Government General Hospital
GMC Guntur Medical College
GMC Guntur Municipal Corporation
GNT Guntur, Narasaraopet, Tenali
GOI Government of India
HIV Human Immunodeficiency virus
IRDP Integrated Rural Development programme
IVDU Intravenous Drug Users
MDO Mandal Development Officer
MPHA (F) Multi Purpose Health Worker (Female)/ANM
MPHA (M) Multipurpose Health Worker (Male)
MPTC Mandal Praja Tribunal Committee
MSM Men having sex with men
NACO National AIDS Control Organization
NGO Non Government Organization
OBG Obstetrics and Gynaecology
PB Polling booth
PD Project Director
6
PLWHA Person living with HIV/AIDS

PMO Para Medical Officer
PMP Private Medical Practitioner
PRD Panchayat Raj Department
RC Research coordinator
RCH Reproductive and child health
RMP Rural Medical Practitioner/PMP
RSC Research Sub Committee
RTI Reproductive Tract Infection
SEEDS Social Education and Economic Development Society
SI Sub inspector of police
SI Sanitary inspector
STD Sexually Transmitted Disease
STI Sexually Transmitted Infection
UN United Nations
UPHC Upgraded primary health centre
7
CONTENTS
EXECUTIVE SUMMARY ..................................................................................................... 9
1 BACKGROUND .......................................................................................................... 15
1.1 ABOUT CHARCA:...................................................................................................... 15
1.2 NEED FOR THE DISTRICT SITUATIONAL ASSESSMENT :...................................................... 16
2 OBJECTIVES OF THE STUDY ................................................................................. 157
3 METHODS ................................................................................................................ 168

3.1 T HE PROCESS FOLLOWED : ........................................................................................... 18
3.2 POPULATION AND SAMPLE:.......................................................................................... 20
3.3 SOURCES OF INFORMATION: ......................................................................................... 21
3.4 T OOLS & T ECHNIQUES:................................................................................................ 22
3.5 ANALYSIS:................................................................................................................. 23
3.6 MAPPING RESOURCES:................................................................................................. 23
3.7 LIMITATIONS OF THE STUDY:........................................................................................ 23
3.8 ABOUT GUNTUR DISTRICT : .......................................................................................... 24
4FACTORS AFFECTING VULNERABILITY OF YOUNG WOMEN TO STI/ HIV/ AIDS... 31
4.1 AWARENESS AND KNOWLEDGE OF STI/ HIV/ AIDS: ....................................................... 24
4.2 KNOWLEDGE AND SKILLS TO PROTECT FROM STI/ HIV/ AIDS:........ERROR! BOOKMARK NOT
DEFINED.4
4.2.1 Knowledge on, and Skill to Use Condoms:.................... Error! Bookmark not defined.4
4.2.2 Saying ‘no’ to Sex: .................................................... Error! Bookmark not defined.4
4.3 SEXUAL ACTIVITY: ..................................................... ERROR! BOOKMARK NOT DEFINED.
4.3.1 Sex within Marriage: ................................................. Error! Bookmark not defined.6
4.3.2 Premarital Sex: ......................................................... Error! Bookmark not defined.6
4.3.3 Extramarital Sex: ...................................................... Error! Bookmark not defined.7
4.3.4 Sexual Abuse: ........................................................... Error! Bookmark not defined.8
4.4 AL COHOL CONSUMPTION............................................................................................. 40
4.5 OCCUPATIONAL RELATED FACTORS (SEXUAL ABUSE IN WORKPLACE , MIGRATION):......... 280
4.6 HEALTH SERVICES: ................................................................................................... 292
4.7 SUPPORT SYSTEMS:................................................................................................... 313
4.8 ENVIRONMENT : ........................................................................................................ 335
4.9 EXCLUSIONS – GENDER, POVERTY, SOCIAL STATUS: ..................................................... 346
5 RESOURCES MAPPED ...............................................................................................................................137
6 CONCLUSIONS ................................................................................................................................................50
ANNEX A: MINUTES OF THE CORE GROUP & RSC...............................................................................53
ANNEX B: DETAILS OF STUDY SITES ...........................................................................................................70
ANNEX C: TOOLS USED IN DSA ......................................................................................... 90
ANNEX D: RESOURCES MAPPED ..................................................................................................................137

ANNEXE: MEDICAL & HEALTH PROFILE………………………………………..………… 143
ANNEXF: STATISTICS OF EDUCATION REFERENCES……………………………….............146
ANNEXG: REFERENCES……………………………………………..………………………..…147
8
Vulne ra bilit ie s of Yo ung Wo me n Aga inst S TI/H IV/A IDS
Guntur District Situational Assessment
Executive Summary
India has an estimated 3.97 million people in the country infected with HIV, an overall
HIV adult prevalence rate of 0.7%10 . An overwhelming majority of these (89%) are in the
age group of 15-44 years. Women constitute 21.4% of known AIDS cases in the country.
Driven primarily by heterosexual transmission, HIV infection is moving steadily beyond
its initial focus among commercial sex workers and their clients, STD patients and
Injecting Drug Users (IDUs), into the wider population. There is now evidence to show
that the HIV epidemic is fast spreading to the general population.
CHARCA (Co-ordinated HIV/AIDS Response through Capacity building and

Awareness) aims to reduce vulnerabilities and increase capacities of young women to
protect themselves against STIs and HIV infection. The Project is planned for three years
in six Districts (Guntur being one) in India. The project is a multi-agency effort, with the
UN agencies in India and GOI being the major partners.
The project is at the stage of developing a district strategic plan for Guntur. The first step
was to understand the situation in the district with respect to vulnerabilities and capacities
of young women to protect themselves against STIs and HIV infection, for which this
study was commissioned during October 2002.
The objective of this study was to assess vulnerabilities and capacities of young women
in the age group of 12-30 to protect themselves against STIs, HIV and AIDS, and
resources and services available to support them. The purpose of this study is to
understand the ground situation to feed into the District Strategic Plan.
The study was conducted by the Research Sub-Committee* set up for this purpose, and
facilitated by the Catalyst Management Services Private Limited (CMS), Bangalore.
*
Research Sub-Committee (RSC) was formed out of the core group for CHARCA in Guntur. Details
given under Methodology.
9
Main Findings :
Young women (12 – 30 years) in Guntur were at a heightened risk of acquiring STI/ HIV,
due to the following major factors:
? Lack of knowledge and awareness on STI/ HIV/ AIDS, sexual health, poor health
seeking behaviour, limited access to qualified health care, lack of awareness on
rights, limited capacity to seek help, and lack of support systems, at the individual
level. Poor awareness levels of the information sources available to individuals and
illiteracy also played important role in increasing the vulnerability.
? Alcohol consumption and the resultant behaviour (physical and sexual abuse of
women) by males was one of the major factors in increasing the vulnerabilities of
young women towards acquiring STI/ HIV. There was a high correlation between
alcohol consumption and sexual abuse of women.
? At the family level, factors increasing vulnerability were guardians’ limited ability to
provide support, guide and counsel young women on issues relating sexuality,
physical and sexual abuse, alcohol abuse within the family. Gender equations within
the family clearly limited women’s capacity vis-à-vis their male partners
considerably, leaving them more vulnerable to HIV and other sexually transmitted
diseases through males.
? At the community level, vulnerability of women was heightened due to lack of

effective support systems to address women’s problems, low position of women in
the society compared to men, low literacy, low capacity to earn and high dependence
on males. Current community initiatives focussed mainly on economic issues, and
social and health issues were covered only by a few. The stigma attached to buying
and using of condoms (that condom is used only in sex work/ multi partner sex)
prevented many from even asking their partners to use this. Similarly, the stigma
towards STI/ RTI prevented women from reporting and seeking treatment for it.
? Even among sections where awareness levels were higher, the same has not resulted
in practice. The factors that affected practice were mainly issues related to lack of
women’s capacity negotiate, seek help, ability to influence, skills to use the
knowledge, supporting systems to back her up in case of troubles.
The category of primary stakeholders affected most were the married women at the
reproductive age group, particularly in rural areas, mostly illiterate, having limited access
to information and help.
The study identified many factors that have the potential to address vulnerabilities of
young women. These are listed below. CHARCA at Guntur can think of effectively
coordinating and utilising these so that the problems of young women can be addressed
holistically and in a concerted fashion.
10
? Most leaders, influencers and support service agencies opined that a very concerted
effort required to weed out social evils like alcohol consumption, exploitation of
women and prevention of spread of STI/ HIV. Many were willing to participate in
the effort in whatever role possible.
? Current programs by government and NGO in organisation of self help groups,
particularly for the poorest and socially disadvantaged, could be used as a platform to
handle these issues related to women. These groups were mainly by and for the
women, and work towards in empowering them economically and socially.
? Current awareness programs by AIDS interventions by APSACS and other agencies
through mass media, and school awareness programs for adolescents seemed to have
created basic awareness on the disease. These programs could be followed up
through community level counselling initiatives so that the felt needs of ‘personal
information sources’ are met.
? Interventions by government, CBOs, and few NGOs in savings, credit and developing
job oriented skills for women have, to some extent, improved the participation of
women in economic decisions at the household level. These interventions have been
contributing to improving incomes and surplus in the hands of women. These
interventions could be linked to health so that higher level of spending is done in
favour of women, and particularly for their preventive health.
? Most CBOs, leaders and primary stakeholders recognised that alcohol consumption
was the main evil that increased women’s vulnerability. Eradication of alcohol has
been taken up by some CBOs as their main social agenda. This could be supported
and nurtured so that the most important vulnerability factor could be addressed.
? Programs like RCH and family planning are working towards improving awareness
on sex related issues. Similarly, free supply of condoms being done through health
centres. These integrated with inputs on skills and personal counselling, so that the
awareness results in practice.
Project Imperatives
To reduce the vulnerabilities of young women from acquiring STI/ HIV, a multi pronged,
collaborative effort may be required. The intervention need to go much beyond just
creating awareness on the issues, but address causal factors that result in a particular
behaviour.
As could be seen from the DSA, there is a major gap between awareness and practice,
and issues affecting these are not issues of health, or STI/ HIV. These relate to
empowerment of women individually, sensitising families and communities to create an
enabling environment for women to protect themselves. The DSA also shows that many
stakeholders are interested in working towards this end, but needed a co-ordinatated and
concerted effort towards this.
The study also showed how important it is to work with men if the women’s vulnerability
is to be addressed. It is clearly evident that the empowerment of women can’t take place
without the transformation of men.
11
Specific Areas that Need to be Addressed:
? Awareness and knowledge building regarding general health, sexual health, human
and sexual rights
? Building support systems via family counseling, ‘personal’ information sources,
community organizations; focus on issues of sexual health within the family and
community
? Evaluation of gender equity and dynamics; sensitisation of male partners / guardians
and equipping the woman to adopt a position of self preservation
? Advocacy among society leaders, influencers and elders regarding the need for
support to individual wo men in trouble; issues of confidentiality and non-judgemental
attitudes combined with care and support
? Reorientation of HIV/STI focus on the potential threat; an orientation to members of
the general community, both male and female, about the realistic nature of the threat
and its ability to reach both good and bad people. Eventually aiming at acceptance of
the threat of HIV /STI among members of the general population.
12
District Situational Analysis – CHARCA - Guntur
1 Background
India has an estimated 3.97 million people in the country infected with HIV, an overall
HIV adult prevalence rate of 0.7%10 . An overwhelming majority of these (89%) are in the
age group of 15-44 years. Women constitute 21.4% of known AIDS cases in the country
(total AIDS cases 39,742 – cumulative; Male 29907, Female 9835 – National AIDS
watch up to August 2002, NACO, MOH, New Delhi). Driven primarily by heterosexual
transmission, HIV infection is moving steadily beyond its initial focus among
commercial sex workers and their clients, STD patients and Injecting Drug Users (IDUs),
into the wider population. There is now evidence to show that the HIV epidemic is fast
spreading to the general population.
Efforts of the National and State Governments have concentrated on working with
priority, ‘high risk’ groups. Governments are now addressing the epidemic among the
general population but given the size and diversity of India, it is an extremely challenging
task. CHARCA – Co-ordinated STI/ HIV/ AIDS Response through Capacity Building
and Awareness – is an effort in addressing the general population, particularly young
women.
1.1 About CHARCA:

CHARCA (Co-ordinated HIV/AIDS Response through Capacity building and
Awareness) aims to reduce vulnerabilities and increase capacities of young women to
protect themselves against STIs and HIV infection. The project is planned for three years
in 6 Districts in India where young women have been identified to have heightened
vulnerabilities to HIV/AIDS - Jaipur (Rajasthan), Guntur (Andhra Pradesh), Kishanganj
(Bihar), Bellary (Karnataka), Aizwal (Mizoram), and Kanpur (Uttar Pradesh). The project
is a multi-agency effort, with the UN agencies in India and GOI being the major partners.
Overview of CHARCA strategy:
Awareness Building Improving

building skills services
Young Women
Building support Creating enabling

structures environment
13
CHARCA aims to reduce vulnerability of young women by providing information,

improving their skills and access to quality services. It also aims to build leadership,
support networks and the necessary enabling environment. Through this process, it seeks
to empower women to protect themselves against HIV/STIs and realise their rights.
1.2 Need for the District Situational Assessment:

In July 2001, a national level workshop was conducted to prepare a proposal for the
CHARCA project. A cross section of stakeholders from the six CHARCA states attended
the workshop. Taking these contributions, a proposal was prepared by UNAIDS [with
the help of Catalyst Management Services Private Limited (CMS) – consultants to
project]. One of the key activities identified in the workshop (and in the proposal) was to
conduct a detailed situational assessment at the field level in each of the selected districts
before launch of the project.
It was also was decided that the District Situational Assessment (DSA) would be
conducted in one district initially, and the learning from this be used in other districts.
Bellary was chosen as the first district for DSA. The DSA for Bellary was completed
during Jan-Feb 2002. The process followed and findings were shared with stakeholders
from other states too, including Guntur * .
DSAs are aimed to identify the sources of vulnerability among young and adolescent
women to HIV and STIs with the participation and guidance of local stakeholders.
Findings of the study would be used as a baseline, and to prepare a District Strategy Plan
(DSP).
The project has been designed in such a way that the process is empowering in itself. It
not only addresses the health issues related to HIV/AIDS, but also the broader issue of
empowerment of women, transformation of men and social change to ensure the right of
every individual to live in dignity.
*
Attended by District Leprosy Officer (Guntur), Officials from Andhra Pradesh State AIDS Control
Society, and SEEDS (an NGO, currently in the core team)
14
2 Objectives of the Study

To assess vulnerabilities and capacities of young women in the age group of 12-30 to
protect themselves against STIs, HIV and AIDS, and resources and services available to
support them.
Scope of DSA:
1. Profile and segment the target group of young women (12-30) in the district of
Guntur.
2. Identify socio-cultural and economic factors that influence the status of women in
family and society.
3. Understand their level of knowledge, skill and capacities to exercise control over
sexual and reproductive issues, and access to relevant information.
4. Map the main vulnerability factors that may increase the target group’s risk of
acquiring STD/ HIV/AIDS.
5. Assess the availability and access to medical services, and perceived quality of
services.
6. Assess the availability and access to support mechanisms, groups and structures to
address issues related to young women’s vulnerability.
7. Map agencies (Government, UN system, multilateral, bilateral and other development
initiatives) that work in Guntur district and identify possible roles and areas of
collaboration with these agencies.
15
3 Methods
3.1 The Process Followed:
The process followed in Guntur incorporated learning from the Bellary and Aizawal
exercises. The process was highly participative and was designed in such way that key
stakeholders (primary and secondary) in CHARCA are involved from the day-one in
planning.
Stakeholders felt that it would be impractical to bring in all of them for every process in
DSA and suggested formatio n of a district level core team to provide intensive inputs.
This team was to be responsible for all processes till the development of the district
strategic plan.
To enable conduct of DSA, the core team suggested a sub-committee to be wholly

responsible for planning and implementing the field survey and present outputs of the
situational analysis to the larger stakeholders.
The process and outputs at each stage is presented below:
Date Forum Stakeholders Main Outputs

10 & 11 Planning Key stakeholders – Understanding of CHARCA by key
Aug 02 workshop Primary (Community stakeholders.
representatives) and
Consensus on the project approach.
secondary stakeholders
(govt., NGOs, APSACS, Formation of the Core Team for DSA
Media, Academicians) and DSP.
03 Sep 02 Core Group Core Group Members Formation of the Research Sub-
Meet Committee (RSC).
Understanding roles and responsibilities
for Core group, RSC and CMS.
Tentative timeframe for DSA and DSP.
15 & 16 RSC – meet Core group and RSC Understanding scope of DSA, specific
Sep 02 members issues to be addressed in DSA.
Definition of ‘Universe’ for DSA.
Finalisation of Research Design.
Selection of Sample Sites.
Finalisation of Methodology.
Research team composition and criteria
for selection of team finalised.
16
Date Forum Stakeholders Main Outputs

19 – 25 Research Research team & CMS Understanding of CHARCA by the
Sep 02 team training research team.
and pre
Research team trained on Tools and
testing tools
techniques for DSA.
and
techniques Pre-tested and finalised tools and
techniques for DSA.
29 Sep 02 – DSA – Field Research team Information gathered from various

31 Oct 02 work respondents in 20 sampled villages of
Guntur district.
03-14 Nov Compilation Research Team Compilation of data from the field,
02 consolidation
15 – 30 Nov Analysis Research Team Analysis of data, draft report

02
1-29 Dec 02 Fine Research Co-ordinator Rough DSA draft Report.

Trimming & CMS
updating Presentation to RSC
Presentation to Core Committee
Presentation to Divisions for feedback
Final DSA draft.
DSP Work Shop
Issues covered in detail, participants and discussions in the planning workshop, core
group meeting and RSC meeting are attached at Annex A.
17
3.2 Population and Sample:

Universe for the Study:
The objective of the DSA was to understand the vulnerabilities of young women to STI/
HIV infection. Hence, the ‘universe’ for the study was defined as ‘young women’ in
Guntur District. The RSC felt that the term ‘young women’ needed to be further defined
in terms of age, and on discussions the age group for the study was defined at “12 – 30
years”. Thus, the ‘universe’ for the study was defined as:
“Young women in the age group of 12 – 30 years residing in Guntur District”
Unit of Sampling:
The data on total numbers of young women at the age group specified was not available
readily from the secondary sources and hence the RSC decided that the ‘unit of
sampling’ be defined by existing boundaries, i.e. village/ ward (administrative divisions).
Data for villages/ wards were available from the Census.
Based on the time and resources available, and experiences of Bellary and Aizawal, the
RSC decided that it would be practical to cover a sample of 20 mandals/villages/wards in
the study.
For each study site, the process included meeting a number of persons in various
categories and triangulating information.
As the issues studied were very sensitive, and are discussed only among the peers,
the respondents were categorised according to gender, marital status and age-group.
18
Tools & Techniques:

A variety of tools were used (in each site) depending on the category of respondents,
and the type of issues.
Analysis:
The data from field was compiled using MS Office package (for quantitative and
qualitative data). Analysis of data was undertaken by the Research Co-ordinator, with
the help of Senior Researchers.
Mapping Resources:
The resources available in the District (institutions, programs) which CHARCA could
assess during its implementation was mapped through discussions with various
government and non- governmental organisations. This exercise was done prior to the
DSA as a part of selection of NGOs for the core group, and provides information mostly
on non-governmental organisations.
Limitations of the Stud y:

The methods used for data collection are largely qualitative; hence the report does not
contain estimates regarding the size of a problem or the extent of its prevalence.
The data was obtained by a recall method, which depends on human memory, hence
prone for bias.
It is the subjective perceptions and disclosures of respondents that were analyzed, no
objective assessment was done.
As every known sub group in the study universe was not included for the study. The
results of the survey may not represent the entire universe views and ideas. However, it
does not mean the results are insignificant.
Nevertheless the exploratory findings obtained in this study could not be ignored.
About Guntur District4,5,6,7,13:

Guntur District (Andhra Pradesh, India) was formed in 1904 with headquarters at Guntur
after bifurcating Krishna and Nellore districts. The district was divided into 57 mandals
(in 1985), and three major administrative divisions – Guntur, Tenali, and Narasaraopet.
It has 728 revenue villages, 1029 gram panchayaths, 9 municipalities and one municipal
corporation There are 4 parliamentary constitutions ( Guntur, tenali, bapatla,
narasaropet) and 19 assembly constituents. The district is bounded on the North by
Krishna and Nalgonda Districts, on the West by Prakasam ad Mahaboobnagar Districts,
on the South by Prakasam District, on the East by Krishna District and Bay of Bengal.
Brief Historical background:
The atmosphere in the district reverberates the Mahayana Dicta of Acharya Nagarjuna,
the sturring Songs about the Heros of the Palnad war and the echos of the war drums of
the immortal Krishna Deva Raya.
19
The antiquity of the district can be traced back to the Neolithic age, by 4 century BC
Bhattiprolu has became an advanced cultural centre. It was a province of vital
importance from the 3 rd century BC to the 3 rd century A.D. during the great Andhra-
Salivahana period.
The Ikshvakus who succeeded Salivahanas ruled this area with Vijayapuri of Nagarjuna
konda valley as their capital. Then the district was ruled by the Pallavas for 3 centuries.
These were followed by Chalukyaas of Vengi who ruled over 4 ½ centuries. At this
period the district was under frequent attacks from Rashtra Kutas of Karnataka and the
Cholas of South India. This continued up to 12th century.
In the beginning of 13th century, the great kakathiya ruler Ganapathi Deva conquered this
district and Motupalli has become as an International Trade centre.
The Sultan of Delhi conquered the Kakathiya empire in 1323 A.D. but Prolaya Vema
Reddy liberated Guntur and Nellore districts and made them in to a kingdom and ruled it
from Addanki later from Kondaveedu. The famous Telugu poet Srinadha stayed here.
By 1422 A.D. the Gajapathi kings of Orissa occupied, later the Bahamani sultans.
Finally Krishna Deva Raya, the great Vijaya Nagara emporer conquered all these area
and restored peace. Later it was conquered by Qutubshahi sultans of Golkonda and came
under Mughal empire with Aurangzeb conquering Golkonda. From 1723 A.D. Guntur
became part of the Nizam’s dominion. The coastal area was divided into five circars,
Guntur was included in kondaveedu circar. By 1753 French took over these circars and
by 1758 English East India occupied them.
Guntur district is a well known center of Bhuddism - Bhattiprolu, Amaravathi, Goli,

Munchukallu, Nagarjuna konda were important Bhuddist Theerdas.
Later a Hindu revival occurred with Ikshwakus in rule and Saivism flourished.
Worshiping these Veera Saivas is still continuing in Palnadu area (karampoodi) which is
said to exists only in Rome and Guntur.
The districts also abodes many epigraphical and art treasures – the Sthupa of
Battiprolu, the Dhathu of Budha at Amaravathi.
The population of the district is 44, 05,521 and about two thirds live in rural areas. The
district covers an area of 11,391 sq. km with 42 km of coastal belt. The total geographical
area of the district is 27, 99,264 acres, of which 13.7% is forest and 52.5% is under
cultivation. Literacy level of Guntur city is 75.8%, India 65.4%, A.P 61%. Out of 75.8%
literates residing in Guntur city males were 74%, females 62.4%. Overall literacy rate of
Guntur district is 55.5% - 2001 Census. The population per sq. km. is 370.
[Note: In the map above, the sites studie are marked in coloured dots.]
It has 78.2 km of National Highway, a popular hangout for mobile sex workers. There are
many pilgrimage and tourist places in the District that attract periodically lakhs of people
and sex workers.
The District is rich in mineral resources – limestone, copper, and lead. River Krishna
with its rivulets covers about 250 km. Two major irrigation projects take care of the
20
irrigation needs, particularly in Guntur and Tenali Divisions. Agriculture is the main
occupation in rural areas with main crops grown are Paddy, Jowar, and cereals, pulses
cotton, chilli, and tobacco.
River Krishna with its rivulets – Naguleru, Chandravanka, and Gundlakamma traverses
the district totaling 250 Kms and forms the district’s Northern boundary. Two major
Irrigation projects constructed on river Krishna are in this district – 1.The Prakasam
barrage with an ayacut of 2, 02,118 Hectors. 2. The Nagarjuna Sagar project with an
ayacut of 2, 72,064 Hectors. Apart from these minor projects like Guntur Branch Canal,
tanks filter points, tube and dug wells provide for irrigation. The district has a very fertile
soil with a break up of 70% black cotton, 24% red loamy and 6% sandy loamy types.
The main crops grown in the district are Paddy, Jowar , and Bajra ( cereals ); Black,
Green and Red grams (Pulses );cotton, chilli, and tobacco ( Commercial crops ).
The commercial crops like tobacco, chilli and cotton produced in the District attracts
large number of business people from various States and countries. There is a high
movement of businessmen, who come for short periods; this has encouraged commercial
sex work in some parts of the District.
The developmental activities of the district is by both government and non- government
organisations, related to poverty reduction, health, welfare programs for socially
disadvantaged, women development and housing programs.
Developmental activities of the district:
District Rural development Agency: An antipoverty program by GOI. The objective of

the program is to identify the families living below poverty line and assist them to cross
the BPL. It implements IRDP, DWACRA, TRYSEM, EAP, artisan improvement
program, old age pension scheme, family welfare scheme, and anti natal scheme.
District SC – service Co-operative Society Ltd: It is in existence since 13-2-1975.The

objective is to identify below poverty line SC families and assist them financially so that
they cross the BPL. The society is umplementing similar schemes as that of DRDA and
in addition to those it is providing special central assistance to SC families not covered by
DRDA / IRDP
District Backwards castes Co-operative society: It started functioning from 3-4-1976.The

objective is to provide economic assistance to financially poor BC Families .It releases
20% of margin money matching with the IRDP subsidy.
District Tribal ( ST ) service Co-operative society: It was established on 3-4-1976.The

objective is to alleviate the tribal poverty through various schemes. It provides 20%
margin money and arranges subsidy through DRDA.
A.P.State Minorities Finance Corporation: It was established on 19-1-1985.with an

objective of assisting economically and socially weaker minorities sections by
implementing various schemes. It launched two major programmes – Anti poverty and
21
Self Employment Programme,they not only provide 20% margin money but also procures
subsidy from DRDA and Banks.
Jawahar Rozgar Yojana: 80% of the funds under this program are provided by the
central government and 20% provided by the state government. Under this program,
allocation is made to housing works under Indira Awas Yojana and Millian Wells
program and PR department works.
Housing: Under the rural permanent housing program and economically weaker section
program and under the Indira Avas Yojana Program houses are constructed for
economically weaker minority communities of the district.
Women Development Programs: There are number of programs initiated by the

government for women development. The exact status of these programs is not clear. In
1958, the district women and child welfare Department was started. In 1985 Women’s
Finance Corporation has been established to assist with an objective of assisting women
belonging to BPL. The district hosts 12 tailoring teaching centers, 7 Balwadis (
paludevarlapadu, Repalle, Amaravathi,, Acchampeta, Narasaropet, Chebrolu, and
Vikuntapuram – They cater boys and girls of 3-6 years), 7 Sisuvihars ( phirangipuram,
vijayapuri south, lalpuram, chilakaluripeta, remidicherla, perecherla, and karumanchi—
they look after the children below 6 years, 3 Balika Sadans( guntur, piduguralla,
bapatla—200 girls student between 6-12 years of age ), 2 women and child welfare
centers( karampudi and pedavadlapudi), one Balavihar ( Arundelpet Guntur), one hostel
for girl college students( Guntur ) and one women employees hostel (Guntur), 4 ICDS
projects with 496 anganwadi centers. There are 1255 registered mahila mandals.
DWACRA scheme: The scheme was started with an objective to empower the
women. Under this scheme in the district there were already 5000 self help groups with
80, 000 women as members.
Places of Tourist Importance: There are many tourist spots in the district. The important
ones are Nagarjuna Sagar Project, Nagarjuna Konda, Lord Panakala Lakshmi Narasimha
Temple at Managalagiri, Lord Amareswara Temple at Amaravathi, Lord Tricuteswara at
Kotappakonda, and various other temples at Ponnur, Pedakakani, Govada, and Satrasal.
The Undavalli caves near mangalagiri and Kondaveedu Fort near Phirangipuram, the
water falls at ethipothala, and Guttikondabilam.
These pilgrimage and tourist places attracts periodically lakhs of people and sex workers.
Culture akin to totempoles (sirimanu) is prevalent in the district which symbolically
represents the Macho of the district.
HIV/AIDS situation:
India has an estimated 3.97 million HIV positive people with an adult prevalence rate of
0.7% in 6 states - Maharastra, Tamilnadu, Karnataka, A.P, Manipoor and Nagaland the
infection is over 1% in antenatal women10. In A.P. the estimated number of people
living with HIV/AIDS is 4 lakhs. Among the STD clinic patients the prevalence is
26.9%, in antenatal clinics the prevalence is 0.2% and among blood doners the
22
prevalence is 0.92%. out of the all districts in A.P., Guntur is considered as number one.
The majority of HIV cases are in the age group of 15-49 years. 90% of HIV cases are
due to heterosexual acts. 4% are through blood, 2% from mother to child, 4% others. The
prevalence rate among antenatal women has increased from 0.2 in 1998, 5.25 by 2001.
The reasons for explosive growth of HIV in A.P. due to high prevalence of paid sex
(20%), 7% of male and females are suffering from STIs. Very low condom usage rate
(25%)11. The Govt. General Hospital department of STD/ HIV/ AIDS medicine show a
dramatic increase in HIV/ AIDS cases between 1998 and 20023.
23
38% of married males and 10% of married

Factors Affecting Vulnerability of Young females reported more than one sexual partner,
Women to STI/ HIV/ AIDS showing high prevalence of multi-partner sex.
Awareness and Knowledge of STI/ HIV/
AIDS: 28% of married males reported forcing their
partners for sex/ sexual abuse; and 28% of
4.1 HIV/ AIDS: married females reported the experience.
Young women of Guntur revealed high level
of awareness of the term ‘AIDS’, similar to [Results of opinion poll]
other sections of the community, whereas
the term HIV was not heard by most. When probed for details, lack of knowledge
exhibited in the areas of symptoms and identifying HIV infected persons.
The knowledge on transmission route was high, with all respondents reporting sexual
route as the most common, followed by blood transfusion. However, routes like
mosquitoes, pesticides, sharing cigarettes, food, etc. too were reported; and the route of
mother to child is reported only by a few.
In particular, the knowledge levels were high among the urban population, student
community (younger generation) and in some rural areas where awareness campaigns
were conducted by health staff as part of Janmabhoomi, World AIDS Day and such other
specific occasions. The high awareness and knowledge levels were attributed to peer
sharing, radio, television, cinema, academic curriculum, and various awareness
campaigns. Literacy played an important role in the awareness about the disease.
Respondents in remote areas villages (e.g. Ipur, Pasuvemula, Mellavagu - Narasaraopet
division) exhibited low knowledge on HIV/ AIDS, main reasons being low literacy, lack
of exposure, and low access to correct information. As can be seen from the secondary
data, Narasaraopet Division has the lowest female literacy among the divisions.
It was also observed that the awareness and knowledge levels of married women and
guardians was low compared to others, reasons being less importance given to issues
other than household work, lack of risk perception, low literacy and the traditional or
cultural barriers in seeking information on HIV/AIDS.
Majority perceived that HIV/AIDS was a threat to only those who practice mult -
partner sex especially with sex workers. There was a recognition that HIV could be
transmitted from/to their spouses, if they engage in multi-partner sex. The opinion poll
results showed a high prevalence of sex before and outside marriage, particularly among
males – increasing vulnerability of women.
Guardians, who were to help and guide younger ones, too exhibited the similar awareness
levels as that of married women (low awareness on details).
The knowledge and awareness levels among the health service providers were
comparatively higher. The local influencers (like opinion leaders, religious leaders, etc.)
had some had myths and misconceptions regarding the transmission, prevention and
treatment.
The results showed a high correlation between awareness of HIV/ AIDS and the literacy
levels of the community. Particularly sites from Tenali Division (e.g. Tenali ,
Karlapalem, Pesarlanka, Kondamudi ), having higher literacy levels exhibited higher
level of knowledge than other sites.
In terms of sources of information, it was mainly the television and radio that provided
information on HIV/ AIDS to those who were aware of details. In some sites, awareness
24
campaigns conducted by the government also contributed to improving the awareness.

For married women it was their friends (and
20% and 11% was the prevalence of STI guardians, sometimes) who provided this
among the married women & men.
information, but the levels of awareness of
The proportion stood at 3% for unmarried these sources were also very poor.
females and 6% for unmarried males. 4.2 STIs:
[Results of opinion poll]
Similar to AIDS, the term of ‘sexual diseases’
is known to the most, particularly among the
married. However, when enquired about
details, only a few were able to come out with correct responses. Specific areas where
there was lack of clarity were:
types of STIs
general diseases too were reported as STIs
transmission routes (sharing dresses, urinating in pub lic places – reported by some)
treatment (some report no treatment for STIs)
The prevalence* of STI among various categories of respondents was enquired through
opinion poll. The results of the opinion poll showed high prevalence of STIs among the
respondents (see box). Please note that women might be reporting plain white discharge
too as a symptom for STI. The question was kept simple for ‘yes/no’ response. As it was
self-reporting, chances of wrong diagnosis could not be ruled out.
Awareness on STIs was particularly low among the rural respondents, and unmarried
category. Low awareness on details of STI, combined with prevalence of the disease,
increases vulnerability.
4.3 Cure for HIV/ AIDS and Perceptions about PLWHAs:
It was interesting to note most were clear that there is no cure for AIDS (only a very few
reported that the disease could be cured through alternative medicines). The message has
clearly trickled down even to the less exposed married women and guardians in the
society. Everybody knew that AIDS was a dreaded disease and cannot be cured. Even
then, very few have actually tried to get more information, as most felt that the disease
would not affect them.
On the issue of identifying a HIV positive person, none differentiated between HIV and
AIDS. Common symptoms like fever and general weakness were reported to be
symptoms for AIDS. A few respondents (mainly in Tenali Division) reported lab
investigations as the basis to decide on the HIV infection status of a person.
During discussions, most sites reported at least two to three cases of ‘AIDS patients’ in
their villages/ neighbouring areas (even though this was not the focus of the study).
The image of the HIV positive person in the community was highly negative. S/he was
associated with high immorality, sexual promiscuity and an unpleasant social behaviour.
This had led to, in most cases, distancing her/ him from the community. If the affected
had been a woman, then she is labelled as a sex worker or person having multi-partners.
The combination of low knowledge on symptoms of HIV/AIDS, care, high social
* *
The research team felt that the figure could have been under reported, as the question was for spot
prevalence of STI at the time of the survey. Some people who might have been suffering at the time of
survey could not have attended the survey. In fact, many came for consultation with the RSC coordinator
with STI complaints during survey /following FGDs (pasuvemula, Ipur, Lingayapalem, Chilakaluripet,
Guntur 16th ward, Kondamudi, Machayapalem), once they came to know that he was a STI specialist form
the GH!!
25
negligence of persons living with HIV/ AIDS, and low status of women in the society,
has a severe negative effect among the young women.
Alcohol consumption was reportedly the major factor for sexual abuse. This was
reported both by unmarried and married females. Most times if females refused sex, they
were forced to have sex with husbands especially when the husband/ partner is drunk.
It was also observed that the prevalence of sexual abuse was higher in urban areas than
rural. The fact that men were reporting higher prevalence of sexual abuse than women
probably indicates a substantial number of unreported cases. Thus it indicates a need for a
strengthened support structure to address these sensitive incidents.
Increased Vulnerability of Young Women to HIV Infection in Guntur –

Issues Related to Sexual Activity
Factors Enhancing Vulnerability Factors Reducing Vulnerability

? Very low age of girls at marriage(12-14 in ? Adolescents being taught about HIV/ AIDS
rural, 16-18 urban) and first child birth(15- as a part of academics
18) ? Programs like RCH and family planning
? §Lack of awareness and information raising awareness on sex related issues.
sources on marriage, sex; lack of life-skill
education.(30% nad 20% of unmarried
males and females, and 25% and 24% of
married males and females are only aware
about source of information on sexuality
issues).High prevalence of premarital
(32% and 5% of unmarried males and
females), extra marital sex(40% and
10% married males and females) and
sexual abuse (17% and 16% of married
males and females); casual sex(22% of
males)
? Preva lence of commercial sex in some
sites.(40% across the district)
? Alcohol consumption increasing sexual
abuse and forced sex within
marriage(40%and 60% of females and
males reported one of their family
members addicted toalcohol)
? Prevalence of sexual abuse in working
environment
? §Lack of knowledge, skill and negotiation
power to influence condom use in sexual
activity.(only 13% and 30% of unmarried
and married females were able to make
their partners to use condoms).Social
values and customs preventing discussions/
questions about sex and sexuality.
26
“Talking about sex is very bad”

Lack of supportive structures for issues related
to sex, and particularly within marriage.
3.3 Alcohol Consumption

Prevalence of alcohol consumption was widely reported in all sites, rural and urban; and
among men. Men, women and the local influencers reported that alcohol consumption
was the main cause for physical and sexual
More than 40 % of female and 60 % of male
abuse within a marriage. Married women could
reported one of their family members
addicted to alcohol. neither use any kind of safe sex methods nor
negotiate with the partner for safe sex, thus
increasing vulnerability to a great extent.
All FGDs (with both men and women)
reported prevalence of alcoholism, and Of various other factors that increases urge to
related physical and sexual harassment of
pre and extra marital sexual contacts among
women males, alcoholism was widely reported as a
major factor. Alcoholism was also identified as
[Results of FGDs]
one of the major factors that increase the
incidence of violence, incest, and forced sex
within marriage. Physical abuse of wives was considered quite common, particularly in
rural areas.
Majority of women considered alcoholism as the most important problem affecting the
lifestyle of the individual and the family as a whole, and heightens the physical and
sexual abuse. Most felt that even if a woman was knowledgeable, and able to negotiate
with the husband, the alcohol consumption by males made them helpless.
To a great extent, alcoholism and related harassment went unreported due to various
factors, specifically the dependency factors of female on male and the traditional way of
handling these problems.
Issues Related to Alcohol Consumption

? High prevalence of alcohol consumption, ? Current programs on organisation of self
and most males start this as a regular help groups of poor and marginalised; this
practice very early in life. (40%and 60% of could be a platform to handle these issues
females and males reported one of their ? Alcoholism an important agenda in women
family members addicted toalcohol) groups in their social meetings
? Addiction to alcohol ? Most community leaders and influencers
? Alcohol available freely and AP is not a recognising that alcoholism is an important
prohibition state social evil that need to be eradicated at any
? Inability of women to talk/ negotiate for cost.
anything when the partner is alcoholic
27
? Resultant physical and sexual abuse

? No support structures to report these
incidents and get justice
3.4 Occupational Related Factors (Sexual Abuse in Workplace,

Migration):
The study tried to understand vulnerability factors that were associated with the
occupations in which females were employed. Sexual abuses in certain workplaces and
during migration came out as most important areas affecting vulnerability of young
women.
Migration was widely prevalent in Guntur District. Migration was mostly in the
unorganised sector, people mainly moving for better paying occupations. Both ‘in’ and
‘out’ migration patterns were visible in the District.
Of the three divisions, Narasaraopet division was characterised by highest migration

specifically with men migrating to Guntur, Tenali, other parts of the country and
sometimes abroad. Guntur and Tenali divisions being urbanised and/ or fertile provided
ample opportunities for employment. Migration to nearby districts for a shorter period
was observed among people in Guntur and Tenali divisions too.
Migrated men were usually employed in brick, cement, and limestone industries.
Migrated women were mostly employed with cotton ginning mills, chillies marketing
yards, and sometimes in sex work. Most migrant labourers went through agents for
employment.
Migration was mostly among the poor and socially disadvantaged households. Most
cases, men migrate to other places, leaving their families behind in their villages. This
was reported as one of the major factor that enhanced the chances of having extra marital
sexual contacts for both the sexes.
Most times, the migrant families were at the mercy of the agents and masters. The
families which were dependent on these agents were usually indebted due to receiving
advances and credit for various purposes. The migrants also lived in very poor
conditions with even basis facilities not available to them. All these factors increased
chances of women getting sexually abused by agents, masters and even co-migrants.
Almost all reported that there were no organizations that catered to the needs of migrated
families.
It was highlighted that women working in cotton ginning mills and chillies marketing
yards were mostly prone to sexual exploitation in their workplaces. Specially, single
women, women from poor families and socially disadvantaged ho useholds were the most
affected. People who exploited these women were agents/ supervisors and owners of the
companies, promising them continuous employment and higher wages.
28
It was interesting to note that the issues were known to many, but there were no support
structures for women to report to or get help from.

Issues Related to Occupational Related Factors

? Lack of employment opportunities in ? Interventions by government and NGOs in
native villages, poor economic status savings, credit and developing employment
forcing people to migrate oriented skills
? Inability to take family along, leaving ? Current programs on organisation of self
women folk at home help groups of poor and marginalised; this
? Poor living conditions in migrated could be a platform to handle these issues.
places….. conditions that enhances
chances of multi-partner sex
? High dependence on agents and masters for
credit, advances and employment
? Fear of losing continuous employment and
higher wages if masters wishes were not
satisfied
? No support systems for women to report
and get justice in case of
exploitation.(22% and 14% of
Unmarried and married females only
reported regarding availability of
support system, while 34% of men said
the same).
? Low literacy and lack of other employment
skills
? Acceptance by most that “these things
happen” .
3.5 Health Services:

The study focussed on the awareness of health services by young women for RTI/ STI
treatment, access to these services and perception of quality of these services. General
health seeking behaviour of the community too was discussed to understand whether the
attitude towards health was the same for all diseases or specific to STI/ RTI treatment.
Role of health services among women was very limited, as most of them neglected
diseases or resorted to self- medication. Usually ‘doctors1 ’ were consulted only when the
pain became unbearable. Most reported accessing traditional healers, particularly in
rural areas. This attitude was common for all diseases.
1
Includes qualified, unqualified, traditional
29
Awareness on availability of services to treat RTI/STI was low, particularly among the
rural women. There were no formal agencies
32% of males and 38% of females reported
providing services specifically for RTI/STIs availability of treatment services for RTIs / STIs
except in Ipur, Chilakaluripeta and Guntur. in their area.
Very few accessed these services, main
reasons being: 20% of males and 47% of females faced
embarrassment or problems from family and
society in taking treatment for STIs. “Sex
? Distance, as these services were located
related problems will come to only bad and
in far away places immoral people”.
? Lack of women- friendly services (place
of checking, counselling, women 14% of males and 32% of females reported not
doctors) seeking treatment if they have STIs.
? Lack of confidentiality while accessing
formal institutions/ doctors
? Doctors spending very less time in
patient ma nagement; sometimes ill-
Knowledge on RTI Service
treated patients Availability
? Non-availability of doctors, or too
much of waiting time for doctors 40
35
Particularly, women reported that they 30
faced embarrassment in taking treatment 25
for STIs, and did not discuss these in open. Percentage
In focus group discussions, majority Males Females

reported that local doctors/ Quacks
[registered medical practitioners (RMP), traditional healers and faith healers] as the
primary source for health services, as they were available readily, accessible at their
doorsteps, maintain confidentiality and affordable to the target population.

Issues Related to Health Services

? Attitudes related – negligence, self- ? Availability of qualified health care in
medication, till the point of reaching certain areas
serious health problem ? Current awareness programs by AIDS
? Belief in traditional and faith healing interventions in the District
? Access issues related to qualified health
care – availability, affordability, distance
? Embarrassment in taking treatment
regarding sexually related problems. “Sex
related problems will come only to bad and
immoral people”
? Lack of women-friendly health services
? Preventive health – not the main agenda in
family budgeting
30
? Belief that “AIDS will not affect me”

? Perception that quality of government
health system is very poor
3.6 Support Systems:

The study focussed on the availability of any kind of support structures (within the
family, community, government and non-government; both individuals and institutions)
for women, especially in case of sexual and other kinds of exploitatio n. If these systems
were available, what was the awareness and access of young women of Guntur District to
these systems, and perceptions of the quality and effectiveness in solving the problems.
As discussed elsewhere in the report, main

Only 34% male and 21% female had reported areas of exploitation were sexual activities
availability of support structures to help within the marriage, premarital and extramarital
women is subjected to exploitation.
sex, physical and sexual abuse related to
[Results of opinion poll] alcohol consumption, sexual exploitation in
work environment. Another major need area
Major support systems reported in times of
exploitation or harassment were family was the reliable and accessible information
members or friends. Very few had reported sources on sex and sexuality.
the formal judiciary or legal structures.
Only about a fifth of women respondents
[Results of FGD] reported having some support systems to talk
about their problems related to exploitation.
These systems were mainly the family elders and peers, who performed the role of
‘consoling’ the affected rather than ‘solving’ the problem in favour of women. Most of
the times, these support systems informed the affected that ‘women need to be patient
and whatever husband says they need to just follow; family life is all about adjusting”.
Any issue between husband and wife was left to themselves for solution, and most
respondents reported that males were the decision makers on these; others were not
allowed to interfere in these matters.
1.5% - 3% of unmarried women and 6 % – Unmarried girls, when subjected to

10% of married women across the district sexual abuse, felt ashamed and the
reported incest. socio-cultural practices did not allow
them to report to anybody, even with
[Results of opinion poll] their peers. As the persons involved
were usually elders respected by
45% of Guntur and 40% of Narasaropet
everyone in the family, it was even more
division of CBOs said that there are
difficult for them to report these.
incidences of incest in the community. While
the CBOs from Tenali division denied the
occurrence of incest. There were no reported community
based initiatives that could help women
[Results of DI] in case of any exploitation.
31
On the existing support systems like the legal and judiciary, almost all were aware that
these existed. But very few accessed it or even interested to access it. Main reasons:
? perception that these systems would favour only the rich and privileged
? lack of awareness on the procedure to access these systems
? fear that there would be more violence from the accused
? fear that the issue would be publicised and “our daughter will not get married”
? history showing that the process takes lot of time
? existing practices of ‘compromising’, using opinion leaders and local influencers so
that the issue is not brought in public
In general, as expected, respondents from urban areas were better informed about these
legal and judicial systems than their counterparts in rural areas. Literacy also played an
important role in awareness levels. Majority of the sites visited had reported definite need
of support structures to help women in distress and specifically in case of exploitation.

Issues Related to RTI/HIV/AIDS Services

? Low level of awareness on availability of ? Even though low the RTI/HIV/AIDS cases
RTI/HIV health services (28% of LLIs are recorded and treated.
only are aware) (31% of males and 28% of ? Acceptance is more wherever there is a
females only are aware) lady doctor.
? Spot prevalence of RTI is found to be 3
and 6% among Unmarried females and
males and 20% and 11% among married
females and males.
? The principle barriers were wrong social
perceptions. 20% of males and 47% of
females felt embrassed to seek treatment
while 14% of males and 32% of females
reported that they do not seek treatment
even if they have STI.
? About 60% of males and 70% of females
felt that treatment of RTI is a costly affair.
32

Issues Related to Support Systems

? Lack of effective support systems to ? Current programs on organisation of self
represent women’s problems. help groups of poor and marginalised; this
? 34% of unmarried and married men and could be a platform to handle these issues
21% and 14% of unmarried and married
females are aware of availability of support
systems.
? Current support systems of family and
peers ineffective.. mainly for consoling and
not for solving.
? Lack of awareness on the legal and
judiciary systems; procedures. (36% and
42%of unmarried males and females, 30%
and 27% of married males and females
only are aware of a legal support structure).
? “Women need to be patient and
adjusting”
3.7 Environment:
The study tried to understand the sensitivities and perceptions of immediate environment
in which a young woman lived. A series of in-depth interviews with local influencers,
health care providers, leaders, elected representatives, and police were carried out.
Most opinion leaders and influencers felt that alcohol consumption was the most
important issue that enhances the vulnerabilities of young women to STI/ HIV by many
folds. They felt that even if a person was well educated, and if he was addicted to
alcohol, it would be next to impossible to convince him of any good behaviour.
Most leaders and influencers had basic knowledge on STI/ HIV/ AIDS and its effect on
the community. However, the knowledge levels of religious leaders on STI/HIV/AIDS
were poor.
The prevalence of pre and extra marital sex and exploitation of women was reported in
almost all interviews. Most reiterated the need for building effective and community
friendly support structures.
The formal structures like police and judiciary had exhibited fair knowledge levels with
regard to STI/HIV/AIDS. Police and judiciary had acknowledged the prevalence of
violence or exploitation against women. It was also acknowledged that majority of the
cases were not being reported due to the sensitivity of the issue. Access to police stations
33
was also reported as one of the factors for not accessing them (most were headquarter
based). Most places did not posses women- friendly systems for the young women to
access and be comfortable (e.g. lack of women police in stations and special provisions
for women ).
The CBOs interacted were reported to have low knowledge levels on STI/HIV/AIDS.
The CBOs had also reported the prevalence of pre and extra marital relations and also
exploitation on women. Most CBOs were focussing on economic activities. However, a
few provided information on condoms as a part of their regular interventions.
The basic knowledge on STI/ HIV/ AIDS among teachers was low, particularly on issues
of transmission and prevention. It is important to note here that this was reported to be
the main source of information for the adolescents.
It was very encouraging to note that most of these influencers, leaders, police and others
were of the opinion that a very concerted effort required to weed out these social evils,
particularly alcoholism, exploitation of women and prevention of spread of STI/ HIV.

Issues Related to Environment

? Environment knowing and acknowledging ? Most opined that a very concerted effort
quite well the vulnerabilities and not doing required to weed out social evils,
anything about it exploitation of women and prevention of
? Over or under reporting of vulnerability spread of STI/ HIV
issues, as per convenience ? Willingness to participate in the effort in
? Low awareness levels of CBOs on STI/ whatever role possible
HIV/ AIDS issues
3.8 Exclusions – Gender, Poverty, Social Status:

The study tried to understand the differences in vulnerability status due to gender, social
and economic reasons.
There was a wide disparity in accepting a male child than a female child in the family.
Most reported that community generally preferred male child, because:
? the expenditure on male child was considered to be much lower than the female child
? female child was related to burdens – performing her marriage and attending to the
problems after marriage.
? male child considered as the bread earner and caretaker during parents’ old age.
? male child needed to perform funerals, for progeny
34
However, the trend seemed to be changing in urban areas, as more girls were able to
become bread-winners of the family.
Girls education generally stopped early due to economic reasons, problems in getting
suitable grooms, and chances of relationships with opposite sex. Girls were kept more at
home, particularly after their puberty. They were get married as soon as they reach
puberty to prevent them from any sexual abuse.
Decisions with women were mainly related to household and day-to-day work like
preparation of food, clothing, etc. Most of the economic and social decisions were with
the male members within the family. Even at the community level, decisions were
mostly taken by male leaders; however the trend seemed to be changing at least in some
locations ( Pallapatla,Lingayapalem), as more women (through CBOs) were participating
in village level decisions.
One of major vulnerability for women was sexual abuse in work places, particularly
during migration and daily wage labour in unorganised set up. Typical profiles of
households entering these were usually the poor and socially disadvantaged. Their
vulnerability seemed to be higher as they were ‘bonded’ through advances/ credit and
promises of continuous employment. Added to this were their illiteracy and lack of
support systems.

Issues Related to Exclusions – Gender, Economic, Social

? Gender disparity….. women treated ? Interventions focussing on empowering
differently from birth; more in rural women, socially disadvantaged and the
? Poor and marginalised forced to enter poor – government and non-government
‘risky’ occupations (knowing well these programs
‘risks’) ? Literacy and awareness of adolescents and
? Lack of supporting structures young
? Socio-cultural barriers against women,
socially and economically marginalised
35
4 Resources Mapped
The resources available in the District (institutions, programs) which CHARCA could
access during its implementation was mapped through discussions with various
government and non- governmental organisations. This exercise was done prior to the
DSA as a part of selection of NGOs for the core group, and provides information mostly
on non-governmental organisations. The list is at Annex D.
On the HIV/AIDS aspects there are lot many NGOs are working either
independently(SHO- Service Health Organization) or through partnership with DFID, APSACS,
etc., (SEEDS, APPU).
There are certain NGOs working on targeted intervention programs through APSACS –
SEEDS, KMM, SPANDANA, VEERA HANUMA, and JAIL Project in GUNTUR. Needs at
Chilakaluripet, CRDS at Narasaraopet, AMM at Mangalagiri.
There are two care and support centers in working in Guntur – APPU (Guntur),
GRETANALTIS ( Morempudi)
The Guntur medical college with its attached teaching hospital has a fully established
department of sexually transmitted diseases / HIV/ AIDS medicine unit which is doing a
pioneering work in the field of HIV/ AIDS & STDs and playing a significant role. The TB & ID
hospital attached to GMC is providing pulmonary care in consortium with district TB centre. The
department of microbiology of GMC is running a voluntary counseling and testing centre in the
premises of Govt. General Hospital (it needs urgently a number for the persons to go directly).
The department of obstetrics and gynecology is running a VCTC and PMTCT program and it is
staffed with qualified counselors and dedicated doctors. Jointly the departments of obstetrics and
gynecology, STD / HIV/ AIDS medicine, microbiology, are conducting surveillance activities
routinely and recently completed community based STI prevalence study in the districts of
Guntur, Prakasam, and Nellore. These departments are also training primary, secondary and
tertiary care doctors and paramedics working in the districts of Guntur, Prakasam, and Nellore on
HIV/ AIDS diagnosis and management.
Apart from GGH, Guntur the area hospital at Tenali, Bapatla, Narasaropet, are also
conducting VCTC. The doctors working under APVVP in the district were also trained to
implement PMTCT program which is already taken up at Tenali and about to start at other
places.
In the government sector there is a well established blood bank at Govt. General Hospital,
Guntur and at Area hospital, Tenali. In the private front there are five licensed blood banks, all in
Guntur town itself. Apart from the STD clinic in Govt. General Hopital Guntur, the area hospital
at Bapatla, Tenali, Narasaraopet, Chilakaluripet also have STD clinics. In the private front there
are numerous skin & VD specialists who are providing care to PLWHA. There are also five
private nursing homes providing inpatient care to PLWHA.
Women Development Programs: ?

DWACRA scheme: ?
36
5 Conclusions
Young women (12 – 30 years) in Guntur were at a heightened risk of acquiring STI/ HIV,
due to the following major factors:
? Lack of knowledge and awareness on STI/ HIV/ AIDS, sexual health, poor health
seeking behaviour, limited access to qualified health care, lack of awareness on
rights, limited capacity to seek help, and lack of support systems, at the individual
level. Poor awareness levels of the information sources available to individuals and
illiteracy also played important role in increasing the vulnerability.
? Alcohol consumption and the resultant behaviour (physical and sexual abuse of
women) by males was one of the major factors in increasing the vulnerabilities of
young women towards acquiring STI/ HIV. There was a high correlation between
alcohol consumption and sexual abuse of women.
? At the family level, factors increasing vulnerability were guardians’ limited ability to
provides support, guide and counsel young women on issues relating sexuality,
physical and sexual abuse, alcohol abuse within the family. Gender equations within
the family clearly limited women’s capacity vis-à-vis their male partners
considerably, leaving them more vulnerable to HIV and other sexually transmitted
diseases through males.
? At the community level, vulnerability of women was heightened due to lack of

effective support systems to address women’s problems, low position of women in
the society compared to men, low literacy, low capacity to earn and high dependence
on males. Current community initiatives focussed mainly on economic issues, and
social and health issues were covered only by a few. The stigma attached to buying
and using of condoms (that condom is used only in sex work/ multi partner sex)
prevented many from even asking their partners to use this. Similarly, the stigma
towards STI/ RTI prevented women from reporting and seeking treatment for it.
? Even among sections where awareness levels were higher, the same has not resulted
in practice. The factors that affected practice were mainly issues related to lack of
women’s capacity negotiate, seek help, ability to influence, skills to use the
knowledge, supporting systems to back her up in case of troubles.
The category of primary stakeholders affected most were the married women at the
reproductive age group, particularly in rural areas, mostly illiterate, having limited access
to information and help.
37
The study identified many factors that have the potential to address vulnerabilities of
young women. These are listed below. CHARCA at Guntur can think of effectively
coordinating and utilising these so that the problems of young women can be addressed
holistically and in a concerted fashion.
? Most leaders, influencers and support service agencies opined that a very concerted
effort required to weed out social evils like alcohol consumption, exploitation of
women and prevention of spread of STI/ HIV. Many were willing to participate in
the effort in whatever role possible.
? Current programs by government and NGO in organisation of self help groups,
particularly for the poorest and socially disadvantaged, could be used as a platform to
handle these issues related to women. These groups were mainly by and for the
women, and work towards in empowering them economically and socially.
? Current awareness programs by AIDS interventions by APSACS and other agencies
through mass media, and school awareness programs for adolescents seemed to have
created basic awareness on the disease. These programs could be followed up
through community level counselling initiatives (through CBOs so that the felt needs
of ‘personal information sources’ are met.
? Interventions by government and NGOs in savings, credit and developing job
oriented skills for women have, to some extent, improved the participation of women
in economic decisions at the household level. These interventions have been
contributing to improving incomes and surplus in the hands of women. These
interventions could be linked to health so that higher level of spending is done in
favour of women, and particularly for their preventive health.
? Most CBOs, leaders and primary stakeholders recognised that alcohol consumption
was the main evil that increased women’s vulnerability. Eradication of alcohol has
been taken up by some CBOs as their main social agenda. This could be supported
and nurtured so that the most important vulnerability factor could be addressed.
? Programs like RCH and family planning are working towards improving awareness
on sex related issues. Similarly, free supply of condoms being done through health
centres. These integrated with inputs on skills and personal counselling, so that the
awareness results in practice.
38
Project Imperatives
To reduce the vulnerabilities of young women from acquiring STI/ HIV, a multi pronged,
collaborative effort may be required. The intervention need to go much beyond just
creating awareness on the issues, but address causal factors that result in a particular
behaviour.
As could be seen from the DS A, there is a major gap between awareness and practice,
and issues affecting these are not issues of health, or STI/ HIV. These relate to
empowerment of women individually, sensitising families and communities to create an
enabling environment for women to protect themselves. The DSA also shows that many
stakeholders are interested in working towards this end, but needed a coordinatated and
concerted effort towards this.
The study also showed how important it is to work with men if the women’s vulnerability
is to be addressed. It is clearly evident that the empowerment of women can’t take place
without the transformation of men.
Specific Areas that Need to be Addressed:
? Awareness and knowledge building regarding general health, sexual health, human
and sexual rights
? Building support systems via family counselling, ‘personal’ information sources,
community organisations; focus on issues of sexual health within the family and
community
? Evaluation of gender equity and dynamics; sensitisation of male partners / guardians
and equipping the woman to adopt a position of self preservation
? Advocacy among society leaders, influencers and elders regarding the need for
support to individual women in trouble; issues of confidentiality and non-judgemental
attitudes combined with care and support
? Reorientation of HIV/STI focus on the potential threat; an orientation to members of
the general community, both male and female, about the realistic nature of the threat
and its ability to reach both good and bad people. Eve ntually aiming at acceptance of
the threat of HIV /STI among members of the general population.
39
Annex A: Minutes of the Core Group & RSC

Minutes of the Core Group Meeting:
CHARCA (Co-ordinated HIV/AIDS/STD Response through Capacity-building and

Awareness) is a project for addressing the vulnerabilities of young women to
STI/HIV/AIDS. As a part of the project initiation a planning workshop was held on 10th
and 11th August 2002 in Guntur. The key objectives were:
? Inform the district stakeholders about the project and its remit
? Build consensus on the project approach
? Form a core group (of stakeholder representatives), which will guide the project
initiation phase
? Map the steps forward in project initiation (including DSA & DSP preparation
mechanisms)
The workshop suggested a Core Group be formed, with the following representation:
Primary Stakeholders 4 (1- PLWHA (preferably women) 1 male and

1 female youth and 1 married women.
Government departments 2 (Including APSACS)
Universities / Academic ins titutions 2 (One University and One Medical College)
Non – Government Organizations 2
Any others as suggested by the District Collector.
It was then left to the District Collector to nominate names. Through an order dated 1st
September 2002, the Collector has nominated 15 Core Group members (Seen Annex A
for names). The Core Group is vested with the responsibility of carrying forward the
CHARCA Project in Guntur.
To begin the activities, APSACS and CMS organised the first Core Group Meeting on 3rd
September 2002 at DRDA Hall, Guntur. The meeting had the following objectives:
? Understand the CHARCA project

? Discuss and decide the individual role of each core group member
? Plan for the conduct of the District Situational Assessment (DSA) – A research to
map the vulnerabilities of young women to STI / HIV / AIDS
Other than the Core Group members, there were other participants and representatives.
For full list attendees, see Annex A1.
40
The project director, APSACS welcomed the participants. Mr. Shiv Kumar, Catalyst
Management Services, Bangalore briefed the participants about the objectives of the
workshop. He also made a presentation about the CHARCA project and recapped the
proceedings of the planning workshop held on 10th and 11th August 2002. He also
explained the importance of the core group and the role of the technical team (CMS). He
highlighted the responsibility of the core group to take forward processes from this point
onwards. Mr. Heeralal Samaria, District Collector attended the meeting briefly.
KEY DISCUSSIONS AND DECISIONS BELOW:
1. Research Sub-committee:
The need for focusing on the next step – research was discussed. As the Core Group
itself was large and that it may not be able to involve itself with all activities, the
feasibility of a Research Sub-Committee was discussed.
Decisions: A Research Sub-committee consisting of the academic and NGO

representatives was formed. This sub-committee will be involved in the planning and
execution of the DSA. They will interact closely with the Core Group and as well as the
researchers. They will guide and manage the research, with the help of CMS. Sub-
committee members:
? Mr. Laxmipathi raju, Nagarjuna University.

? Dr. T.L.N. Prasad, Guntur Medical College.
? Mr. Roshan Kumar, SEEDS Organisation.
? Mr. Ranjan Kumar, CARDS Organisation.
? Dr. Seva Kumar, SHO organization.
2. Need for the DSA:
Mr. Venkateshwar Rao, NYK and Mr. Caleb, SC/ST Corporation raised the issue that
Guntur is now quite infamous for HIV. Therefore is there a need for the research (DSA)?
As most of us understand the situation, can we not proceed with the project
implementation?
Ms. Damayanthi and Shiv Kumar explained the need to understand, esp. from the point
of view of young women, what are their specific problems in protecting themselves.
Though we have data on HIV and STDs, we have little by way of behaviour, barriers to
health access, etc. These are issues that CHARCA will address; and hence the research.
3. Research team
The profile of research team was discussed. CMS informed the Core Group that a budget
for paying the researchers and expenses was available, which the Convenor can access.
They also shared their experience in other states where at least 10 researchers and two
41
supervisors are essential. The mix of male / female and background of researchers were
discussed.
Decisions:
? The research team will comprise of a coordinator and 2 senior researchers and 4
junior researchers.
? Research sub-committee will select the research team.
? The research team should be a mix of NGO Outreach workers (with experience) and
social researchers.
? Team should have at least 50 % women.
? Few extra persons will need to be selected, keeping in mind drop out rates.
? CMS will guide the sub-committee in selection, based on their experience elsewhere.
4. Research:
The conduct of the research, sampling and other issues were discussed. Dr. Prasad
offered that he has already collected sufficient secondary data, which will save time.
CMS also offered to send a list of secondary data requir ed for planning the research.
Decisions:
? CMS will forward the CHARCA Bellary report and tools to be used in Mizoram to
the Core Group in the next four days.
? A Planning workshop will be held on 15-16th September at Guntur
? Research sub-committee and CMS staff will participate in this meeting
? This workshop will plan the entire research (sampling, research team, logistics, tools,
etc)
? The outputs will be presented to the Core Group on 16th at 5.30 pm
? The Core Group’s feedback will be incorporated to finalise the research
methodologies.
5. Need for speed and focus:
The issue of how often the Core Group needs to meet was discussed. Fortnight and
weekly options were examined. PD, APSACS expressed that Core Group needs to meet
every week and the Research Sub-committee every day, so that sufficient focus is given
to the project. CMS representative suggested that rather than meeting for a few hours
everyday, it may be more productive if the sub-committee met for two intensive days for
planning the research.
Decision:
? The Core Group will meet every fortnight till the project initiation phase.
? The Research Sub-committee will meet on 15-16th Sep initially, and then on a weekly
basis.
42
6. Pre-testing:
The issue of pre-testing was discussed. Some of the partic ipants felt that Mizoram
checklists can be straight away pre-tested and then the tools modified. CMS
representative cautioned that without the researchers in place, pre-testing will not be very
useful and may have to be done twice. He also explained that pre-testing will be more
beneficial after the tools have been modified for Guntur (by the Research Sub-committee)
and when the researches have been trained). PD, APSACS stressed the need to learn from
other states rather than reinventing the wheel.
Decision: Pre-testing to follow the training of researchers and after the tools have been
modified for Guntur setting.
7. Stakeholder consultations
The issue of how primary stakeholders can be consulted was discussed. PD, APSACS
felt that adding a few primary stakeholders in Core group was not sufficient. Other
options were also discussed. PD, APSACS suggested that the results of the DSA
(research) needs to be presented at divisional level and feedback and suggestions for
strategic plan obtained from primary stakeholders. There were other suggestions that the
DSA results need to be presented to elected representatives, doctors, etc
Decisions:
? After the DSA is complete, the Core Group will take responsibility for presenting the
findings of the DSA at divisional level to a cross section of primary stakeholders.
Feedback for validation of results along with suggestions for strategic plan will be
obtained.
? Post this consultation, a DSA workshop will also be organised at district level for
sharing findings with various stakeholders (mainly secondary stakeholders).
8. Schedules and time frame:
The following schedule were agreed upon:
Designing tools Research Sub Committee 15th and 16th September

2002
Presenting the tools Research Sub Committee 16th September 2002
developed to the core group (5.30 pm)
Training the research team Catalyst Management 19-21 September 2002
Services
Research Field work Research team 23 Sep to 3 Oct
DSA report preparation Research Sub Committee, 4 Oct to 16 Oct
assisted by CMS
43
Divisional level Core Group 17-25 Oct

dissemination of the DSA
report to various stakeholders
DSP workshop 29-30 Oct
(Only a –d) discussed in the workshop. The rest are suggestions from CMS, which will
need to be discussed and finalised in next Core Group Meeting)
9. Action points:
Workshop minutes Catalyst Management Services 7 September 2002
Research tools used in Bellary Catalyst Management Services 7th September 2002
and Mizoram
Format for Secondary Catalyst Management Services 7th September 2002
information to be gathered.
Profile of the research team Catalyst Management Services 7th September 2002
Annex A1: List of Participants:
CORE GROUP
? Dr. C. Vasanth Kumar, Professor OBG, Guntur Medical College.
? Dr. D. Madhavi, Medical Officer, PHC.
? Dr. T.L.N. Prasad, Asst. Professor, Guntur Medical College
? Dr. Seva Kumar, SHO, NGO.
? Dr. Uma Devi, District Leprosy Officer. - Convenor
? J. Rani, Community Representative, Sharada Colony.
? Lakshmi, Community Representative, Sharada Colony.
? Mr. B. Venkateshwar Rao, NYK
? Mr. G. Babu Rao, Government Hospital, Guntur.
? Mr. M.Caleb, SC Corporation.
? Mr. Roshan Kumar, SEEDS, NGO.
? Ms. Vasantha Laxmi, MPDO.
? P. Ranjan Babu, CARDS, NGO.
? Pankajakshi, Sai Yuva Shakti.
? Prof. M. Laxmipathi raju, Dept. of social work, Nagarjuna University.
? Mr. Sudharsan, CEO, STEP
?
44
SNO Name Organisation/ Profession DESIGNATION
1 Dr. P. Uma Devi District Leprosy Officer, Guntur Convenor
2 Mr. J. Murali Project Director, DRDA, Guntur Member
3 Mr. M. Caleb Chief executive officer, SC corporation, Member

Guntur
4 Mr.G. Sudarshan Youth welfare Officer, Guntur Member
5 Prof. C. Vasantha Kumar Head of Obstetrics & Gynecology Member

Department, Guntur Medical college,
Guntur
6 Prof. G. Babu Rao Superintendent, Fever Hospital, Guntur Member
7 Dr. T.L.N. Prasad Assistant Professor of STD, Guntur Member

Medical College, Guntur
8 Dr. T. Seva Kumar President Service Health Organization, Member

Guntur
9 Prof. M. Laxmipathi Raju HOD Social work, Nagarjuna Member

University, Guntur
10 Mr. D. Roshan Kumar Project Director SEEDS, Guntur Member
11 Mr. P. Ranjan Babu Project Director CARDS, Guntur Member
12 Dr D. . Madhavi Medical Officer PHC, Pedakakani Member
13 Ms. Vasantha Laxmi Rural MDO, Guntur Member
14 Ms. K. Laxmirajyam PLWH Member
15 Mr. D. venkateswara Rao Youth Leader Member
16 Miss. J. Swarupa Rani Primary Stake holder nominated by ED Member

SC corporation
17 Pankajakshi Primary stake holder nominated by PD Member

DRDA, Yuva Shakthi
45
Other attendees:
? Mr. Heeralal Samaria, District Collector

? Ms. K. Damayanthi, Project Director, APSACS,
? Mr. D. Venkateshwarlu, DEO.
? Mr. G. Sudershan, CEO, STEP.
? Mr. J.V.K. Prasad, DPRO, Guntur.
? Mr. K. Antony, A.I.R, Vijayawada.
? Mr. K. Shravan Kumar, Catalyst Management Services, Bangalore.
? Mr. K.Venkateshwarlu, APMO, DLO Office.
? Mr. N. Shiv Kumar, Catalyst Management Services, Bangalore.
? Ms. Ramani, APSACS.
? Ms. S. Sivaparvathi, M.D.O.
? Ms. Sudha Murali, UNICEF.
? Ms. Vedavathi, A.I.R, Vijayawada.
Minutes of the Research Sub-Committee Meeting: (15-16 Sep 02)
? To plan for the District Situational Assessment in Guntur.
Participants:
S.No Name Organisation

1 Dr. C. Vasanth Kumar Head of the Dept., Gynaecology,
Government General Hospital, Guntur.
2 Prof. M. Lakshmipathy Raju Head of the Dept., Social work,
Nagarjuna University
3 Dr. T.L.N. Prasad Asst. Prof. of STD & HIV/AIDS
medicine, Government General
Hospital, Guntur.
4 Dr. P. Uma Devi District Leprosy Officer, District
Medical and Health Office, Guntur.
5 Ms. Ramani Consultant, Andhra Pradesh State AIDS
Control Society, Hyderabad.
6 Mr. D. Roshan Kumar Project Director, SEEDS, NGO.
7 Mr. P. Ranjan Babu Project Director, CARDS, NGO.
8 Mr. Raghunathan Catalyst Management Services.
9 Mr. K. Shravan Kumar Catalyst Management Services.
10 Ms. Nisha Bora Catalyst Management Services.
46
Core Group Members (0n 16th September 2002)
S.No Name Organisation

1 Dr. G. Babu Rao Professor of TB and CD, Fever
Hospital, Guntur.
2 Dr. C. Vasanth Kumar Head of the Dept., Gynaecology,
Government General Hospital, Guntur.
3 Mr. M. Caleb Executive Director, SC Corporation,
Guntur.
4 Ms. Vasantha Lakshmi MPDO, Guntur.
5 Mr. G. Sudarshan CEO, District Youth and Welfare
Office, Guntur.
6 Ms. K. Lakshmi Rajyam Community Representative, Guntur.
7 Ms. J. Ra ni Community Representative, Guntur.
DAY – I (15t h Septe mber 2002)
Mr Raghunathan, CMS representative, welcomed the participants and presented a brief

explanation on the agenda for the meeting including:
? Explanation of objectives and the expected outputs of the research sub committee
meeting.
? Highlighting the need of developing the DSA plan for Guntur based on the
experiences and learning of DSA implemented in Bellary and Mizoram rather than
reinventing the wheel. Participants expressed their consent to develop the Guntur
DSA plan based on the experiences and learnings of the DSA conducted in other
districts.
? A discussion was conducted about the process adopted, experiences and learning
from the DSA implemented in Bellary and Mizoram, followed by a dis cussion among
participants regarding the scope of the DSAs in Bellary and Mizoram.
? Participants felt that the DSA scope of the pilot districts exhaustively cover the issues
with regard to all the components of CHARCA.
? Based on these discussions the objectives and the scope of the DSA in Guntur were
identified and agreed upon
? A discussion was held on Guntur-specific factors that are relevant to CHARCA and
would need to be included in the research tools and DSA, if not already covered in
Bellary and Aizawl
? The universe for the DSA was defined.
? A list of issues to be researched was presented by CMS. The RSC members evaluated
the list and identified the sources of information for each. Some issues were expanded
to fit the Guntur context.
? The research team size and structure were discussed and finalized. Outline of criteria
for selection of researchers was discussed. The Research Sub Committee members
agreed to locate researchers in time for the next meeting, to be held on Sep 16.
47
CMS representatives led a discussion on the methodology for data collection used in
Bellary and Mizoram, followed by an agreement on the broad methodology to be
followed in Guntur. This was followed by a discussion on the exact categories of
participants among whom the research would be conducted. CMS presented the
categorization used in Bellary (Females married and unmarried, Males married and
unmarried) and Mizoram (Young Adult Females 13-17 years unmarried, Adult Females
14 –25 years married and unmarried, Males 16-30 years married and unmarried,
Guardians i.e. mothers and mothers- in-law of 13-25 year old women). The rationale for
the stated categorization was as follows:
? Experiences of married and unmarried people vary greatly. Hence there is a need to
address them separately
? Perceptions and experiences of a 13-year-old girl are bound to be very different from
that of a 25-year-old woman. Hence it is necessary to split the age groups in order to
introduce an element of homogeneity
? The male partners need to be addressed as their behaviour has a strong impact on the
health of the woman. Moreover the behaviour of the woman cannot be meaningfully
altered without addressing her partner as well.
? Female guardians need to be met with, as they are the closest family member in the
life of the primary stakeholder. The female guardian’s perceptions and beliefs often
dictate hoe the young woman behaves, what she is allowed and not allowed to do.
The RSC decided that the population in Guntur required further categorization as the age
band for the primary stakeholders had been widened here vis-à-vis Bellary and Aizawl,
i.e. from 13-25 years to 12-30 years. Following this, a detailed plan of the sample in
every village was listed.
DAY – II (16t h September 2002 )
The day began with a brief recap of the day one meeting. Later the following were
discussed.
A plan of activities for each village. Prior experiences form Bellary and Aizawl were
shared in terms of local contacts. CMS stated that the village level activities would be
difficult to conduct without the cooperation and help of local influential people to garner
the required number of people in each village, 158+. The RSC agreed that it would be
necessary to enlist local help for the fieldwork in each site. A plan of activities for the
implementation of DSA in selected samples was prepared.
CMS representatives presented the sampling method adopted in conducting DSA in

Bellary and Mizoram. The RSC members discussed the sampling process and developed
the criteria to select the sample in Guntur District for conducting DSA. It was discussed
that the sample will be selected based on the three divisions in Guntur districts.
Representatives from NGOs, Academicians and others were requested to join the meeting
in the afternoon for selecting potential members for the research team. In the afternoon,
48
the representatives joined the meet. They introduced themselves to the RSC and were told
about the proposed research activities. Majority of them were having experience in
working with HIV/AIDS programme or in conducting research. Selection was not done
on that day as some other representatives were expected.
Later discussed on the training for the research team. CMS representatives had said that
they would intensively train the selected coordinators who in turn will train the other
researchers. Mr. Roshan Kumar and Mr. Lakshmi Pathy Raju had taken the responsibility
of recruiting the research team by 18th September 2002. CMS had tentatively planned the
training programme on 19th September to 21 September. After the training programme to
the team members, a field test on the tools developed was planned on 23rd, a review and
analysis of the field visit is planned on 24th September 2002.
Presentation to the Core Group
After the RSC meet, Dr. T.L.N. Prasad, Asst. Professor, Guntur General Hospital had
presented the proceedings and the outputs of the meet to the core group members.
Discussion points
The ED, SC Corporation discussed on sampling methods, research team and the training
schedule of the team members. CMS representatives explained him the sampling method
adopted in selecting the sample for implementing DSA and had said that as some of the
secondary data needs to be collected the selection of samples will be completed on 18th
September 2002. The ED had also suggested that it would be better if CMS provides the
training for entire team members. He had also suggested that the DRDA hall could be
used for training the research team. ED also had mentioned that he could extend his help
in collecting the secondary information.
The MPDO had discussed about the field visit for the pre testing. In the discussions, she
had mentioned that she could make arrangements for the field visit, such as informing the
village leaders and mobilizing the members for group discussions and polling booth. She
had also suggested Potthur village for the pre testing.
Out puts of t he RSC Mee t
DAY –I
Scope of Guntur DSA
? Profile and segment the target group of young women (12-30) in the district of
Guntur
? Identify socio-cultural and economic factors that influence the status of women in
family and society.
? Understand their level of knowledge, skill and capacities to exercise control over
sexual and reproductive issues, and access to relevant information.
49
? Map the main vulnerability fa ctors that may increase the target group’s risk of
acquiring STD/ HIV/AIDS.
? Assess the availability and access to medical services, and perceived quality of
services.
? Assess the availability and access to support mechanisms, groups and structures to
address issues related to young women’s vulnerability.
? Map agencies (Government, UN system, multilateral, bilateral and other development
initiatives) that work in Guntur district and identify possible roles and areas of
collaboration with these agencies.
Guntur-specific issues to be dealt with in DSA
Three revenue divisions
? Tenali – coastal, agricultural, rich, thickly populated

? Narsaraopet – upland, dry, rain dependent, characterized by both inward and outward
migration, with a high rate/ incidence of violence, tribal population, and strong
presence of Naxals
? Guntur – with a largely urban population, sites for melas and pilgrimages, hub of
commercial crops, with business visitors, an education centre, several industries,
women at work, tertiary medical services and the highest proportion of 12-30 years
women
Presence of different sub- groups, for e.g. cross-dressing as a part of religious practices,
which are vulnerable towards acquiring STD/HIV/AIDS.
The socio-cultural schisms are based on:
? Caste, Sect, Religion.

? Rural / Urban / Peri- urban differences.
? Literacy / Illiteracy.
? Marital status.
? Economic status ( income, assets, occupation).
List of issues to be researched
The highlighted issues were added by the Research Sub-committee
Issues to be Researched Sources of Information

Profile of the target population (12 – 30)
Age, sex, marital status, literacy status, educational CPO – Chief Planning Officer,
qualifications, occupational status, housing, income levels District Manager Industries.
(BPL), religion and caste, household size, head of househo ld Assistant Director Industries
(dejure/ defacto), earning members, women in industries : (for female wo rkers) + District
tobacco, cotton, chilly (300 small scale and 50 large scale census
industries in Guntur District)
50
Migration patterns
Gender composition of migration, Age profile of migrants, Field research + census records
Seasonal migration, Exploitation in migration. Types of + CPO
migration – daily, seasonal, long term
Marriage
Age at marriage, social expectations, hopes and reality in DM & HO (for age of marriage)
marriage, divorce, polygamy, sex before or outside marriage, + field research + Dr Prasad
separation, desertion and widowhood, practices (For baseline research findings)
Health status
Pregnancies before and after marriage, STI, miscarriages, DM&HO (For FHAC, on
anaemia, abortions, use of contraceptives/ sterilization, general general status and STI) + Dr
health status Prasad (For STI figures) + field
research
Level of knowledge, perception and understanding of issues:
Reproductive system (male, female) – menstruation, child birth, Dr Prasad (For some indicative
pregnancy prevention findings) + Field research
Sexual health issues – menstrual hygiene, changes in cultur al
practices in sex (especially violence), communication of sex and
sexuality (children, peers, spouses, parents,…………….)
RTI/ STI - HIV/ AIDS
Health care – availability of services
Myths and misconceptions prevalent about sex, sexuality, body,
HIV/AIDS, STI
Rights – legal, violence
Education – importance, value, constraints
Inter linkages – violence & health
Health seeking behaviour
Where and for what? - Menstrual, child birth, STI, (RCH list) Field research + Dr Prasad (for
Existing practices and places accessed some background information)
Health issues which are a problem – information, cure
Priority given to women health
Social and cultural barriers to access – preventive & curative
Availability of health care systems – govt., private, others
Access to the target group
Cost of health care
Perception of the quality of services
Levels of autonomy, dependence and barriers
Delayed treatment- interval between onset of illness and actual
treatment
Knowledge of health services available
Health infrastructure:
Practitioners – Private, Government, traditional, Traditional DM&HO + field research
Indian Systems of Medicine (TISM)/ Other systems of medicine
51
Hospitals, nursing homes, PHC/PHUs, SC, CHC, Dispensaries,

pharmacies
Health workers – ANMs, leprosy, TB, TBAs (trained &
untrained)
Gender sensitivity of services
Sensitivity to STI / HIV
Facilities – RTI/STI, termination of pregnancy, child birth
Counseling and youth services
Availability of lady doctors
Care and support services
Blood availability
Programmes and schemes
Utilization
Gaps in services
Other relevant issues:
Cultural beliefs, religious, values, practices Field research
Violence and abuse – domestic and outside
Trafficking –women & children, labour, adoption
Substance abuse – Drugs, alcohol, tobacco
Child labour Child Labour Dept + Field
research + DPEP
Stigma, discrimination and violence – Field research
Unproven cases of violence Family Counseling centers +
Police + CBO + NGO + PSH
Prevalence of STI, HIV/AIDS – own, spouses, others APVVP, DCHS, VCTC, Dept
of STD + GGH + PMTCT +
Blood banks + Field
Information on sex work NGOs in TI + Police
Incidence of female feticide, infanticide, Incidence of sex Field research
selective abortions
Support available to PLWHA APSACS / NGOs
Institutions, programmes, schemes:
Institutions – Govt, NGOs, CBOs, clubs, local govt (Village, RD DRDA + NGO networks +
block and district) NSTDC + Govt Doctors’
Programmes / schemes – NACP II (also FHAC), RCH, ICDS, Association + PMV +
JRY, adult education etc., DWACRA- 2000 groups in Guntur. Respective deptts
Programmes are defined as those with specific focus on women,
medicine and health
Departments of Govt – Health, education, youth affairs, women
& child development, WDC, social welfare, rural development,
women, tourism, endowments
Projects – IPP IX, other project (user groups),
Commission and committees - human rights commission,
women’s commission
52
Forums – IMA, School development, lawyers, migrants,

women’s forums, if any
Support groups, institutions, type and quality of services, CBOs,
field workers
Private sector
Civil society initiatives
RESEARCH DETAILS
Universe for Guntur DSA

? Young women in the age group of 12 – 30 years in Guntur District
? Agencies working directly or indirectly on issues related to CHARCA
Research team size and structure

? 3 teams of four members each
? One female senior researcher, one female junior researcher
? One male senior researcher, one female junior researcher
? One team would be assigned to each division
A Research Coordinator would lead the entire research team. The research sub committee
nominated Dr. TLN. Prasad as the research coordinator.
Criteria for selection of researchers

? Experience in Social Sciences
? Experience in Field work
? Communication skills
? Ability and willingness to travel
? Time commitments
Methodologies for data collection

? Focus group discussions, using a story line (FGD)
? Polling booths (PB)
? Individual interviews (DI)
? Secondary data collection
Profile of sample per village
Primary Stakeholders (Females, 12 – 30 Yrs)

Sub-group Reasons Technique to be Used
12-20 Unmarried Exposure before and after marriage – Polling Booth & FGD
21-30 Unmarried varies widely, particularly issues Polling Booth & FGD
12-20 Married related to the research Polling Booth & FGD
21-30 Married Age factor Polling Booth & FGD
Maturity factor
Value systems
53
Males

15-25 Unmarried Exposure before and after Polling Booth & FGD
15-25 Married marriage - varies widely, Polling Booth & FGD
26-50 Married particularly issues related to the Polling Booth & FGD
research
Age factor
Maturity factor
Value systems
Husbands, fathers, brothers,

partners, guardians….
Mothers and Mothers- in-law

40-50 years Mothers and mothers- in- law FGD
having at least one daughter or
daughter- in- law of at least 12
years
DAY –II
Plan at every village
Total number of days per site : 3
Team II (SR-M, JR-M) Time

Before arrival Information to village,
opinion leaders, panchayat –
on the study and the
proposed public meeting by
local contact, as well as
participant requirements
Day 1
On Arrival Public Meeting – to Setting up polling booth 1.5 hours
introduce the team, brief on
study, cooperation and
support
The research sample per village will be as follows:
54
Focus Group Discussions - Approximately 2 hours each, with 8-10 members each
Sample
15-25 Unmarried Males
15-25 yr old Married Males
12-20 yr Unmarried Females
21-30 yr old Unmarried Females
12-20 yr Married Females
21-30 yr old Married Females
40-50 yr old Female Guardians
Polling Booths - Approximately .5 hours each, with 8 – 10 members each

Sample
15-25 Unmarried Males
15-25 yr Married Males
12-20 yr Unmarried Females
21-30 yr old Unmarried Females
12-20 yr Married Females
21-30 yr old Married Females
Total number of Focus Group Discussions per site: 8

Total number of Polling Booths per site: 7
Interviews RURAL URBAN

Opinion Religious leaders Religious leaders
leaders Community leaders (caste) Community leaders (caste)
Influential families Influential families
Group leaders (labour, Agri …)
Group leaders (labour, Agri …)
Administration GP member – President & Female
Political leaders (ward counsellors,
Village Secretary MLAs, MPs..)
District administration
CBOs Women Leaders – (DWACRA, DRDA, DWCUA, SHGs
SHG…) – SC/ST, Other Castes Maithri sanghas
Health Mahila mandal’s/ Pragathi Mahila
Maithri sanghas Sangha
Others Rotary / Lions clubs (Innerwheel)
Lok sattha, Jana Vignana vedika
55
Service Medical officer/MPHEO/Male and NGOs in HIV, RCH, Health, Women

providers Female Health workers Empowerment
Pvt allopathic practitioners UHCs
AWW Medical colleges
NGOs/Trusts Taluk and divisional hospitals
Other TISMs Rly hospitals
Unqualified pvt medical practitioners
Police hospitals
Teachers ESI hospitals
Pvt hospitals / Clinics
Other TISMs
Unqualified pvt medical practitioners
Agencies Police (Sr. persons, women members) Police (Sr. person, Women cell)
dealing with Judiciary Judiciary/ Legal Aid/ Family
violence Family Counseling centers counselling centers
Total number of interviews per site: rural – 8, urban – 11
The categories marked in bold were identified by the RSC as being critical to the study
and a part of the minimum list of interviewees to be covered.
Criteria for sampling
To select the sample mandals based on division wise the RSC members identified the
following factors.
? Caste.
? Economy.
? Literacy.
? Rural / Urban city.
? Population Density
? Sex Ratio.
Action Points
Particulars Responsibility Date

Secondary information on Mr. Roshan Kumar, SEEDS 17th September 2002
BPL and village wise data
Selection of Research team Dr. Laxmipathy raju, 18th September 2002
members Nagarjuna University and Mr.
Roshan Kumar, SEEDS.
Sample for conducting DSA Catalyst Management Services 19th September 2002
Commencement of training to Catalyst Management Services 19th September 2002
the research team
56
Annex B: Details of Study Sites
MACHAYAPALEM
Mandal Division District
Bellamkonda Guntur Guntur
Population details 7
Total Male Female

1891
Infrastructure details
? Remote village with poor transport facilities. RTC buses ply only twice a day. Other means of
transport are private taxis and autos.
? No protected drinking water supply.
? Irregular power supply.
? Police station is about 3 kms from the village and covers about 15 near by villages. There were 32
cases o violence and 3 rape cases registered.
? Poor educational infrastructure. The village has one govt. and one private institutions but lack
proper infrastructure.
? No banks or financial Institutions.
? SC Rural Development society.
Health services
? One sub centre with one female MPHA provides health care services. The sub centre is attached
to Chandrayapalem PHC, which is about 6 kms away from the village. In the last one-year 12
cases of RTI were registered by the MPHA.
? 3 RMP doctors als o provide health care services in the village.
Profile of women
? Most of the women are illiterate, poor peasants.

? Women are engaged in agricultural and other forms of labour. They also go to forest for
cattle herding and to gather food.
? Due to extre mists problem, men are frequently not available in the village and the women
are the victims for police enquiries / inquest.
Statement of vulnerability
? Low level of literacy.

? Poor awareness on RTI/STI (Majority do not know about RTI/ STI – as evident in the FGDs).
? Low usage of condoms.
? Presence of extramarital sexual contacts were widely reported by the local influencers.
LINGAYAPALEM
Thullur Guntur Guntur
TOTAL MALE FEMALE

1800
Infrastructure
? Very rich and fertile land – Agriculture is the major occupation.
? Poor transport facilities.
? Poor hygienic conditions – lack of proper sanitation facilities.
? Police station is about 13 km away from the village.
? 1 Balwadi centre.
? No post office.
Health services
? A Sub centre with a lady doctor provides health care services. The sub centre is also equipped with
a male and female MPHAs. Sub centre provides routine ANC/ PNC services and treatment for
minor ailments. In the last one year, 1 case of sexual violence, 1 case of unwanted pregnancy and
3 RTI cases were registered.
? 3 RMP doctors in the village.
? The service provided by the sub centre are utilised by many. How ever, people feel convenient to
access services at Vijayawada, which is near by as they feel the services there available are more
qualitative.
Profile of women
? Women are active in agriculture work and spend most of their time in fields. They also play a key
role in procuring orders and transporting the produce.
? They frequently visit Vijayawada on business related activities.
? Thrift and Credit, SHG groups and Mahila mandals are very active and are getting loans from
banks. Also are revolving the funds among themselves.
? No special activities for youth.
? Low literacy levels.

? Lack of proper Medicare.
? Wide prevalence of pre and extra marital activity. For status or recognition and for favours in
business. (A DWACRA group leader had mentioned that sexual favours are very common for
improving business).
? Poor knowledge and awareness on RTI/ STI/ HIV issues.
? Most of the times women are working with men in the fields and in market yards. Exploitation in
these areas are reported as quite common and are un noticed or un reported.
? High migration.
? High prevalence of alcoholism.
58
PEDANANDIPADU

Pedanandipadu Guntur Guntur
Total Male Female

6119 3111 3008
? One of the rich villages of Guntur district, administered by a young politician who is keen in
supporting CHARCA issues.
? Excellent educational facilities from primary to post graduation level both in govt and private sectors.
? Various banks and financial institutions are present.
? There is a police station in the village. No separate services for women - no women constables.
? Well connected by road to all major villages and Guntur.
? Although various organisations are present no specific activities on women and youth particularly on
sex and sexuality related aspects are implemented.
Health services
? PHC with male and female doctors and paramedical staff is providing round the clock health care
services. As the PHC is not a medico legal centre, they do not accept cases of violence, rape and
such others. Nearest referral hospital is GUNTUR Govt. General Hospital. The PHC caters the
health care services to 19 villages and 16 panchayats.
? As per PHC records there were 25 cases of RTI recorded in the last year.
Profile of women
? Women from different economic classes play different roles. Women from poor economic
conditions are engaged in agriculture labour while middle and upper class women are involved in
entrepreneurship.
? Active participation of women in Self Help Groups, DWACRA and Mahila Mandals.
? Temporary or permanent migration to cities like Hyderabad and Vijayawada – for business or
providing education to children
? Wide prevalence of alcoholism.

? Prevalence of pre and extra marital sex – as reported by the local influencers.
? Presence of activities related to commercial sex – on the field work day a sex worker was caught
along with the client and was brought to the police station to book a case against them. When
probed, presence of activities related to commercial sex were reported.
? Many young men and women live in hostels pursuing studies with money and freedom (lack of
supervision by parents) – which gives ample scope to involve in risky sexual practices (as reported
by a youth leader).
59
REDDYGUDEM
Rajupalem Guntur Guntur
Population details
Total Male Female

2458 1250 1208
? Poor sanitation.
? No protected drinking water supply.
? Most families belong to Islamic religion and are economically poor.
? No sub centre or PHC.
? Two Anganwadi schools.
? Three primary schools.
? No bank.
? No proper transportation facilities. Sharing autos is the common way of transportation.
? Nearest police station is about 10 kms from the village.
Services
? Very poor health services. Majority depends on Sattenapalli, Guntur or other near by villages for
seeking health care services.
Profile of women
? Poor literacy.
? Functional literacy among women is being promoted. The women are also participating actively.
? Women are also actively involved in various forms of labour to support their families
economically.
? The village is situated very near to the high way giving opportunity of risk behaviour practices
under disguise.
? Easy availability of alcohol.
? High consumption of alcohol - both the sexes.
60
NIDUMUKKALA
Tadikonda Guntur Guntur
Population details
Total Male Female
5000 2500 2500
? 3 Government and 2 private educational institutions.

? Well connected by road with Guntur and other places. It is on the road connecting Gu ntur and
famous pilgrimage centres like Amaravathi.
? No police station.
? No banks or financial institutions.
Health Facilities
? A sub centre building with a male and female health worker is operational.
? The PHC is about 14 kms away from the village. The PHC has a female doctor. She provides
routine ANC/PNC/FWP & UIP services.
? 3 RMP doctors in the village.
Profile of women
? Most of the women are agricultural labourers, while some of them are in cattle herding.
? Low Literacy levels.
? Poor awareness on RTI.
? Actively involved in SHG and Mahila mandals (about 15 in number). Their main thrust area is on
income generation activities.
? Poor literacy.
? Low level of awareness on RTI/ STI.
? Presence of commercial sex activities.
61
GUNTUR 8TH WARD

Guntur Guntur Guntur
Total Male Female
Infrastructure
? The 8th ward of Guntur is one of the posh localities of the city.
? There are 4 banks and numerous private financial institutions.
? Protected drinking water facility
? Good transport facilities - bus, auto and private vehicles all managed privately.
? There is a slum at the periphery of the ward.
? One old age home run by a Sisters of Mother Theresa order, who provides shelter, food and
treatment facilities to destitute.
? There are 10 educational institutions both of private and govt sector.
? One police station. As per the records there were 18 cases of violence (16 cases on women) and 5
rape cases are reported in the last year.
? The police station has 3 WPC.
Health services
? Government general hospital is only 2 KMs from the site.

? A tertiary care hospital is also present.
? There are 20 private practitioners both general physicians and specialists providing health care
services.
? Nirmal Hruday, a local NGO runs a old age home and provides care and support to its inmates.
Profile of women
? Women are actively involved in various forms of labour like domestic workers and petty vendors.
While a major portion of them are house wives and students.
? Active participation of women in mahila mandals, SHG, DWACRA, inner wheel and lions ladies
club.
? There are 25 SHGs in this area and their main thrust is on income generation programs. They also
work on housing and sanitation.
? There is a congregation of youth due to numerous educational institutions leading to eve teasing,
physical and sexual abuse.
? Commercial sex work activities on the periphery were also reported (mainly near the cinema
theatres and market).
62
GUNTUR 16TH WARD

Guntur Guntur Guntur
Total Male Female

4765
Infrastructure
? Is a big peri-urban slum formed due to migrant labourers. The recognition for the slum is given
after the formation of Municipal Corporation.
? Good roads with good transport facilities.
? Police station is about 5 km from the site.
? No banks.
? Three private (Marwari) financial institutions.
Health services
? One urban health centre with a doctor, MPHA (female) and a pharmacist on contractual basis
provides health care services. The UHC provides medical and health services to an average of 50
people per day. The emergency cases are referred to GGH, Guntur.
? 12 RMPs and 6 general physicians also provides health care services.
Profile of women
? Women are actively involved in various labour forms – as labour in cement factories, leather
factories, some as vegetable vendors.
? Dairying is also one of the major source of income where women are actively involved.
? The women are actively involved in income generation activities. There are 12 SHGs, 12
DWACRA groups and 2 Mahila mandals. They also focus on vocational trainings like pickle and
candle making.
? There are no separate activities for youth.
? Though literacy levels are high the awareness levels on RTI/STI is poor.
? Presence of anti social elements – rowdy sheeters.
? Availability of and consumption of alcohol is widely prevalent. There are about 22 wine shops and
arrack shops. There are frequent assaults, attempt to rape (20), and many violence cases registered
in this area.
63
MANGALAGIRI 8TH WARD

Mangalagiri Guntur Guntur
Total Male Female
4372
Infrastructure
? Is a pilgrimage centre.
? Poor sanitation facilities.
? Primary school and few private schools.
? Two colleges on the periphery of the site.
? One public library.
? Police station is in the town and is 3 KM away from the site.
? Presence of anti social elements – rowdy sheeters.
Health facilities
? A Community Health Centre with male doctor and para medical staff.
? 100 bedded TB sanctorum, which also caters as a teaching hospital for Nagarjuna university
medical college.
? 10 Private practitioners and more than 20 RMP doctors.
? 6 Nursing homes.
Profile of women
? Majority of women belongs to weaver community and work at par with men over looms, apart
from attending domestic chores.
? They also actively participate in SHG, DWACRA, Janmabhoomi, clean and green, and health
campaigns.
? Actively involved in thrift and credit.
? High prevalence of commercial sex activities as a place of pilgrimage.

? Alcohol consumption is high.
? Although literacy levels are high, awareness levels on RTI/STI is poor.
64
MELLAVAGU
Bollapalli Narasaraopet Guntur
Total Male Female

2042
? Poor drinking water facility as well as under ground water.

? Poor sanitation facilities.
? The village comes under the jurisdiction of Karampudi police station.
? One government higher secondary school.
? One Primary and high School.
? Primary education centres by Joseph Mary Charitable Trust, an NGO.
? No banks or financial institutions.
Health services
? There is a sub centre with no building. Except few medicines, no other equipment or infrastructure
is provided. Only one Female MPHA provides health care, the male position is still vacant. The
sub centre covers 4 panchayats. She provides treatment for general ailments, UIP, FWP and ANC
services.
? 2 Traditional healers.
Profile of women
? Poor literacy levels.

? Early marriages – by the age of 12 – 14 or immediately after attaining puberty.
? Women mostly involved in agricultural labour.
? Women groups (SHG and mahila mandals) are present but inactive.
? Poor economic conditions.

? Poor literacy levels leading to poor knowledge on RTI/ STI (as evident in the FGDs)
? Early marriages.
? Women mostly involved in agricultural labour. Most of the times just with the male members.
? Ample scope of sexual abuse in fields (as reported in the FGDs).
? Lack of proper supporting structures.
? There is prevalence of pre and extra marital relationship. But if identified, they are severely
punished. Recently a person was severely punished. So such activities are not highlighted and are
done very secretly – As reported by the Female MPHA.
65
RENTACHINTALA
Rentachintala Narasaraopet Guntur
Total Male Female

13923
? Police station is located in the village.

? About 30 educational institutions.
? One bank and one private financial institution.
? Good transport facilities – public and private.
? NGOs working in awareness and health issues – Swasakthi rural youth society.
? 15 SHGs.
Health services
? PHC covering 11 village panchayats. The PHC is equipped with one doctor and 12 para medical
staff (10 female and 2 male). The PHC is also equipped with the sterilisation facilities. The
medical officer provides UIP, FWP, ANC and other services related to all the national medical and
health programs.
? Health camps by NGOs.
Profile of women
? Poor literacy.
? Involved in various income generation activities. Majority into labour – agriculture and daily
wage.
? 15 SHGs are formed in the village and are inactive.
Extent of vulnerability
? Poor literacy with poor knowledge levels on RTI/ STI.

? Due to frequent drought conditions and weak economic conditions, for lively hood and repayment
of debts, women barter sexual activities.
? High migration in search of occupation/ income.
66
PASUVEMULA
Macherla Narasaraopet Guntur
Total Male Female

1465 700 765
? One Anganwadi centre.

? One primary health centre.
? No police station.
? No bank and other financial institutions.
? Poor public transportation facilities. Major modes of transportation are the private vehicles –
Autos and taxis.
? No NGOs working on development issues.
Health Services
? No PHC. Only one female MPHA provides health services in the village including with other 7
villages. She generally provides UIP, FWP, ANC and treatment for minor ailments. Except few
medicines, there are no other equipment provided to the MPHA. The MPHA provides her services
in the Anganwadi centre as there is no building facility available for providing treatment.
? 4 RMPs and PMPs also provides health related services.
Profile of women
? Poor literacy.
? Actively involved in SHGs. About 5 SHGs are formed in the village and the main thrust area is
savings.
? Women involved in various income generation activities to support their families.
Statement of Vulnerability
? Poor knowledge levels on RTI/ STI/ HIV/ AIDS.

? Lack of proper support structures.
? Availability and consumption of liquor is high.
67
IPUR
Ipur Narasaraopet Guntur
Total Male Female

5255 3013 2242
? One police station with its jurisdiction in about 33 villages and 12 panchayats. (it was reported that
the police station was blasted by the extremists).
? One primary and one secondary educational centre.
? Poor infrastructures – roads, sanitation and electricity.
? One Andhra Bank.
? Poor public transportation facilities. Major modes of transportation are the private vehicles –
Autos and taxis.
? Active NGO participation implementing programmes in health, education, income generation and
environment – Rural development society and Bala Vikas Social Service Society.
Health Services
? 30 bedded PHC which provides services round the clock. The PHC is equipped with one male and
one female doctors and 17 other staff including pharmacist, lab technician, Pharmacist, dhobi,
cook. Is also equipped with x-ray and other lab facilities. The PHC covers about 36 villages and
18 panchayats . All the national medical and health programmes are being implemented by the
PHC. In the discussions with the villagers, some of the respondents had expressed their un
satisfaction towards the services rendered in the PHC.
? 2 PMPs also provides services with regard to health related problems.
Profile of Women
? Economically poor.
? 7 SHGs are formed in the village. Various trainings were imparted as part of income generation
and leadership building.
? Women involved in agriculture and daily labour to support their families economically.
? Regular melas or jatharas, giving scope for high-risk practices. It was also reported that during
these occasions sex work activities are widely prevalent.
? Poor knowledge levels on RTI/ STI/ HIV and AIDS.
? The youth leader had reported high prevalence of extra marital relations, specifically in Angaluru.
68
NARASARAOPET 8TH WARD

Narasaraopet Narasaraopet Guntur
Total Male Female

17000
? One police station in the field site.

? Poor infrastructure – roads, sanitation and electricity.
? No bank or other financial institutions.
? Active NGO participation implementing programmes in health, education, income generation and
environment – CRDS, Hands of compassion and others.
? Continuous education programmes are implemented by the CBOs.
Health Services
? There is no PHC available in the area. They visit the near by health care service providers. How
ever, some RMP and PMP doctors provide services for minor ailments.
Profile of women
? Majority of women found in steel utensil (mobile) business. While some of them are working in
the nearby mills and go downs.
? Poor literacy.
? Active participation in DWACRA, SHG and Mahila mandals. About 12 SHGs are formed in the
village and are actively into income generation activities.
? High prevalence of Sex work activities. The community leaders had reported that during festivals
like Siva Rathri huge number of sex workers visits Narasaraopet and having sexual contacts with
them is considered as a cultural ritual. It was also said that the community also encourages as a
cultural ritual.
? Migration. Specifically due to the new road line work.
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CHILAKALURIPET 8 TH WARD
Chilakaluripet Narasaraopet Guntur
Total Male Female

3969
? Good infrastructure - roads, sanitation and electricity.

? This ward in under the jurisdiction of two-town police station.
? One educational institute in the ward. Various institutions in the city.
? Active NGO participation implementing programmes in health (specifically on STI/ HIV/ AIDS),
education, income generation and environment – NEEDS
? Highly connected by road - National highway # 5 connecting Chennai – Hyderabad pass through
Chilakaluripet.
Health services
? 30 bedded Community Health Centre (CHC) of Andhra Pradesh Vaidya Vidhana Parishad
(APVVP) provides health care services. Doctors relating to various specialities (gynaecology,
ophthalmology, orthopaedics, dental, paediatrics, and anaesthesiology) provide services. The CHC
is also well equipped with operation theatre, lab and other facilities.
? The CHC regularly implements all the national medical and health programmes. Regularly
conducts ANC, UIP, FWP, MLC, Post mortems and treatment to general ailments.
? Special programmes for women and children are also implemented. A scheme called ‘sukheebava’
is operational. The scheme provides financial help of Rs 500/- to pregnant women for health care
and immunisation of the child.
? CHC also provided care and support services for about 4 HIV cases in the last year.
? NGOs are also providing care and support for the HIV positive patients.
Profile of women
? Actively participation in DWACRA and SHGs. There are two SHGs in the ward – Mary Matha
Mahila Sangam and Mahila Podupu sangam. Their main focus is on education. They are running
night schools for adults. Also are focusing on thrift and credit.
? Women involved in various forms of labour to support their families economically.
? Migration – mainly among sex workers on contract basis.

? Although aware of STI/ HIV, poor negotiation skills for safe sex practices.
? Easy access to money is through commercial sex.
? Chilakaluripet is famous for commercial sex activities. Brothel based business is highly prevalent.
Various profiles of clients from other parts of the country visit for seeking sexual pleasures.
? Awareness on support structures is low and barriers in seeking support reflecting poor health
seeking behaviours.
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KONDAMUDI
Ponnur Tenali Guntur
Total Male Female

1284 668 616
? Major occupations are agricultural labour.

? Poor infrastructure – roads, sanitation, streetlights and water supply.
? Two Govt. Educational institutions.
? Poor communication facilities and irregular power supply.
? RTC and private transportation facility available.
? One polic e station in the village
Health services
? Poor health services. No public health service systems providing health care services. The
villagers depend on the near by villages for health care.
? Few RMP doctors and traditional healers provide treatment for minor ailments.
Profile of women
? Poor literacy levels.

? Women are involved in various activities to support their families economically. The
major activities women involved are in agriculture, dairying, aqua culture work, tailoring,
making dinner plates, vegetable vending and some of them are also running petty
business.
? Frequent migration in search of occupation.
? Poor literacy.
? Low awareness on RTI/ STI/ HIV/ AIDS.
? Frequent migration by both the sexes.
? Unavailability of proper health care services and support structures.
? Working in fields with men predisposes women towards sexual or physical exploitation.
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KARLAPALEM
Karlapalem Tenali Guntur
Total Male Female

10455 5500 4955
? Major occupations are agricultural labour.

? Good infrastructure – roads, sanitation, streetlights, communication facilities and water
supply.
? Two Govt. Educational institutions.
? RTC and private transportation facility available.
? One police station in the village
? Active local NGO – Gramasiri. Major focus is to developing weaker sections of the
society. Implements various programmes, major focus area is thrift and credit.
? Near to Bay of Bengal, so frequently drought prone area.
Health services
? PHC with a male medical officer and 17 para medical staff provides health care services.
? RMP and traditional healers also form part of health care providers for the villagers.
Profile of women
? Low literacy levels among families with poor economic conditions.

? Majority are into agri business / labour and into dairying and poultry. They also
participate in various forms of labour for income generation. Economically middle and
high-class women are into entrepreneurship, whereas poor women are into labour.
? Developed social marketing system to dispose their goods effectively and for good
benefits.
? Active involvement in DWACRA and SHG
? Poor literacy.
? Low awareness on RTI/ STI/ HIV/ AIDS.
? Frequent migration by both the sexes.
? Lack of proper support structures.
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PESARLANKA
Battiprolu Tenali Guntur
Total Male Female

1218 700 518
? Is a remote village.
? The major occupations are agriculture followed by dairying and fishing.
? No proper infrastructure – roads, electricity and water.
? Lacks basic civic amenities.
? 4 Educational institutions and one Anganwadi centre.
? No police station
? No banks/financial institutions
Health services
? One sub centre with a female health worker provides health care services to the village. The
female health worker also covers 7 other villages.
? Lack of proper infrastructure for the female health worker. Only basic medicines are provided.
? 2 RMP doctors also provide health care services.
? Reported 2 HIV/ AIDS cases in the last one year.
Profile of women
? Poor literacy.
? Majority involved in agriculture, dairying and fishing.
? Actively involved in DWACRA and such other programmes.
? IRTDS, a local NGO is actively involved in providing vocational trainings to women on tailoring,
candle making, embroidery and such others. Women are actively participating in such
programmes.
? Poor knowledge and skills to protect themselves from acquiring RTI/HIV/AIDS (as
evident from the FGDs).
? Lack of supporting structures/ services.
? Lack of basic sanitation.
? Working in the fields along with males and lack of proper infrastructure heightens their
vulnerability towards sexual abuse vis a vis to STI/ HIV/ AIDS. (There were 8 rape
cases, and 12 cases of violence on women registered last year.)
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PALLAPATLA
Nizampatnam Tenali Guntur
Total Male Female

4401
? The major occupations are dairying and toddy business.

? No proper infrastructure – roads, electricity and water.
? No police station
? No proper transportation facilities.
? NGOs/ CBOs are actively involved in various development activities – GORD, Jana Priya
DWACRA group and SHGs.
Health services
? Pallapatla village is under the jurisdiction of Cherukupalli PHC and is very far off.
? It was reported that, many do not access the PHC services. Mostly, the villagers depend on the
health services available in Nizampatnam and Guntur.
? The deputy paramedical officer of leprosy control, a male and female health workers visits the
village to provide health care services.
Profile of women
? Poor literacy.
? Majority involved in dairying and toddy business. Prevalence of alcoholism reported high among
both male and female.
? Actively involved in DWACRA and such other programmes.
Vulnerability statement
? Lack of knowledge and skills necessary to protect themselves from acquiring

RTI/HIV/AIDS.
? There were 4 rape cases and 2 abortion case registered with the health facility and 15
cases of violence on women and 2 cases of rape were registered with police.
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GODAVARRU
Duggirala Tenali Guntur
Total Male Female

2454
? The major occupations are dairying, toddy business and agricultural work.
? One Anganwadi centre and one primary school.
? Lack of proper roads and sanitation.
? No police station
? No proper transportation facilities.
Health services
? Godavarru village is under the jurisdiction of Duggirala PHC and is not accessed by many. They
depend on the health care services in Vijayawada.
? The deputy paramedical officer of leprosy control, a male and female health worker visits the
village from the PHC to provide health care services.
Profile of women
? The major occupations where women actively participate are agricultural work and dairy
activities. Some of them are also involved in fruit and fish vending.
? Actively participate in DWACRA and SHGs
? Low literacy.
? Lack of knowledge and skills to protect themselves from
RTI/HIV/AIDS.
? Prevalence of RTI/ HIV/ AIDS. In the last one year 3 HIV/ AIDS cases,
12 RTI/ STI cases and 2 unwanted pregnancies are reported.
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TENALI 8TH WARD

Tenali Tenali Guntur
Total Male Female

13210
? Situated near Ratna picture palace.

? About 20 educational institutions.
? Good infrastructure – roads, sanitation and street lights.
? Numerous private and government institutions providing health care services – 30 General
physicians and 14 RMP doctors clinics.
? Very close to the ward one care and support centre for HIV positive is also located.
Profile of women
? Belongs to different economic strata. Most of the women from economically poor communities
work as domestic servants, daily wage labourers and fruit/ vegetable vending.
? Literacy levels are high among the upper caste while low in the lower caste women
? Although high literacy levels, knowledge with regard to RTI/ STI/ HIV/ AIDS is poor.
? High prevalence of activities related to commercial sex.
? Although very good health infrastructure is available, poor health seeking behaviour. Many afraid
of going to a doctor for the reason being noticed by other community members and are afraid of
being branded.
? Tenali has supplied good number of female actresses to telugu film industry. Still, young women
aspire to be in the film industry. In these aspirations, they elope to cities and are vulnerable to
sexual abuse – As reported by a community leader.
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Annex C: Tools Used in DSA

Opinion Poll – Females
1. Is there anybody who is addicted to alcohol in your family?

2. Do you come from a broken home /divorced parents?
3. Have you ever had sex?
4. Does your husband / partner usually use condoms while having sex with you?
5. If you were to receive a condom from a mahila mandal worker, would you be willing to ask
your husband / partner to use it?
6. Can you influence your husband / partner to use a condom?
7. Do you have more than one sexual partner?
8. Has your husband / partner ever forced you to have sex with him without your consent?
9. Have you ever refused sex with your husband / partner?
10. Have you ever been sexually abused by a family member?
11. Have you been sexually abused by any person outside your family?
12. Have you ever been forced to deliver / terminate a baby against your wishes?
13. Is there any individual or organization in your locality, which can support women to report
sexual or physical abuse?
14. Do you currently have any disease, which you have acquired due to sexual relations?
15. Is any treatment available in your locality for such diseases?
16. If you had any such disease would you go for its treatment?
17. If you want to go for such treatment would you be able to afford it?
18. If you wanted to go for such treatment, would you face any problems from your
family/society?
19. If you wanted to know about sex related problems, is there anybody who can provide you
such information?
20. If you faced any violence or sex related problems, is there anybody you can talk to?
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Opinion Poll – Males:
1. Is there anybody who is addicted to alcohol in your family?

2. Do you come from a broken home /divorced parents?
3. Have you ever had sex?
4. Do you use condoms while having sex with your sexual partner?
5. If your partner were to ask you to use a condom, would you be willing to do so?
6. If your sexual partner were to receive a condom from a mahila mandal worker,
would she be willing to ask you to use it?
7. Do you have more than one sexual partner?
8. Have you ever forced your wife / partner to have sex with you?
9. Has your wife / partner ever refused sex with you ?
10. Have you ever sexually abused a female relative?
11. Have you ever sexually abused any other female outside the family?
12. Have you ever forced your wife / partner to deliver / terminate a baby against her
wishes?
13. Is there any individual or organization in your locality which can support women
to report sexual or physical abuse?
14. Do you currently have any disease, which you have acquired due to
sexual relations?
15. Is any treatment available in your locality for such diseases?
16. If you had any such disease would you for its treatment?
17. If you want to go for such treatment would you be able to afford it?
18. If you wanted to go for such treatment, would you face any problems from your
family/society?
19. If you wanted to know about sex related problems, is there anybody who can
provide you such information?
20. If a woman faced any violence or sex related problems, is there anybody she
could talk to in your area?
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Sample of Focus Group Discussions: Unmarried Females:
Introduction
All of you probably know why we are here today…. I want to start with saying thank
you for taking time out to meet us…. There are some things I would like to let you
know before we start….
- Introduction of the two researchers

- Confidentiality
- No right/wrong answers
- Importance of participation- for the discussion and for society
- We are going to do some story telling now… we shall tell the story of a young
woman’s life… the situations she faces… how she copes with them…
Birth – Teens (10 minutes)
1. Let us begin with the story of a girl who born in this or in a neighbouring area..
somewhere close to where we are today….What is the reaction of the family
when she is born?
a. Is there any rejoicing… why?

b. Would it have been any different if the baby were a male… why do you
think so…?
Let us give the girl a name… X
2. When does ____X______ join school?
a. Who decides about her schooling? Why?

b. Is anybody consulted outside the family? Why/Why not?
c. If yes, who is consulted? Why?
d. Does the family think that it is important for her to go to school? Why?
e. What is the benefit they expect from her experience of going to school?
3. When does she first know that she is a girl and different from boys?
a. Is it explained to her or does she find out by herself? Can you please
explain what happens?
b. Does somebody explain the difference to her?
i. If yes, who? Why?
ii. If not, why not?
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Teenage (30 minutes)
4. Now she is in her teens / adolescence. One day she starts menstruating.
a. What is her first reaction when this happens? Why? Does she know
anything about it, or is she taken by surprise?
b. Who does she go to? Why?
5. Tell me when she comes to know about sex….

a. What are the sources of information? What does she learn from each?
b. Can you tell me what she thinks about sex… what are her expectations…?
6. Now tell me a little about her family life…
a. What does her father mean to her? How does he spend time with her?
Why?
b. What role does her mother play in her life? When they are together, what
to they talk about? Why?
c. What is her relationship with her brothers and sisters? Why?
d. Who are the people outside her family who are important to her at this
age? Why?
e. Is there any difference in the way the family perceive her now, as
compared to when she was child? Why?
7. How does she spend her free time?
a. How does she entertain herself? Where does she go? Why?
b. What are the organizations she is a member of? Why?
c. What social activities does she participate in?
8. Suppose she stands in front of a mirror one day… and starts dreaming …
a. What does she want most from her life at this stage? Why?
b. What does she dream about her body and her looks? Why?
c. Does she dream of a family or a career? Why?
d. What does she dream of in a husband? Why?
Education
9. Her elder sister drops out of school.
a. What age do you think it is? At what age is it normal for girls to drop out
of school?
b. Why does she drop out? Whose decision is it? Why?
i. Is it because she has to help in household chores? Does she have
any other options?
80
c. Is there anyone she can consult in the process?

d. What happens to her as a result?
i. Imagine that there is another girl in her village who studies further.
Is X’s life any different from a girl who goes for higher studies?
Why/Why not?
e. If her brother had dropped out what would his reasons be?
i. Could it be that the boy’s reason for dropping out are different
from the girl’s?
Sexual abuse/incest (5 minutes)
10. One day a man corners her and forcibly touches her.
a. Can you imagine the scene? Where would it happen? Why?

b. Who would the person be? Would it be somebody known or unknown?
Could it be a relative? Why do you think so?
c. Why do you think it happened to her? Is this a normal occurrence? If not,
what are the circumstances under which this takes place?
d. What would her reaction be? What would the girl do? Why?
e. Is she likely to go to anybody for help? Why/Why not? Would it be an
elder? Why/Why not?
f. If yes, who would it be? Why? What would their advice be?
Occupational exploitation
11. Now let us imagine that X has to start working… she is compelled to join an
industry where many women are exploited…
a. Could you tell me what work she might be doing… why do you think so..
(PROBE ON THE INDUSTRY – TOBACCO / COTTON/ CHILLI)
b. Now tell me about all the different ways in which she might be
exploited…
i. Physical labour
ii. Economic exploitation
iii. Sexual exploitation
FOR EACH, ASK:

1. Are there some types of women that are exploited more
than other women? Why / Why not?
2. Which castes do most women here belong to? Why?
3. Which religion do most women here belong to? Why?
4. Who are the people that exploit these women in this way?
Why?
5. What is the result of this on the woman?
6. What are the ways in which she protects herself? Why?
7. Who does she go to for help? Why?
8. What advice or help do they provide? Why?
81
12. Now tell me a little more about sexual exploitation…
o Is the young woman ever forced into having a sexual relationship because
of some pressures?
o What sort of women get exploited?
o What is her capacity to fight back?
o What is the environment like?
? What are the support structures that she has access to in this
situation?
? What is the impact on her health as result of this?
? What is the impact on her life as result of this?
Caste based differences
13. Now imagine that X belongs to a high caste…
a. Is there going to be any difference in her situation? Why / Why not?

b. What are the social conditions that might make a high caste woman more
vulnerable to harm than other women? Why?
c. Could you tell me which high castes might be more vulnerable to harm
than other high castes… why do you think so?
14. Imagine that X belongs to a low caste…

b. What are the social conditions that might make a low caste woman more
c. Could you tell me some castes in which the woman is more likely to be at
risk of sexual exploitation than others… why do you think so?
Religion based differences
15. Tell me a little bit about X’s religion…

a. If we had to choose a religion for her in which she would be least
exploited, which would it be… why?
b. If we had to name one religion in which she is most likely to be exploited
than others, which would it be… why?
Premarital relationships/sex (20 minutes)
16. Now let us imagine she has a boyfriend, Mr. Y.
a. What is her age at that point of time? What is the normal age to have a
boyfriend?
b. Who is he likely to be? Why?
82
c. What is her age and occupation at this time? Why?

d. Let us guess why she is having a relationship before marriage…
17. They are very close and he wants to have sex with her.
a. What is her reaction? Is she surprised, or is this something she has heard
about before?
18. Let us imagine she says ‘no’ to him.
a. What could her reasons be for refusing him?

b. How would her boyfriend react? What would happen to her?
19. Suppose she says ‘yes’
a. What could her reasons be?

b. What would her deepest fear be? Why?
c. What would happen to her? Would her life change in any way? Why/Why
not?
d. Is she worried about any physical harm? Why/ why not?
Protection/ condoms (15 minutes)
20. Suppose she were to come to us for advice at this stage… says that is having a
sexual relationship and wants to know how to be careful, so that she does not
come to any harm…
a. What precautions should we advice her to take? Why?

i. What is the biggest danger she might face in the relationship?
Why?
ii. Let us tell her all the physical problems that she might face as a
result of this relationship…
iii. Now can you list the problems in order of importance…
21. Let us talk about pregnancy…
a. Would she take any precautions to make sure that she doesn’t become
pregnant? How?
i. Where does she get information regarding these matters?
ii. What would happen to her if she were to become pregnant in spite
of not wanting to?
b. What about the man? Would he do anything to avoid pregnancy? Why?
i. If yes, what would he do? Why? Where does he learn these
methods, if any?
22. Let us imagine a new situation… she wants him to use a condom…
83
a. Is her request normal?

b. Where does she find information about the condom?
c. What will his reaction be when he hears her request? Why?
d. If he does not use a condom can she still prevent herself from being
pregnant? How would she do that?
STI/HIV (15 minutes)
23. Now let us talk about HIV … Imagine that X is invited to a village meeting that is
being held only for women, where she is supposed to advice young women about
HIV… what will she tell them…
- What are the sources of HIV?

- Are there some specific types of beha viour that are more likely to result in
HIV than others?
- Can boyfriends spread HIV t o their girlfriends?
- Can drug users spread HIV to each other?
- What are the symptoms? How does one know whether they have HIV?
- What can one do to avoid getting HIV? How can the spread of HIV be
checked?
- Is there a cure? If yes, what is it? Who cures HIV patients?
- If no, what does she advise HIV positive people to do?
i. Should they consult somebody? If yes, who? Why?
24. Imagine that the group at the meeting was asked to make a poster…the topic of
the poster is “Risky Behaviour Which Can Lead to HIV”…
a. What pictures will you show on it…
b. Will the men be married or unmarried… why…
c. Will there be any women on the poster… why…
d. If yes, will they be married or unmarried… why…
25. Now that she has told the young women about what they can do to avoid HIV…
there are some that think they should follow her advice, but still cannot…
a. What are the reasons why the women in her village, in spite of knowing
about ways to prevent HIV, do not follow them?
i. Is it because they do not think that they are at risk?
ii. Is it because they want to but cannot, as they are stopped by their
husbands/partners?
iii. Is it because they are embarrassed to ask anybody, and don’t know
what specifically to do?
84
26. Let’s tell these young women about other diseases and infections that can occur
due to sexual relationships… Give me a list of all the problems… Now let us
discuss them one at a time…
a. ASK THE FOLLOWING QUESTIONS FOR EACH
DISEASE/INFECTION MENTIONED.
i. Is it common?
ii. What are the other causes?
iii. Can she get it from her partner? Why?
iv. What are the symptoms?
v. Is it curable?
vi. Is there any way to prevent it?
(NOTE WHETHER CONDOMS IS PERCEIVED AS A METHOD OF

PREVENTION OF DISEASES)
27. The young women are now aware that this can happen…they are concerned about
getting some diseases… Want to ask for some advice… So one day a meeting is
held to tell people about these problems…
a. Who can hold such a meeting? Why?

b. Some women do not attend… why?
c. Some other women want to ask questions, but are unable to do so… what
do you think stops them…
Treatment (15 minutes)
28. Let’s look at another situation. One day X finds out that she is ill
a. How does she know that she is ill?

b. Does she tell the man about it? Why / Why not?
c. Who would she go to for help? Why this person and not others (e.g
boyfriend, best friend, mother, aunt etc.)
i. What would their advice be? What would she do?
d. Would she go for treatment? Where could she go?

i. Is there a place in the neighbourhood that can offer her treatment
for such problems or help in any other way?
ii. For what sort of problems would she consider it important to seek
medical help? Why?
iii. For what sort of problems would she consider it unnecessary to
seek medical help? Why?
e. Let us look at her in comparison with another woman, A, who knows that
she is ill, but does not seek help
i. Why does A not seek help?
85
ii. If she does not get treated, what do you think will happen later?
29. Now let us look at all the different places X can go for treatment
a. Government hospital
b. Private practitioner
c. Faith healer
FOR EACH OF THESE, ASK THE FOLLOWING QUESTIONS:
i. Is this easily available in or around her village? Where is the

closest place?
ii. What are the advantages of going to such a place?
iii. What are the reasons that one might not go there?
iv. What are the problems that this place is specially good for?
v. Is it more likely to be a male or a female doctor? Does that make a
difference to X?
1. If male, what can he do to make X more comfortable?

2. The doctor tells her to come back after a week for ano ther
examination. Would she go back?
vi. Suppose she goes to this place once, but then refuses to go back
there ever again. What could her reasons be? Why is she unwilling
to go back there?
(PROBE LACK OF SERVICES IN GENERAL AND WOMEN

FRIENDLY IN PARTICULAR AS A REASON FOR WOMEN
NOT TO SEEK TREATMENT IN GOVT MEDICAL CENTRES)
Influencers (10 minutes)
30. All these problems that X has been facing…. There are people who can help her..
i. Faith healers
ii. Community based organisations
iii. Mother
iv. Mother- in- law
- Could you explain what is the role of each of these in her life, when she is in trouble?
- What are the problems that she can go to them with? Why?
- For what problems does she approach this person/ organization? Why?
- What is their advice in the case of each of these problems that you have mentioned?
- What are the problems that she will never take to them? Why?
86
6 FGD DISCUSSION GUIDE: SINGLE

WOMEN
6.1 Introduction
All of you probably know why we are here today…. I want to start with saying
thank you for taking time out to meet us…. There are some things I would like to
let you know before we start….

- Confidentiality
- Importance of participation- for the discussion and for society
- We are going to do some story telling now… we shall tell the story of a young
6.2 Birth – Teens (10 minutes)
31. Let us begin with the story of a girl who born in this or in a neighbouring area..
somewhere close to where we are today….What is the reaction of the family when she
is born?

b. Would it have been any different if the baby were a male… why do you think
so…?
Let us give the girl a name… X

b. Is anybody consulted outside the family? Why/Why not?
c. If yes, who is consulted? Why?
d. Does the family think that it is important for her to go to school? Why?
e. What is the benefit they expect from her experience of going to school?
a. Is it explained to her or does she find out by herself? Can you please explain
what happens?
87
6.2.1 Teenage (30 minutes)
a. What is her first reaction when this happens? Why? Does she know anything
about it, or is she taken by surprise?
b. Who does she go to? Why?

a. What are the sources of information? What does she learn from each?
b. Can you tell me what she thinks about sex… what are her expectations…?
a. What does her father mean to her? How does he spend time with her? Why?
b. What role does her mother play in her life? When they are together, what to
they talk about? Why?
d. Who are the people outside her family who are important to her at this age?
Why?
e. Is there any difference in the way the family perceive her now, as compared to
when she was child? Why?
37. How does she spend her free time?
a. How does she entertain herself? Where does she go? Why?
b. What are the organizations she is a member of? Why?
c. What social activities does she participate in?
38. Suppose she stands in front of a mirror one day… and starts dreaming …
a. What does she want most from her life at this stage? Why?
b. What does she dream about her body and her looks? Why?
c. Does she dream of a family or a career? Why?
d. What does she dream of in a husband? Why?
6.2.2 Education
39. Her elder sister drops out of school.
a. What age do you think it is? At what age is it normal for girls to drop out of
school?
i. Is it because she has to help in household chores? Does she have any
other options?
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i. Imagine that there is another girl in her village who studies further. Is
X’s life any different from a girl who goes for higher studies?
Why/Why not?
i. Could it be that the boy’s reason for dropping out are different from
the girl’s?
40. One day a man corners her and forcibly touches her.

b. Who would the person be? Would it be somebody known or unknown? Could it
be a relative? Why do you think so?
c. Why do you think it happened to her? Is this a normal occurrence? If not, what
are the circumstances under which this takes place?
e. Is she likely to go to anybody for help? Why/Why not? Would it be an elder?
Why/Why not?
6.2.3 Occupational exploitation
41. Now let us imagine that X has to start working… she is compelled to join an industry
where many women are exploited…
a. Could you tell me what work she might be doing… why do you think so..
(PROBE ON THE INDUSTRY – TOBACCO / COTTON/ CHILLI)
b. Now tell me about all the different ways in which she might be exploited…
i. Physical labour
ii. Economic exploitation
iii. Sexual exploitation
FOR EACH, ASK:

1. Are there some types of women that are exploited more than
other women? Why / Why not?
2. Which castes do most women here belong to? Why?
3. Which religion do most women here belong to? Why?
4. Who are the people that exploit these women in this way?
Why?
5. What is the result of this on the woman?
6. What are the ways in which she protects herself? Why?
7. Who does she go to for help? Why?
8. What advice or help do they provide? Why?
42. Now tell me a little more about sexual exploitation…
o Is the young woman ever forced into having a sexual relationship because of
some pressures?
o What sort of women get exploited?
o What is her capacity to fight back?
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o What is the environment like?

? What are the support structures that she has access to in this situation?
? What is the impact on her health as result of this?
? What is the impact on her life as result of this?
6.2.4
6.2.5 Caste based differences
43. Now imagine that X belongs to a high caste…

b. What are the social conditions that might make a high caste woman more
c. Could you tell me which high castes might be more vulnerable to harm than
other high castes… why do you think so?
44. Imagine that X belongs to a low caste…

b. What are the social conditions that might make a low caste woman more
c. Could you tell me some castes in which the woman is more likely to be at risk
of sexual exploitation than others… why do you think so?
6.2.6 Religion based differences
45. Tell me a little bit about X’s religion…

a. If we had to choose a religion for her in which she would be least exploited,
which would it be… why?
b. If we had to name one religion in which she is most likely to be exploited than
others, which would it be… why?
6.2.7 Premarital relationships/sex (20 minutes)
46. Now let us imagine she has a boyfriend, Mr. Y.
boyfriend?
b. Who is he likely to be? Why?
c. What is her age and occupation at this time? Why?
d. Let us guess why she is having a relationship before marriage…
about before?
a. What could her reasons be for refusing him?

b. How would her boyfriend react? What would happen to her?
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49. Suppose she says ‘yes’
a. What could her reasons be?

b. What would her deepest fear be? Why?
c. What would happen to her? Would her life change in any way? Why/Why not?
d. Is she worried about any physical harm? Why/ why not?
50. Suppose she were to come to us for advice at this stage… says that is having a sexual
relationship and wants to know how to be careful, so that she does not come to any
harm…
a. What precautions should we advice her to take? Why?

i. What is the biggest danger she might face in the relationship? Why?
ii. Let us tell her all the physical problems that she might face as a result
of this relationship…
iii. Now can you list the problems in order of importance…
a. Would she take any precautions to make sure that she doesn’t become
pregnant? How?
ii. What would happen to her if she were to become pregnant in spite of
not wanting to?
b. What about the man? Would he do anything to avoid pregnancy? Why?
i. If yes, what would he do? Why? Where does he learn these methods, if
any?

d. If he does not use a condom can she still prevent herself from being pregnant?
How would she do that?
STI/HIV (15 minutes)
53. Now let us talk about HIV … Imagine that X is invited to a village meeting that is

- Are there some specific types of behaviour that are more likely to result in HIV
than others?
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checked?
54. Imagine that the group at the meeting was asked to make a poster…the topic of the
poster is “Risky Behaviour Which Can Lead to HIV”…
55. Now that she has told the young women about what they can do to avoid HIV… there
are some that think they should follow her advice, but still cannot…
a. What are the reasons why the women in her village, in spite of knowing about
ways to prevent HIV, do not follow them?
husbands/partners?
56. Let’s tell these young women about other diseases and infections that can occur due to
sexual relationships… Give me a list of all the problems… Now let us discuss them one
at a time…
a. ASK THE FOLLOWING QUESTIONS FOR EACH DISEASE/INFECTION
MENTIONED.
i. Is it common?
v. Is it curable?
(NOTE WHETHER CONDOMS IS PERCEIVED AS A METHOD OF PREVENTION

OF DISEASES)
getting some diseases… Want to ask for some advice… So one day a meeting is held to
tell people about these problems…

b. Some women do not attend… why?
c. Some other women want to ask questions, but are unable to do so… what do
you think stops them…
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a. How does she know that she is ill?

b. Does she tell the man about it? Why / Why not?
c. Who would she go to for help? Why this person and not others (e.g boyfriend,
best friend, mother, aunt etc.)
d. Would she go for treatment? Where could she go?

i. Is there a place in the neighbourhood that can offer her treatment for
such problems or help in any other way?
medical help? Why?
iii. For what sort of problems would she consider it unnecessary to seek
medical help? Why?
e. Let us look at her in comparison with another woman, A, who knows that she
is ill, but does not seek help
c. Faith healer
i. Is this easily available in or around her village? Where is the closest

place?
v. Is it more likely to be a male or a female doctor? Does that make a
difference to X?

2. The doctor tells her to come back after a week for another
vi. Suppose she goes to this place once, but then refuses to go back there
ever again. What could her reasons be? Why is she unwilling to go
back there?
(PROBE LACK OF SERVICES IN GENERAL AND WOMEN

FRIENDLY IN PARTICULAR AS A REASON FOR WOMEN
NOT TO SEEK TREATMENT IN GOVT MEDICAL CENTRES)
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60. All these problems that X has been facing…. There are people who can help
her..
i. Faith healers
ii. Community based organisations
iii. Mother
iv. Mother-in-law
- Could you explain what is the role of each of these in her life, when she is in trouble?
- For what problems does she approach this person/ organization? Why?
- What is their advice in the case of each of these problems that you have mentioned?
- What are the problems that she will never take to them? Why?
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7 CHARCA DISCUSSION GUIDE:

MARRIED WOMEN
7.1 Introduction

- Confidentiality
- Importance of participation- for the discussion and for Guntur society
We are going to do some story telling now… we shall t ell the story of a Guntur
7.2 Birth (5 minutes)
2. Let us begin with the story of a Guntur girl who was born in this or in a neighbouring
area.. somewhere close to where we are today….What is the reaction of the family
when she is born?
- Is there any rejoicing… why?

- Would it have been any different if the baby were a male… why do you think
so…?
Let us give the girl a name X. She is married to a man… his name is Y.. let’s give him a
name too…
Marriage (10 minutes)
3. Let us talk about her marriage…
- At what age does she get married? Why?

- How much schooling has she completed by then… why…
- Who decides who she marries? Why?
- How is the choice of partner made? What is the basis on which the man is
selected?
- Does ____X____ have any say in the matter?
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4. Now tell us how X feels when she is getting married…
- What are her dreams… why…

- What are her deepest fears… why…
- What does she know about marriage… where did she learn these things…
5. If we were to imagine that she had a normal marriage, like most women in the village,
what would we say her relationship with her husband would be like…
- Is there any difference between her dreams and reality?
i. What are these differences?

ii. How does she cope with these differences?
Sex education/awareness/practices (10 minutes)
6. Now she is in a sexual relationship for the first time…
- What does she know and think about this process before she actually
experiences it… why?
i. Where has she got her information from…why?
ii. Do you think her elders have given her any advice on this matter? If
yes, who is it, and what have they told her?
- What are her expectations… is it the same as the reality that she sees… why do
you think so…
- What are the problems she might face in the process of having sex… why do
you think so…
- Do you think that she needs to take any precautions during intercourse?
i. If yes, why? What should she do?
ii. If no, why not?
7.2.1 Decision making authority/ participation (20 minutes)
7. Now let’s talk about her relationship with her husband….
- What are the matters in married life that only her husband can decide? What
are the decisions that he can take without consulting her? Why?
- What are the matters in married life that only X can decide? What are the
decisions that she can take without consulting her husband? Why?
- What are the matters in married life X and Y talk with each other and make a
decision? Why?
- (FOR EACH JOINT DECISION, ASK WHO’S OPINION MATTERS MORE:
HUSBAND’S OR WIFE’S)
8. Now let’s talk about some specific decisions… tell me who decides about each of the
following…
- Whether to have sex
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- When to have a baby

- Methods of protection during sex
- (FOR EACH DECISION, ASK WHY)
9. One day her husband comes home and wants to have sex with her… but she does not
want to do it….
- What could her reasons be…?

- (PROBE EXTRA MARITAL AFFAIRS, DRUG OR ALCOHOL USE BY
HUSBAND AS A REASON FOR REFUSING SEX)
- What would she do? Can she say no? Why? Why not?
- If she actually says no, how will he react… why… (PROBE MARITAL RAPE,
VIOLENCE WITHIN MARRIAGE)
- Do you think it is possible that he forces himself on her? Why?
- What would happen to her marriage… why do you think so? Do you think she
had done the right thing by refusing him?
Condoms (10 minutes)
10. Suppose she wants to avoid pregnancy at that stage in her life
- What could her reasons be?

- What should she do to avoid becoming pregnant?
- Whom can she ask for advice? Why?
- What are the problems that she might face? What will her husband do?
- Do you think she might be willing to use a condom? Why?
- Where does she find information about the condom?
- Do you think her husband will accept the use of condom? Why?
- (PROBE CONDOM ISSUES, ISSUES OF NEGOTIATION)
- If he does not use a condom can she still prevent herself from being pregnant?
Problems (20 minutes)
11. Now let us imagine that X faces many problems with her husband… I want to ask
about some specific problems….
- He is an alcoholic
i. Is her situation common, or is it extraordinary for a Guntur woman in

this village? Why do you think so?
ii. How does he behave with her after he drinks?
iii. What are his reasons for behaving in this manner?
iv. What are the problems she faces as a result?
v. What is her deepest fear regarding his habit?
vi. What does she do to deal with the problem?
vii. Who do you think she might go to for advice? What do you think they
will tell her?
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- He is involved in a sexual relationship with some other woman

ii. Who is the other woman likely to be?
iii. What are the reasons why he is unfaithful to her?
iv. What are the problems X faces as a result?
v. What is her deepest fear regarding his habit?
vi. What does she do to deal with the problem?
vii. Who do you think she might go to for advice? What do you think they
will tell her?
- Her husband has a traveling job… is often away for long periods…

ii. Are there ever any doubts or fears in her mind? Why?
iii. What are the problems X faces as a result?
iv. What is her deepest fear regarding his work?
v. What does she do to deal with the problem?
vi. Who do you think she might go to for advice? What do you think they
will tell her?
12. Is it possible that she might become close to another man? Why do you think so?
- Who do you think the man might be?

- Do you think there might be any special risk to her as a result? If so what are
the risks? (PROBE IS THERE ARE ANY RISK TO HER BODY)
13. Suppose she were to come to us for advice at this stage…
- What shall we tell her is the biggest danger she might face in the relationship?
Now can you list the problems in order of importance…
- PROBE FOR EACH OF THE FOLLOWING
i. Violence
ii. Infections/ diseases
iii. Emotional/mental abuse
iv. Being disowned by him
v. Social censure
vi. Any other problems, as mentioned by participants
- What precautions should we advice her to take? Why?

- (NOTE WHETHER CONDOMS MENTIONED AS PREVENTIVE
MEASURE)
HIV (15 minutes)
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14. Now let us talk about HIV … Imagine that she is invited to a village meeting that is
than others?
- Can husbands spread HIV to their wives?
checked?
- What pictures will you show on it…

- Will the men be married or unmarried… why…
- Will there be any women on the poster… why…
- If yes, will they be married or unmarried… why…
are some that want to follow her advice, but still cannot…
- What are the reasons why the women in her village, in spite of knowing about
husbands/partners?
STIs (5 minutes)
at a time…
- ASK THE FOLLOWING QUESTIONS FOR EACH DISEASE/INFECTION
MENTIONED.
i. Is it common?
iii. Can she get it from her husband? Why?
v. Is it curable?
- (NOTE WHETHER CONDOMS IS PERCEIVED AS A METHOD OF

PREVENTION OF DISEASES)
99
getting some diseases… Want to ask for some advice… So one day a meeting is held to
tell people about these problems…
- Who can hold such a meeting? Why?

- Some women do not attend… why?
- Some other women want to ask questions, but are unable to do so… what do
you think stops them…
- How does she know that she is ill?

- How would the husband react? Why?
- Who would she go to for help? Why this person and not others (e.g husband,
- Would she go for treatment? Where could she go?

medical help? Why?
medical help? Why?
- Let us look at her in comparison with another woman, A, who knows that she
- Government hospital
- Private practitioner
- Faith healer

place?
v. Is it more lik ely to be a male or a female doctor? Does that make a
difference to X?
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2. The doctor tells her to come back after a week for another
vi. Suppose she goes to this place once, but then refuses to go back there
ever again. What could her reasons be? Why is she unwilling to go
back there?
(PROBE LACK OF SERVICES AND WOMEN FRIENDLY

STAFF AS REASONS)
21. All these problems that X has been facing…. There are people who can help
her..
i. Church
ii. Faith healers
iii. YMA/ MHIP/ Other community based organisations
iv. Mother
v. Mother-in-law
FOR EACH, ASK:

- What is the role of each of these in her life, after she is married?
- What is the advice that they offer in the context of marital problems,
pregnancy, fidelity, sexually transmitted diseases?
101
8 FGD DISCUSSION GUIDE: GUARDIANS
8.1 Introduction

- Confidentiality
- We are going to do some story telling now… we shall tell the story of a Guntur
1. Let us begin with the story of a Guntur girl who born in this or in a neighbouring area..
somewhere close to where we are today….What is the reaction of the family when she is
born?
b. Is there any rejoicing… why?

c. Would it have been any different if the baby were a male… why do you think
so…?
Let us give the girl a name… X. Her mother’s name… Y…

b.
c. Does the family think that it is important for her to go to school? Why?
d. What is the benefit they expect from her experience of going to school?
a. Is it explained to her or does she find out by herself?

102
8.2.1 Teenage (30 minutes)
a. What is her first reaction when this happens? Why? Does she know anything
about it, or is she taken by surprise?
b. Who does she talk to about it? Why?
c. What are the things that it is important for a girl to know about her body by
this age? Why?

a. What are the sources of information?
b. Who does she learn about sex from?
c. Does Y ever discuss sex with X … why/why not….
a. What does her father mean to her? How does he spend time with her? Why?
b. What role does her mother play in her life? When they are together, what to
they talk about? Why?
d. Is there any difference in the way that she is expected to behave now, as
compared to when she was a child? Why/Why not?
6. One day, Y sits quietly and thinks to herself, ‘My daughter is now a woman….’
a. At what age would you think that X turns into a woman from a girl? Why?
b. What are the changes that mark her growth from a girl into a woman?
i. Physical changes
ii. Emotional changes
iii. Social changes
c. What are Y’s dreams for her daughter at this stage? Why?
d. What is her biggest fear? Why?
7. Suppose Y dreams that her daughter X is getting married to a very good man…
a. How is Y’s husband chosen? Who is the main decision maker?

b. How does the family decide whether the man is good for marriage or not?
c. What does Y do to make sure that her daughter can find a good match
i. Is there any special way a girl should look/behave to find a good man?
ii. What sort of women attract good men?
8. X drops out of school.
a. What age do you think it is? At what age is it normal for girls to drop out of
school?
103
i. Is it because she has to help in household chores? Does she have any
other options?
i. Imagine that there is another girl in her village who studies further. Is
X’s life any different from a girl who goes for higher studies?
Why/Why not?
i. Could it be that the boy’s reason for dropping out are different from
the girl’s?
Drugs (10 minutes)
9. One day, Y finds out that her son takes drugs.
a. How does someone get into drug us e? Why?

b. What age is it normally starting? Why?
c. Do girls take drugs? Why/ Why not?
d. What are the drugs? (probe definition of drugs eg. Cough syrup)
i. Is injecting drug use a problem in your area?
e. Can you give me list of all the dangers that may arise to them as a result of this
habit….?
NOTE WHETHER HIV MENTIONED
f. What does Y do next? Why?
i. What is the result of her action/inaction?
10. One day a man corners X and forcibly touches her.
a. Where would it happen? Why?

b. Who would the person be? Would it be somebody known or unknown? Could it
be a relative? Why do you think so?
Why/Why not?
g. What does Y do when she finds out?
8.2.2 Premarital relationships/sex (20 minutes)
11. One day, Y finds out that X has a boy friend.
boyfriend?
b. What is Y’s reaction? Why?
i. What does she think her daughter should do?
ii. Does she ever talk to her daughter about it?
iii. Does she ha ve any fears or concerns at this stage?
104
1. If yes, what? Why?

2. If no, why not?
iv. Do you think that Y might talk to her husband about it?
1. If yes, why? What will his reaction be?
2. If no, why not?
12. Let us make some guesses now…
a. What do you think could be X’s rela tionship with this man… why…Is it more
normal among her age group to have sex or to refrain from it… Why do you
think so…?
b. Somebody in her family guesses that she has started to be in a sexual
relationship.
i. Which family member would it be? Why?
ii. What would his/her reaction be on finding out… why?
c. Somebody else in society finds out the same information…
i. Who do you think it might be… why…
ii. What would his/her reaction be… why…
d. What will Y do under these circumstances? Why?
i. Does she think it is necessary to talk to X about it?
1. If yes, why? What does she tell X?
2. If no, why not?
13. Imagine that Y’s son in married by this time… His wife’s name is M… So now
Y has two women in the house, her daughter X and her daughter-in-law M….
M’s husband, the son, is an alcoholic… he comes home drunk at times and
abuses his wife…
a. Would X ever talk to M about this problem? Why/Why not?

b. If yes, what would she advice M to do? Why?
14. Seeing that M is not happy, Y is worried that her own daughter X might be in the same
situation one day… she decides to tell X a few things about how to be happy in a
married life…
a. What will her advice be… why…

b. What are the things that she will warn X about… why…
c. Can you give me a list of all the ways in which a woman might be abused by
her husband…
i. Does he ever force himself on her sexually, even when she does not
want to sleep with him (Marital rape)?
ii. Does he have affairs with other women? Who could these be (Extra
marital affairs)?
iii. Does he beat/hurt her (Violence)?
FOR EACH OF THE ABOVE PROBLEMS, ASK:
? What is the reason for its occurrence? Why does it happen?
? What sort of men behave like this?
105
? What sort of women are treated like this?

? What should the woman do in this situation?
a. Should X take any precautions to make sure that she doesn’t become pregnant
before marriage? How?
ii. What would happen to her if she were to become pregnant in spite of
not wanting to?
b. What about the man? Should he do anything to avoid pregnancy? Why?
i. If yes, what would he do? Why? Where does he learn these methods, if
any?
16. Let us imagine a new situation… X she wants the man to use a condom…

d. If he does not use a condom can she still prevent herself from being pregnant?
17. Let us imagine another situation… Y finds out that M is asking her husband to use
condoms too…
a. What would she think about M’s request? Why?
b. Would she think that it is normal for married couples to use condoms?
Why/Why not?
c. What are M’s reasons for wanting to use a condom?
Decision making (10 minutes)
18. Suppose that Y finds out that X is pregnant

a. What would her first thought be? Why?
b. Who does she share the information with? Why?
c. What is biggest fear for her daughter at this stage? Why?
d. Is their any village organization/ club that can help her in some way…
e. What would their advice be? What would she do?
f. What do you think will happen to X? Why?
g. What do you think will happen to her baby? Why?
19. Now let’s imagine that it is not her daughter X, but her daughter-in-law M who is
pregnant, but does not want to have the baby….
a. What could M’s reasons be…

b. What would Y do in this situation…
c. Would she encourage M to follow her own wishes, or would she try and oppose
her? How?
STI/ HIV (20 minutes)
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20. Now let us talk about HIV … Imagine that Y is invited to a village meeting that is

- Can husbands spread HIV to their wives?
checked?

are some that think they should follow her advice, but still cannot…
a. What are the reasons why the women in her village, in spite of knowing about
husbands/partners?
iv. Is it because they are ashamed and do not want the other villagers to
find out?

OF DISEASES)
at a time…
MENTIONED.
i. Is it common?
107

v. Is it curable?

OF DISEASES)
24. Let’s look at another situation. One day M finds out that she is ill
a. How would Y react when she finds out? Why?

b. Who should M go to for help? Why this person and not others (e.g boyfriend,
c. Would she go for treatment? Where could she go?

medical help? Why?
medical help? Why?
d. Let us look at her in comparison with another woman, A, who knows that she
25. Now let us look at all the different places X or M can go for treatment
c. Faith healer

place?
26. All these problems that X and M have been facing in their lives…. There are
people who can help/advise them….
i. Church
ii. Faith healers
108

iv. Female friends
v. Male friends
FOR EACH, ASK:

- Could you explain what is the role of each of these in her life?
- Is it more important before or after she is married?
109
9 CHARCA DISCUSSION GUIDE: MEN
9.1 Introduction

- Confidentiality
We are going to do some story telling now… we shall tell the story of a Guntur
Let us begin with the story of a Guntur girl who born in this or in a neighbouring
area.. somewhere close to where we are today. Let us give her a name… __X__.
She has a brother. Let’s give him a name too… __Y__
61. What is the reaction of the family when she is born?

b. Was it any different when her elder brother was born… why do you think
so…?
c. How does her father feel when she is born… is he involved with her in any
way… why?
d. What about her brother? Why?
a. Why does she go to school?

b. Does the family think that it is important for her to go to school? Why?
i. What is the benefit they expect from her experience of going to school?
ii. Is it more or less important for girls to study than for boys? Why?
63. Gradually the neighbourhood boys notice that X is turning into a woman…
a. What age would she be now?

b. How old would the neighbourhood boys be?
c. Why have they noticed her? What qualities in a female would attract attention?
Why?
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64. Is there any difference in the way the family perceive her now, as compared to when
she was child? Why?
Abuse (15 minutes)
65. X has a father who is an alcoholic. He comes home drunk every night
a. How is his behaviour with his wife? Why?

b. How is his behaviour with X? Why?
c. How is his behaviour with Y? Why?
d. Who has to face the worst consequences of his habit? Why?
e. What are the other consequences on the family life?
f. Do you think he might ever try and harm his wife or daughter in some way,
under the influence of alcohol?
i. Could you explain some of the things he might end up doing?
66. Let us talk a bit about men abusing women…

a. Can you describe the different ways in which abuse takes place?
i. Mental
ii. Physical
iii. Verbal
FOR EACH TYPE OF ABUSE, ASK:
? When is this most common?
? Why does this happen?
b. Are there certain sorts of women who are abused more than others?
c. Are there certain sorts of men who are more abusive than others?
67. One day a man corners X and forcibly touches her.

b. Who would the person be?
i. Would it be somebody known or unknown? Why do you think so?
ii. Could it be a member of her family? Why/why not?
Why/Why not?
Drug abuse (20 minutes)
68. Y drops out of school.
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a. What age do you think it is? At what age is it normal for boys to drop out of
school?
b. Why does he drop out? Whose decision is it? Why?
c. What happens to him as a result? Is his life any different from a boy who goes
for higher studies?
d. Some neighbours are suggesting that it is because he has got into bad habits.
What do they mean? What are these habits that they are talking about?
69. Some of his close friends take drugs.
a. How does someone get into drug use? Why?

b. What age is it normally starting? Why?
c. What are the drugs? (probe definition of drugs eg. Cough syrup)
d. Are there some drug habits that are more dangerous than others? If yes, what
are these?
i. Is injecting drug use a problem in your area?
e. Can you give me list of all the dangers that may arise to the friends as a result
of this habit….?
f. Can you describe some of these friends to me… Tell me something about their
lives… how is their life different from that of somebody who does not use
drugs…
g. Is their future different from somebody who does not use drugs… why do you
think so…
70. His friends want him to have drugs too.
a. Would he take drugs too? Why?

b. Is it normal for him to refuse or is it more normal for him to give in… why?
c. What would happen if he refuses? Why? What can one do to say ‘no’ to drugs?
d. He is scared. What is his biggest fear about? Why?
e. He advises his friends to get help. Where would they go for help? Why?
f. What are the reasons why they might choose to ignore his advice? What would
be their deepest fear? Why?
71. If he came to you for advice, what would you recommend in this case… what do you
think he should do… why...?
9.3 Pre marital relationships/ sex (40 minutes)
72. Let’s talk about X again. One boy, Mr Z, thinks about her very often. He wants to meet
her
a. What are his intentions? Why does he want to meet her? What is the normal
thought of a young boy who has seen a woman he is interested in?
b. What does he discuss with his friends?
c. Does he share the information about his interest with anybody?
d. How will he go about trying to meet her?
112
73. Finally, he gets a visit to her house. What do you think her reaction will be?
a. Who has introduced him?

b. How does her family decide whether to welcome him or not? Why?
c. How does she decide whether to welcome him or not? What sort of boys do
Guntur girls like?
about before?
a. Is her behaviour normal, or is it strange? Why?

b. What could her reasons be for refusing him?
c. What is her deepest fear at this stage? Why?
d. How would her boyfriend react? What would happen to him?
e. Would he talk to anybody about it? How would they react? Why?
f. Would she talk to anybody about it? How would they react? Why?
a. What will his reaction be when he hears her request? Why?

b. What does he think her reasons might be? Why?
c. Suppose he agrees to use a condom, what do you think his reasons might be…
what are the things that a condom can ensure?
d. Suppose he does not want to use a condom, what do you think his reasons
might be… What are the drawbacks of using condoms?
e. Let us do some guessing… is he more likely to agree or disagree?
f. If he wants some information about condoms, who can he talk to? Why?
77. Imagine that she gets pregnant…
a. What will his first reaction be? Why?

b. What do you think that she should do? Why?
c. What do you think he will do? Why?
d. Who decides what to do with the baby? Why?
78. Let us imagine that Z gets married…
a. Do you think that he would want to marry X, or would it be somebody else…

why….
b. Will his sexual habits change after marriage.. why/why not…
c. What about condoms… will his willingness to use condoms change after
marriage… why…
113
79. Let us imagine another situation… imagine that Y is married…One night his wife says
that she does not want to have sex that night…
a. What could her reasons be….

b. Is her behaviour normal or strange? Why?
c. What will Z’s reaction be… why…
d. Will their married life change because of this one night….
e. Suppose he were to come to us for advice at this stage… say that he cannot
understand her problem…
i. What would we suggest that he should do? Why?
ii. What is her biggest reason for refusing him?
HIV/ STI (45 minutes)
80. Now let us talk about HIV … Imagine that Y is invited to a village meeting that is
where he is supposed to advice young men about HIV… what will he tell them…

than others?
- How do men get HIV?
- How do women get HIV?
checked?
- If no, what does he advise HIV positive people to do?
i. If yes, will they be married or unmarried… why…
82. Now that he has told the young men about what they can do to avoid HIV… there are
some that think they should follow his advice, but still cannot…
a. What are the reasons why the men in the village, in spite of knowing about
ii. Is it because they are embarrassed to ask anybody, and don’t know
83. Let’s tell these young men about other diseases and infections that can occur due to
at a time…
114

MENTIONED.
i. Is it common?
iii. Can it be spread between married partners? Why?
v. Is it curable?

OF DISEASES)
84. The young men are now aware that this can happen…they are concerned about getting
some diseases… Want to ask for some advice… So one day a meeting is held to tell
people about these problems…

b. Some men do not attend… why?
c. Some other men want to ask questions, but are unable to do so… what do you
think stops them…
85. Let’s look at another situation. One day Z finds out that he has HIV.
a. What do you think could be the most common source for him?
i. Is there certain sort of behaviour that is more likely to lead to HIV than
other sort of behaviour?
b. How does he find out that he is ill?
c. Will he tell X about it? Why/ Why not?
d. Who would he go to for help? Why that person and not others (e.g best friend,
etc.)
e. What would their advice be? What would he do?
f. Would he go for treatment? Where could he go?
86. He is told that he needs to be careful from now on

a. What would he do to be extra careful? Why?
b. Would he change his sexual activities in any way now? Why?
c. What are the precautions that you would recommend to him? Why?
87. All these problems that Y and Z have been facing in their lives…. There are
people who can help/advise them….
i. Church
ii. Faith healers
iv. Father
v. Male friends
115
FOR EACH, ASK:

- Could you explain what is the role of each of these?
- What are the problems that he can go to them with? Why?
116
CHARCA/ SAQ FOR ALL LOCAL LEVEL INFLUENCERS

SNO PLEASE TICK THE YES/NO BOXES FOR THE YES
NO
FOLLOWING QUESTIONS
1 CAN PREGNANCY BE PREVENTED?
2 DO CONDOMES PREVENT PREGNANCY?
3 DOES HAVING SEX WITH MULTIPLE PARTNERS LEAD TO STDs?
4 DOES CONDOM USE PREVENT SUCH DISEASES TRANSMITTED
THROUGH SEX?
5 IS HIV/AIDS SPREADING IN GUNTUR DUE TO THE LOOSE
CHARACTER OF WOMEN?
6 IS HIV/AIDS SPREADING IN GUNTUR DUE TO OUTSIDERS?
7 ARE WOMEN HAVING STDs MORE PRONE TO HIV/AIDS
INFECTION?
8 CAN HIV/AIDS BE TRANSMITTED THROUGH SEX?
9 WILL CONDOM USE PREVENT HIV/AIDS?
10 CAN WE EASILY INDENTIFY HIV/AIDS INFECTED PERSONS?
11 THE ONLY WAY TO KNOW THAT SOME ONE IS HIV/AIDS POSITIVE
IS THROUGH BLOOD TEST?
12 A BLOOD TEST WILL BE HIV/AIDS POSITIVE AS SOON AS PERSON
IS INFECTED?
13 DOES INJECTING DRUG USE SPREAD HIV/AIDS?
14 CAN HIV/AIDS DUE TO INJECTING DRUG USE BE PREVENTED?
15 WILL BREAST FEEDING OF A CHILD BY HIV/AIDS INFECTED
MOTHER LEAD TO HIV/AIDS IN THE CHILD?
16 IF ONE’S FATHER IS HIV POSITIVE WILL THE CHILD GET THE
HIV?
17 IF MY BROTHER/SISTER IS HIV/AIDS POSITIVE WILL I GET
HIV/AIDS?
18 CAN HIV SPREAD THROUGH BLOOD TRANSFUSION?
19 CAN HIV/AIDS SPREAD FROM MOTHER TO CHILD?
20 CAN HIV/AIDS SPREAD BY MOSQUITO BITE?
21 CAN HIV/AIDS SPREAD THROUGH SHAVING OF RAGERS WITH
HIV/AIDS INFECTED PERSON
22 CAN HIV/AIDS SPREAD THROUGH KISSING?
23 CAN HIV/AIDS SPREAD THROUGH ANAL SEX?
24 CAN HIV/AIDS SPREAD THROUGH THE BARBER SHOP?
25 CAN HIV/AIDS SPREAD BY SHARING TOWELS WITH AN HIV/AIDS
INFECTED PERSON?
26 CAN HIV/AIDS SPREAD THROUGH EATING IN THE SAME PLATE
USED BY A HIV/AIDS INFECTED PERSON?
27 CAN HIV/AIDS SPREAD BY SEATING ON THE SAME TOILET SEAT
USED BY A HIV/AIDS INFECTED PERSON?
28 CAN HIV/AIDS BE CURED?
29 CAN TRADITIONAL HERBS CURE HIV/AIDS?
30 WHAT IS THE AVERAGE AGE OF MARRIAGE FOR MEN IN YOUR
AREA?
117
31 WHAT IS THE AVERAGE AGE OF MARRIAGE OF WOMEN IN YOUR

AREA?
32 IS THERE DRUG USER IN YOUR NEIBHOURHOOD?
33 IS THERE SEX WORK IN YOUR AREA?
34 IS THERE ANY RELATIONSHIP BETWEEN DRUG USE/
ALCOHOLISM AND SEX WORK WITH HIV/AIDS AND STDs?
35 PLEASE RANK THE FOLLOWING IN ORDER OF SEVIORITY IN
YOUR AREA.
A. MULTIPARTNER SEX
B. COMMERCIAL SEX WORK
C. HIV/AIDS
D. ALCOHOLISM/ INTRAVENOUS DRUG ABUSE
36 ARE THERE ANY SERVICES NEAR BY TO TREAT PERSONS
ADDICTED TO ALCOHOL OR DRUGS OR TO THE PATIENTS OF
STD/HIV/AIDS?
118
CHARCA/DI DICUSSION GUIDE FOR ALL LOCAL LEVEL INFLUENCERS
1. First tell me about your community…..what are the various activities the women are
involved in this village….
2. Is there any difference in the status of older and younger women within the family…
a. How is it before marriage…
b. Does it change after marriage…
c. Does is it change after the children are born…
d. Does it depend upon whether the child is male or female ?
e. How does this emerge in the manner of behaviour….
3. Does the women have any decision making powers in her life ?
a. What are the decisions that an unmarried girl can make for herself, without
any interference?
b. What are the decisions that she can take only with the elders permission?
c. What are the decisions that a married women can take by herself without any
interference?
d. What are the decisions where her husband has to be consulted?
e. What are the decisions where her mother-in-law has to be consulted ?
f. What are the decisions that the husband makes by himself , without consulting
his wife ?
4. Now let us talk about some specific decisions……
a. Who decides about the children in the family?
b. Who decided about the methods of sexual protection?
c. Who decides about sexual practices?
5. Can a wife say no to sex with her husband?
a. what are the reasons for this to happen?
b. What is the consequence of her action?
c. Is it possible that he might force himself on her against her wishes? If yes,
when is this most likely to happen?
6. Can the couple do anything to avoid pregnancy?.
a. If yes, what are the methods ?
b. Is this advisable/ recommended behaviour ?
7. In your community, have you come across incidence of sex before marriage ?
a. Does it exist ? What do you think are the reasons for this…
b. What are the end results of this phenomena…
c. Is it more visible among men or among women…why…
d. Who are their partners ….
8. In your community, have you come across incidence of sex outside marriage ?
a. Does it exist ? What do you think are the reasons for this ….
b. What are the end results of this phenomena…
c. Is it more visible among men or women..why…
d. Who are their partners….
9. Is alcohol consumption common in the community ?
a. Does the consumption affect the life of women anyway? Could you please
explain in some detail?
10. Does migration exist in your community…..do people travel out on work for more than
one month…..
a. Who are these people…
b. How does it affect their life…
c. Do you think it has an impact on their sexual habits….
119
11. Are sexual abuse and incest known ? Please explainthese phenomena in your society
in some detail.
a. Young women who are sexuallu abused
b. Women who are sexually abused my male family members
c. Illegal sexual practices within the family
12. What about violence o women…
a. When are the women treated violently in the family..
b. What type of women are more likely to be abused…
c. What type of families are we more likely to see abuse in ?
d. What do the women do once the violence is commited ?
e. What are the reasons for their behaviour ?
13. Is there anybody who can help people in case of violence and sexual abuse ?
a. if yes, where is this help available ? is it nearby or faraway ?
b. Who provides it ?
c. What are the problems associated with seeking help ?
14. What does the term STI mean ?
a. Have you ever come across anybody with STI ?
b. Is it a common or rare occurrence? Why do you think so ?
15. Is there any body who can provide information on sex and sexual diseases ?
a. If yes, where is the help available ? is it near by or faraway ?
b. Who provides it ?
c. What are the problems associated with seeking help ?
16. In your community, have you come across incidence of HIV/AIDS positive person ?
a. What do you think are the resons for being HIV infected …
b. What are the end results ?
c. Is there any cure ?
17. Imagine that someone has come to you for advice on STI or HIV …
a. What willyou tell them ?
b. How would you advice them to avoid the problem…
18. If somebody were to come to you and ask for advice on the use of condoms, what would
you tell them …..
a. What are the advantages…
b. What are the disadvantages of using the condom…
c. Is the use of condom widely prevalent in your community… what are the
reasons for this…
19. If somebody were to suffer from drug abuse/HIV/AIDS/STI/RTI , where would they go
for treatment ? Why ?
a. Government
b. NGO
c. Private Practioners
d. Faith healers
e. Others
20. What stops /prevents such people from seeking help ? why?
21. Are special services for women with the above problems necessary ?
a. If yes,why ?
b. What are the problems that might be faced by a woman who wants to seek
health care for STI/RTI/Gynaecological problems ?
120
c. What are the problems that might be faced by a woman who wants to seek
advice and counseling for marital problems / abusive relationships /other
personal matters ?
22. Are services available, especially to those woman with the above problems , in your
area ?
a. If yes, what are these ? what are the services / features that are geared to
specially meet women’s needs ?
23. What do you think that needs to be done tohelp young women to protect themselves
from domestic violence ?
24. How do you specifically help to reduce the burden of HIV/AIDS among the women in
Guntur ?
a. as a responsible member of society
b. As a professional
c. as a leader responsible member of an organization/departme
25. what support services should be available for them by
- Government
- Private practioners
- NGO
- Others
26. How would you recommend that we try and respond to…
- Drug use
- Sex work
- HIV/AIDS
27. Many organizations are required to work together to prevent HIV
among the youth in Guntur. Please advice us to how this can be achieved ?
121
CHECKLIST FOR POLICE & LEGAL SYSTEMS PERSONS

Designation _________________________________________________
Area of Jurisdiction ________________________________________________
Taluk ___________________________________________________
No. of Villages / Gram Panchayats

No. of violent cases in the last year
No. of cases of violence on women (include all
categories of burning, physical battering,..) in
the past one year
No. of sexual violence cases (rape, molestation,
….) in the past one year
No. of female police officers

Are there any special facilities for women. Are there any differences in services for the women
who are exploited?
Can you please quote some instances of action having been taken for violence against
women
How does a case come to the police? Is it directly reported by the victim? Does it move from a
Village Council to police and then to the law? What are the phases involved?
122
CHECKLIST FOR SENIOR HEALTH OFFICERS
Designation _________________________________________________
Area of operation ________________________________________________
Description of health providing unit
No. of Villages / Gram Panchayats

Details of facilities available
Details of staff members

- male/female
- specialization of each
-
No. of cases of violence on women (include all

categories of burning, physical battering,..) in
the past one year
No. of cases of STI/ RTI in the past one year
No. of cases of HIV AIDS in the past one year

No. of cases of drug abuse in the past one year
No. of cases of unwanted pregnancies among
single women in the past one year
Are there any special facilities for women. Are there any differences in services for the women
who are exploited?
How does a case come to the health officer? Is it directly reported by the victim? Does it move
from a Village Council to police and then to the health officer? What are the phases involved?
123
CHECKLIST FOR CBO/ RELIGIOUS LEADERS

Name of the organization _______________________________________
Designation of person met with _______________________________________
Age of operations in the area
Could you please tell me some of the main areas of concern that your organization
works towards in the community
Could you tell me some activities that you are involved in, specifically for men
Could you tell me some activities that you are involved in, specifically for women
Could you tell me some activities that you are involved in, specifically for the youth
PLEASE NOTE THAT THE INFRASTRUCTURE QUESTION SHOULD BE ASKED ONLY

FOR CBOS, and NGOs
Infrastructure Number within the Closest facility outside village
village (in approx kms)
Education (schools, Balwadis
others)
Health institutions/ persons (govt.,

private)
Banks/ Financial Institutions
Police sta tion
Transport (motorable roads,

bus service)
124
CHECKLIST FOR VILLAGE COUNCIL
Village Name
Block
Total population
Total households
Gender (No. of people)

Male Female
Religion/caste (No. of households)

Scheduled Tribe Christian
Scheduled Caste Muslim
Backward Caste Hindu
Others Other Religion
Main Occupations (% of households)

Agriculture Business
Labour Services (private, government)
Artisans Others
125
Annex D: Resources Mapped
Type of organization Program Area Nature of

intervention
Development
Implementa-
reproductive
Community
Sexual and
Research
Womens
General
Support
health
health
issues
Sl. Government/NGO/CBO
tion
No. (ALL NGOs ONLY)
01 02 03 04 05 06 07 08 09
Mr. P. Ranjan Babu
Director, CARDS
01 ? ? ? ? ?
Santhosh Nagar
GUNTUR – 522 004
Fr. Windy
Director, VRO
02 ? ? ? ? ?
Byepass Road
PEDAKAKANI – 522 509
Mr. Churchil Babu
Director, CRDS
03 ? ? ? ? ? ?
D.No : 11-8-11/6, Ramireddy Peta
NARASARAOPET - 522 601
Mr.Satya Raj
Project Coordinator
04 ? ? ? ? ?
CASA,
BAPATLA
Mr. K. Navaneetha Raju
Programme Director, AELC
05 Projects Wing, P.Box No : 264 ? ? ? ?
# 5-98-57/5, Becker Compound
Brodiepet, GUNTUR – 522 002
Sr. M. Alphonsa
Adavalla Hakkula Sangham
06 ? ? ? ? ?
C/o Good Shepherd Convent
MANGALAGIRI – 522 503
Mr. T. Vijaya Benjamin
Director, Hands of Compassion
07 ? ? ? ? ? ?
# 15-06-40, Panasathota
NARASARAOPET – 522 602
Mr. K. Milton Luther Sastry
Director, CONSIDER
08 ? ? ? ? ?
H.No : 3-309, V.L.Puram
BAPATLA – 522 101
126

intervention
Development
Implementa-
reproductive
Community
Sexual and
Research
Womens
General
Support
health
health
issues
tion
No. (ALL NGOs ONLY)
Mr. R. Inyasi
Director, RDO,
09 ? ? ? ? ?
L.N.Colony,
PERECHERLA – 522 009
Bro.J. Chinnaiah
Founder Chairman
10 Valley of Love and Compassion ? ? ? ? ?
D.No:22-45, Sharf Bazar
PONNUR – 522 124
Sr. Marcella
Director
11 St.Ann’s Social Service Society ? ? ? ? ?
(SASSS) Bhartpet, Amaravathi
Road, GUNTUR – 522 002
Mr. N.S. Rama Krishna
Nava Vikasa Nirmana Samithi
12 ? ? ?
# 14-61-3, Near Between two gates,
TENALI – 522 202
Mr. Narasimha Murthy
Secretary, GRAMASIRI
13 Jaya Prakash Nagar ? ? ? ? ?
NANDI RAJU THOTA – 522 120
Bapatla (M),
Mr. Ch Kiran Kumar
Director, CAVI,
14
Behind Cinema Hall ? ? ? ?
PEDDAKAKANI – 522 509
Mr. Azahar
Director, INDIA, # 1-4-21
15
Near Travellers Bangalow
? ? ? ?
MANGALAGIRI
Mrs.K.Parishuddam
President, SWSMM
16
D.No: 7-20-1089, 27th Lane,
? ? ? ?
Saradha colony, GUNTUR–522 002
Mr. T. Mohan Rao
President, REDS, C/o A Amarchand
17
Perantalamma well street ? ? ? ? ?
Itanagar, TENALI
Mrs. G. John Mary Vijaya
Secretary, AMSSS
18
Hanumaiah Nagar, 5th Lane
? ? ? ?
GUNTUR – 522 007
127

intervention
Development
Implementa-
reproductive
Community
Sexual and
Research
Womens
General
Support
health
health
issues
tion
No. (ALL NGOs ONLY)
Mr. K. Lazarus
Director , CAMP
19
P.B. # 7, 2nd Lane, Santhi Nagar
? ? ? ? ? ?
PONNUR – 522 124
Mrs.K.Salome, Director , SEWA
20 D.No: 7-17-119/3, 3rd lane, Sri ? ? ? ? ?
Nagar, GUNTUR – 522 002
Mr. S. Ravindra Babu
President, Sahrudaya Seva Sangam
21
D.No: 4-8-70, Amaravathi Road
? ? ? ?
Near Rama Buildings, GUNTUR-2
Mr.P.Ashok Kumar
Director URDM
22 Old LIC Building, 2nd lane, ? ? ? ?
Pandaripuram
CHILAKALURIPET – 522 616
Mr.T.X.Niranjan Kumar
23 President, LEARDS ? ? ? ? ?
PEDAKURAPADU, Guntur (Dt)
Mr. Solomon Paul
24 Director, LAMP ? ? ? ? ?
Christian Pet, SATTENAPALLI
Mr. D.Vijaya Rao
Executive Secretary, MASS
25
D.No : 12-16-3/3, Prakash Nagar
? ? ? ? ?
NARASARAOPET-522 601
Mrs. S. Janaki
Secretary, AWSMM
26 D.No:24-7-10, Near Block Tank ? ? ?
Koneru Road, R.Agraharam
GUNTUR – 522 003
Fr.A.Showraiah
President, The Mentally Retarted
27
Welfare Society, Petareddy palem
? ? ? ? ? ?
CHEBROLU – MUTLUR ROAD
Mr. Yarru Sambasiva Rao
Secretary, AIRTDS
28 # 1-27-14, Tankasalavari Street ? ? ? ? ? ?
Nazarpet,
TENALI – 522 201
Mr. K. Ravi Pradeep
Executive Secretary, SIRD
29
# 15-12-68, Venkatarao Nagar
? ? ? ? ?
GUNTUR – 522 001
128

intervention
Development
Implementa-
reproductive
Community
Sexual and
Research
Womens
General
Support
health
health
issues
tion
No. (ALL NGOs ONLY)
Ms.Mangadevi
Director, Venkateswara Bala Kuteer
30
Shyamalanagar,
? ? ? ?
GUNTUR
Ms.P.Swarna Latha Devi
Director, WEDS
31
Santhosh Nagar, NGO Colony
? ? ? ? ?
GUNTUR – 522 004
Mr. Syed Jakir Hussain
Director, MRDS
32
MUNAGAPADU (PO) – 522 549 ? ? ?
Phirangipuram (MD)
Mr.Sk.Karimoon
Director, MIMRDS
33 D/O Sk. Nasarvali, D.No:16-217 ? ? ? ? ?
Madarbazar,
CHILAKALURIPET
Mr.Sk.Nowshad Begum
President, IMMC Guntur
34
Cobald Pet, ? ? ? ? ?
GUNTUR – 522 004
Ms. K. Ratna Kumari
Director, DAWNS
35
KUCHUPUDI – 522 313
? ? ? ? ?
Amruthaluru (PO)
Mr. Sk. Chakravarthy
Director, CAREER
36 Old Nallacheruvu, Old Bridge, ? ? ?
Koneru road, R.Agraharam,
GUNTUR – 522 003
Mr. G. Paul Vijaya Kumar
Director, CARES
37 Velur (po) 522 619 ? ? ?
Chilakaluripet (M),
Guntur (Dt)
Mr.M.Venkateswarulu
Christian Institute for Social
38 Development (CISD) ? ? ?
KATTEVARAM – 522 295 (Po)
Tenali (Md), Guntur (Dt.)
Mr.D.Roshan Kumar
Social Educational and Economic
39 Development Society (SEEDS) ? ? ? ? ? ? ?
P.O.Box # 249, 3rd Lane Srinagar,
GUNTUR – 522 002
129

intervention
Development
Implementa-
reproductive
Community
Sexual and
Research
Womens
General
Support
health
health
issues
tion
No. (ALL NGOs ONLY)
Ms.M.Lakshmi
Harijan Weaker Sections Mahila
Mandali D/o K.Venkamma,
40
VEMAVARAM (V)
? ? ?
Machavaram (Md),
Guntur Dist.
Mr.Anja Saheb
Noor Basha Dudakula Seva
41
Sangham
? ? ? ?
PIDUGURALLA
Ms.B.Jhansi Rani
Dalit Kasturi Bai Mahila Mandali
42 Railway Station Road ? ? ? ?
D # 10-73,
PIDUGURALLA – 522 413
Dr.R.Rama Rao
Health India,
43
D # 1-1434, Opp Bus stand
? ?
MANGALAGIRI
Mr.K.T.Bose
IWCDS, H # 11-6-69
44
Vengalreddy Nagar
? ? ? ? ?
SATENAPALLI
Mr.Ranga Rao
Executive Director
ASSIST INDIA, Adda Road,
45
33/379
? ? ? ? ? ?
Lakshmi Rice Mill Corner
CHILAKALURIPET – 522 616
Mrs.Padmaja
Director, SPANDANA
46
6/18 Brodiepet ? ? ? ? ? ?
GUNTUR – 522 002
Mr.Eswar Prasad
Director, NEEDS
47
(Opp) APTRANCO Office
? ? ? ? ?
CHILAKALURIPET
Mr.S.Rajasekhara Babu
Secretary, GOODWILL
48
Slum & Rural Development Society
? ? ? ?
Vidya Nagar, BAPATLA
Fr.Inna Reddy, Director
Guntur Diocese Social Service &
49
Development Society , Jyothi ? ? ? ? ?
Nilayam, Brodietpet, GUNTUR-2
130

intervention
Development
Implementa-
reproductive
Community
Sexual and
Research
Womens
General
Support
health
health
issues
tion
No. (ALL NGOs ONLY)
Mr. K. Navaneetha Raju

Executive Secretary, IRTDS
50 P.Box No : 264 ? ? ? ? ?
# 5-98-57/5, Becker Compound
Brodiepet, GUNTUR – 522 002
Mr.P.Venkat
Project Director
Kothapeta Mahila Mandali
51
Venkatadiripet
? ? ? ? ? ?
Near Weavers colony
Nehrunagar, GUNTUR
Sk.Nurjahan
SUPPORT, near Masid
52
Old Muslim Village ? ? ?
KARRELAPALEM -522111
131
Annex E: Medical & Health profile
1. DISTRICT PROFILE
POPULATION 44, 05, 521 - 2001 CENSUS
URBAN POP 12, 31, 233
MALE 6, 18, 125
LITERATES 4,40,742
FEMALE 6, 13, 108
LITERATES 3,59,222
RURAL POP 31, 74,288
MALE 16, 02,180
LITERATES 9,57,076
FEMALE 15, 72,108
LITERATES 6,89,864
NO OF MANDALS 57
NO.OF DIVISIONS 3
GUNTUR
NARASARAO PETA
TENALI
NO.OF CORPORATIONS 1
– GUNTUR
SLUM POP 4,06,766
- MALE ?
- FEMALE ?
% OF SLUM POP TO TOT POP – 9.23%
FEMALE SLUM LITERACY - 60.29%
SEX RATIO - 990/1000 MALES
NO.OF PHCs 64
NO.OF SUBCENTERS 582
NO.GRAM PANCHAYATS 1025
OTHER MEDICAL FACILITIES
PP UNITS 6
GOVT.DISP 4
FWC.s 7
UHCs 21
CHCs UNDER DMHO 3
APVVP HOSP 8
TEACHING HOSP 1
FEVER HOPS 1
UNIVERSITY HOS 1
L.C. UNITS 6
T.H.WARD 1
RURAL HEALTH LAB 1
SUBSIDARY HEALTH CENRERS 3
BEDS 1759/1817 – (1991-1992)
132
Beds for lakh of population ?
Medical man power

CAS CADRE 131
DY.CAS CADRE 5
ADDL.DM&HO 6
PARA MEDICAL STAFF
CADRE MALE FEMALE
MPHEOs 93
CHOs 24
HEs 8 3
PHNs - 24
MPHS 153 102
MPHA 365 639
OTHER SYSTEMS OF MEDICAL CARE PROVIDERS

UNANI DISPENSARIES 2
HOMEOPATHY DISPENSARIE 10
AYURVEDA DISP 43
MEDICAL COLLEGE OF MODERN MEDICINE 1
REGIONAL TRG CENTERS MALE 1 & FEMALE 1
VCTC GGH,GUNTUR 1
STAFF UNDER NLEP
CADRE MALE FEMALE
PMO VACANT -
HEO 1 -
DY.PMO 30 -
APMO 124 2
PHYSIOTHERAPISTS 4 -
GOVT BLOOD BANKS 2

PRIVATE BLOOD BANKS 4
NO.ICDS CENTERS 7
S.S.UNIT ? 1
DIST AIDS COMMITTEE MEMBERS 13
Health Status Situation – Health indicators ?

SNO INDICATOR DISTRICT STATE NATIONAL
1 C.B.R
2 C.D.R
3 Annual G.R
4 C.P.R
5 M.M.R
6 I.M.R
133
7 SEX RATIO
8 BEDS/ ONE
LAKH
9 DOCTORS/
ONE LAKH
10 MPHA(F)/ONE
LAKH
11 NURSES/ONE
LAKH
12 INSTITUTIONS
RATIO
134
Annex F: Statistics of Education

1. No. of pre-primary schools 3
a. No. of teachers 4
b. No. of Girl Students 69
2. No. of primary schools – Mandal Wise 237
3. No. of primary schools – Muncipality Wise 281
4. No. of Upper-primary schools – Mandal Wise 190
5. No. of Upper-primary schools- Muncipality wise 57
6. No. of High schools 346
7. No. of Oriental Schools 8
8. No. of Special Schools 2
9. No. of colleges 72
Social welfare hostels for SC students:

1) No. of Boys hostels 52
a) No. of Boarders 4813
2) No. of Girls Hostels 35
a) No. of Boarders 3175
Tribal welfare for ST students
1. No. of Boys hostels 24

a. No. of Boarders 2351
2. No. of Girls Hostels 8
Govt. Hostels for BC students:
1. No. of Boys hostels 51

135
2. No. of Girls Hostels 11

Registered Mahila Mandals in the District 1485

No. of Balvadis 25
No. of Vocational training centers for women 18
No. of Child welfare institutions 21
No. of women welfare institutions 7
136
Annex G: REFERENCES
1. Prasad .T.L.N. - Sexual Behaviour Patterns among Sexually Active Population in and
around Guntur Town. - Doctoral Thesis , NTRUHS,2002
2. Prasad. T.L.N. – Auditing ICE - Are we really communicating the Message – Paper
presented at 29 th State Conference of Indian Association of Dermatologists,
Venereologists and Leprologists, 21 st October 2001, Guntur
3. Prasad. T.L.N. – HIV disease trends at Government General Hospital, Guntur.
Presentation on 01/08/2002 at AIDS Update 2002, Guntur.
4. K.Raja Babu. & G.Sujatha (Eds) – District wise census 2001-prelimenary
reports.Andhra Pradesh.May 2001, Government of AP,Hyderabad.
5. Subhash Setia & Mahada Pakrti (Eds) - Census 2001 some findings.Yojana
45:5:2001.Government of India.
6. Cheif Planning Officer, Guntur. Hand book of Statistics, Guntur district, 1991-92 &
1992-93.
7. V. S. Bhaskar, : Provisional Population Totals. Census of India 2001, Series 29,
Andhra Pradesh, Paper II of 2001.
8. District Medical & Health officer, Guntur; Family Health Awareness Campaign
Document – 2001.
9. Summary Report. Behavioural Surveillance Survey in A.P., INDIA. DFID, APSACS
& FHI document.
10. AIDS Update. Volume 7 #2, October – December 2002. Editor—S.K. Hira.
11. Current scenario of HIV/ AIDS and AP’s response to its prevention and control.
Document of APSACS, A.P., Hyderabad.
12. HIV/AIDS Karadeepika – APSACS, A.P., Hyderabad.
13. M. Rama Rao; The Guntur District – the Archives. 1971.
137

STI-HIV-AIDS Vulnerability Research GUNTUR

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Vulnerabilities of Young Women

Against STI/ HIV/ AIDS

Guntur District Situational Assessment

Co-ordinated HIV/AIDS/STI Response through

The Research Team

Dr. T.L.N. Prasad Asst. Professor of STD, Research Co-ordinator

The Research Sub-Committee

M/s Catalyst Management Services Pvt. Ltd.

The Core Group for Project Planning

SNO Name Organisation/ Profession DESIGNATION

3 Dr. P. Uma Devi District Leprosy Officer, Guntur Convenor

4 Mr. J. Murali Project Director, DRDA, Guntur Member

5 Mr. M. Caleb Chief executive officer, SC corporation, Member

6 Mr. G. Sudarshan Youth welfare Officer, Guntur Member

7 Prof. C. Vasantha Kumar Head of Obstetrics & Gynecology Member

8 Prof. G. Babu Rao Superintendent, Fever Hospital, Guntur Member

9 Dr. T.L.N. Prasad Assistant Professor of STD, HIV/AIDS Member

10 Dr. T. Seva Kumar President Service Health Organization, Member

11 Prof. M. Laxmipathi Raju HOD Social work, Nagarjuna University, Member

12 Mr. D. Roshan Kumar Project Director SEEDS, Guntur Member

13 Mr. T. Ranjan Babu Project Director CARDS, Guntur Member

14 Dr. D. Madhavi Medical Officer PHC, Pedakakani Member

15 Ms. Vasantha Laxmi Rural MDO, Guntur Member

16 Ms. K. Laxmirajyam PLWH Member

17 Mr. D. venkateswara Rao Youth Leader Member

18 Miss. J. Swarupa Rani Primary Stake holder nominated by ED Member

19 Ms. Pankajakshi Primary stake holder nominated by PD Member

Ms. K. DAMAYANTHI, IAS

We also thank individuals and agencies – governmental, non-governmental, community

On behalf of the research sub committee & research team,

ABBREVIATIONS USED IN THE DOCUMENT

PLWHA Person living with HIV/AIDS

3 METHODS ................................................................................................................ 168

ANNEX A: MINUTES OF THE CORE GROUP & RSC...............................................................................53

ANNEX B: DETAILS OF STUDY SITES ...........................................................................................................70

ANNEX C: TOOLS USED IN DSA ......................................................................................... 90

ANNEX D: RESOURCES MAPPED ..................................................................................................................137

Vulne ra bilit ie s of Yo ung Wo me n Aga inst S TI/H IV/A IDS

Guntur District Situational Assessment

CHARCA (Co-ordinated HIV/AIDS Response through Capacity building and

? At the community level, vulnerability of women was heightened due to lack of

Specific Areas that Need to be Addressed:

1.1 About CHARCA:

Overview of CHARCA strategy:

Awareness Building Improving

Building support Creating enabling

CHARCA aims to reduce vulnerability of young women by providing information,

1.2 Need for the District Situational Assessment:

2 Objectives of the Study

To enable conduct of DSA, the core team suggested a sub-committee to be wholly

The process and outputs at each stage is presented below:

Date Forum Stakeholders Main Outputs

Date Forum Stakeholders Main Outputs

29 Sep 02 – DSA – Field Research team Information gathered from various

15 – 30 Nov Analysis Research Team Analysis of data, draft report

1-29 Dec 02 Fine Research Co-ordinator Rough DSA draft Report.

Presentation to Core Committee

Presentation to Divisions for feedback

Final DSA draft.

DSP Work Shop

3.2 Population and Sample:

Tools & Techniques:

Limitations of the Stud y: