Fiinal

nal R eport
Report

Pilot Study on
Male Sex Workers
in three cities in India

Conducted by With technical support from

Network of Indian Male Sex Workers Sexual Health Resource Centre

Kolkata New Delhi

April 2006
 Acknowledgement

This report is prepared by Sexual Health Resource Centre (SHRC), New Delhi on behalf of the
Network of Indian Male Sex Workers (NIMSW), Kolkata and is a summary of a quantitative and
qualitative research study on Male Sex Workers in three cities – Kolkata, Ahmedabad and
Vijayawada. The study is supported by Department for International Development, New Delhi.

At the outset, I place on record my appreciation and gratitude to the number of Male Sex Workers
and other key stakeholders who cooperated in giving their views to assess the position of MSW
and also throw light on the various issues they face in the three cities across the country.

I thank Dr. Thomas Philip, Chief Technical Officer for guiding me and Mr.Leo J. Sengo,
research Project consltant for supporting me to complete this study rapidly. My thanks are also
due for Mr. C. R. Gunashekhar, Consultant, SHRC for shepherding this study into a report that
may be used by the readers effectively.

My sincere regard and thanks also go to the technical team in SHRC directly related to this
project. Mr. Udayan, Technical Officer and Mr. Mohamed Aslam, Associate Technical Officer
deserve special mention.

In the three states where the study had taken me, I must cite the support and cooperation for
ensuring that the field work continued without any bottlenecks by many key individuals. My due
regard and appreciation to Ms. Menka, NGO Advisor, West Bengal State AIDS Control Society,
Mr. Jayanthi Bai, Managing Trustee and Director, CHUWAL Trust, Ahmedabad and Mr. Yatin J.
Patel, Director, SAATHI, Vijayawada.

I also extend a word of thanks to the numerous volunteers, outreach workers and staff of the three
coordinating NGOs who ensured the smooth completion of this landmark research. Here,
mention must be made of Mr. Subarthi Mukherji, Project Coordinator, PLUS, Kolkata, Mr.
Chandu Bai, Managing Trustee, and Mr. Balakrishnan, Project Coordinator,CHUWAL Trust,
Ahmedabad and Mr. Suresh Kumar, Project Coordinator, SAATHI, Vijayawada.

Finally, sincere thanks to all others who helped shape this report.

Hope the report sets the ball rolling for furthering the role, status and position of Male Sex
Workers in the country.

Agniva Lahiri
Principal Research Consultant and Network Coordinator (NIMSW)
 Abbreviations

AIDS Acquired Immuno-Deficiency Syndrome

CBO Community Based Organisation
DFID Department for International Development
DI Depth Interview
FGD Focus Group Discussion
FSW Female Sex Worker
GLBT Gay Lesbian Bisexual and Transgender
HIV Human Immuno-deficiency Virus
MSM Men who have sex with Men
MSW Male Sex Worker
NACO National AIDS Control Organisation
NACP-II National AIDS Control Programme – Phase II
NGO Non-Governmental Organisation
NIMSW Network of Indian Male Sex Workers
PLUS People Like Us
SACS State AIDS Control Society
SHRC Sexual Health Resource Centre
SIN Sex Industry Network
SPSS Statistical Package for Social Sciences
SRS Sex Reassignment Surgery
STI Sexually Transmitted Infections
TG Transgender
TV Television
1.0 INTRODUCTION

Male Sex Workers (MSW) are becoming
increasingly visible in India but there is
limited information about them. Research
studies on men who sell sex are urgently
needed not because they can be a health treat
to the ‘general population’ but because
MSW are also an integral part of the Indian
society and we need to find out appropriate
ways to make them take care of themselves
(as they may be at risk) and to protect
themselves from acquiring STI/ HIV.
Males selling sex are likely to be at higher
risk of sexually transmitted infections and
HIV than others having multiple sex
partners. Transactions of money, gifts or
favour in return for sex are known among
Men who have Sex with Men (MSM) but
these are not always considered paid sex or
selling sex. A very thin line exists between
recreational sex and survival sex in the
country and this is found across cities. This
has caused a difficulty in defining MSW.
These Male Sex Workers are definitely not a
homogenous and networked group who can
be targeted for interventions and sexual
health services easily. Sexual health
interventions in India that have tried to focus
on those males who ‘sell’ sex have come
across several barriers. One of the barriers
HIV prevention interventions efforts have
been facing is the task of identifying “Male
Sex workers”.
A definition of this group is yet to be agreed
upon by community groups and
interventions. Most Interventions have
ended up focusing on all Men who have Sex
with Men (MSM) with the assumption that
all MSM could have multiple partners and at
higher risk of HIV and a subset of Men who
have Sex with Men could be Male Sex
Workers with higher risk. However, many
men who have sex with men for money
alone and also those who have sex with
other women (on a commercial basis) have
been excluded from interventions despite the
fact that the risk and vulnerability of HIV
infection for MSW is similar to MSM in the
absence of safe sex practices.

1.1 Definitional Issues

Suggested Definition

MALE SEX WORKER …

“… A person passed puberty who receives money or goods in exchange for sexual service
and consciously defines those activities as income-generating”.

[The definition applies irrespective of the gender of the people involved and whether or not
they do this full-time/ part-time or occasional basis].

Source: MSWS (Making Sexwork Safe Project) by INSW, NSWP

A working definition of Male Sex Workers consider themselves as having sex in

could be “Males who consider themselves as
having sex in exchange for money, favour or
gifts”. While such a definition has many
limitations, it is important to start with a
definition to conduct any further enquiry.
The hypothesis here is that those males who
exchange of money, gifts or favour are a
significant proportion of those males at
higher risk of HIV. This hypothesis could be
disproved by this study itself and the reverse
could be proved that only a small proportion
of those interviewed say that they ‘sell’ sex
or receive money gifts or favour. Also
previous research shows in other countries
that the risk perception among those who
sell sex in terms of money and those who
sell sex in transaction with gifts or favour
are different it may be applicable in these
study as well then we need to design
appropriate structure of intervention as well
as definition.
Other barriers to interventions are a lack of a
good mapping and size estimation of Male
Sex Workers. Without an effective mapping
and size estimation, Interventions,
1.2 Purpose of Study
This study seeks to clarify this issue of
defining Male Sex Workers. While different
community groups and interventions are
discussing the definition of MSW, it is
possible to find out from the community
itself, the proportion of those that consider
themselves as having sex in exchange of
money, favour or gifts.
Till date, available studies on male sex
workers have focused on their sexual risk
behaviour pattern in relation to risk of
acquiring STI/ HIV and only a few studies
have examined the phenomenon of the male
sex work itself and the various forms of
male sex work and the unique problems
faced by Male Sex Workers at various
settings and under various circumstances.
There may a number of information needs
and questions that will remain unanswered
Photo courtesy: Srinivas Kurungati
epidemiological studies and services tend to
grope in the dark and effectiveness of
intervention efforts cannot be measured. But
Before beginning extensive mapping
exercises and size estimations of the male
sex worker populations which are essential
for beginning STI/HIV prevention
interventions, it is also crucial to understand
the presence and nature of the various forms
of male sex work in different parts of India
and to find out the issues faced by them and
to understand their needs in the context of
HIV/STI prevention and care.
after this study. However many questions
that are “qualitative” in nature such as those
on social, legal, trade and health
environments, behaviour, practices and risk
will be opened up through this study.
Note: Regardless of anatomy, Hijras in sex
work may not feel they come under ‘male’
sex workers. Also, the issues related to HIV
prevention and care needs seem to be
distinct for this population. However, as
gender-variant sex workers in the country
are viewed more akin to men than women,
they have been included in this study as they
too in the wider perspective are generally
categorised as male sex workers. What is
important is that their exclusion will mean
losing a whole lot of information on their
needs, perceptions and practices.
AIM

A multi-city pilot study in selected cities to understand the dynamics of Male Sex
Workers in the country.

[The selected cities were Kolkata, Ahmedabad and Vijayawada in the first phase. These cities
were selected as they lie in states (West Bengal, Gujarat and Andhra Pradesh) covered under
DFID supported programmes where SHRC has a presence through working with non-government
and community based organisations that would facilitate easier access to the hidden community
of Male Sex Workers that is critical in such a rapid study.]

SPECIFIC OBJECTIVES

1. To identify and classify different sub-groups of people who consider themselves as

having sex in exchange of money, favour and gifts in selected study areas to arrive at
working definitions of MSW and different sub-groups of males who together are broadly
known as Male Sex Workers
2. To chart out the different locations, sex industry (trade) network-SIN and buddy
networks where such males in each sub-group are found to aggregate and find out the
selected avenues to reach out those network
3. A qualitative analysis to understand of the social environments wherein Male Sex
Workers operate and the barriers they encounter in accessing health facilities
4. To understand the major differences between Male Sex Worker (MSW) and Men who
have Sex with Men (MSM) in India
5. To measure the proportion of Men having Sex with Men who consider themselves as
having sex in return of money, favour and gifts
6. To find out the indicators and risk perception where sex work does NOT comprise
exchange of sex for cash and yet is not survival sex within the male sex worker sector
7. Provide specific recommendations for action on Male Sex Workers in India as a result of
the research findings
8. To understand the needs, demographics, composition of partners, vulnerabilities and
sexual behaviours at selected cities in the country through a rapid quantitative baseline
survey on MSWs and intensive qualitative processes

Transgender or ‘Hijras’ as they are popularly known

 1.3 Methodology
The study methodology included Primary
and Secondary Research to enable
triangulation of data and information in an
area that has hitherto been hidden. The
focus on Male Sex Workers in the study is
more pronounced due to the paucity of
information about this group and the need to
understand clearly the issues facing MSW in
the light of the growing HIV/ AIDS
epidemic in the sub-continent.
A. Desk Research
A secondary sources review of relevant
literature available on the issues affecting
MSW was a must. Caution needs to be
applied in differentiating work on MSM in
the various projects and interventions that
are currently in place. The sources for
secondary information included:
a) Unpublished reports/ records of
grassroots data on the MSW
populations and sub-groups
b) Published reports on MSW
(research studies/ Case studies and
so on)
c) Conference abstracts, poster
presentations and materials on CD
d) Newspaper articles, other media
coverage
e) Information accessed through the
Internet
f) Personal memoirs of MSW willing
to share the same (with
confidentiality)
g) Any other authentic available
sources of information that are
documented
B. Primary Research
In order to understand first-hand the
dynamics in Male Sex Workers a primary
investigation of the target population was
done that sought to obtain insights into not
only the demographics of the ‘hidden’ MSW
population, but also examine their concerns
– physical (to be read medical), social,
psychological and environmental.
Both Quantitative and Qualitative research
techniques were applied to capture data from
the field. Such a combination of tools and
techniques, mingled with a review of
secondary literature sources facilitated
triangulation of data and information
contributing to more valid information that
could be translated into inputs for designing
effective programmatic interventions.
a. Quantitative Techniques
Quantitative Data collection was done
through administering Semi-Structured
Questionnaires to the respondents (MSW).
A total of 75 Questionnaires were
administered in each of the three cities
planned in the pilot stage of the project,
totaling 225 interviews in 3 cities. Each
Questionnaire had 43 main questions with
several sub-sections. The purposive
sampling technique was adopted as the study
deals with Male Sex Workers who are by
and large a ‘hidden’ population, who could
be approached easily by NGO/ CBO
working among them. Moreover, the
objective of the study is to obtain the extent
of the problems faced by MSWs, in order to
provide a better understanding about their
lives and identify risks and vulnerability
factors. Quantitative data analysis was done
using SPSS Version 12 to generate
Frequency tables as well as for cross-
tabulation across multiple variables outlined
in the study.
b. Qualitative Methods
Given the uniqueness of the study, it was
apparent that certain issues might remain
unanswered in the Quantitative study and
hence, a Qualitative component of analyzing
detailed issues was also added. This aided
in crosschecking information obtained in the
quantitative phase and provided
triangulation.
The qualitative methods aided in
understanding the nature of the various
subpopulations of male sex workers; also
examining their immediate needs better. The
qualitative information lead to a clearer
understanding of different sub-groups of
males with one or more similar
characteristics. A working definition and a
set of clearly identifiable sub-groups among
Male Sex Workers has emerged from the
study.
In-depth interviews
Male sex workers belonging to different
subpopulations [Kothi-identified male sex
workers, masseurs in sex work, brothel-
based male sex workers, etc.] were
interviewed. Wherever possible, In-Depth
Interviews were tape recorded in order to
capture all responses provided by the
participants through an Interview Guide.
Depending upon the various subpopulations
present, around 5 in-depth interviews were
conducted in each city, aggregating to 15
Depth Interiews.
Focus Group Discussions
At least 3 FGDs were conducted in each city
using a semi-structured FGD guide, totalling
9 FGDs. The qualitative tools used included
Depth Interviews and Focus Group
Discussions (FGD) among Key Informants.
The participants for the Depth Interviews
and FGD included the following persons:
Male Sex Workers
Koti (floating population)
Network/ NGO/ CBO intervention
personnel
Peers/ Volunteers working among
MSW/ MSM Targeted Interventions
Clients of MSW (where possible)
Pimp/ Masseur/ Massage parlour
owner/ worker
Health Care Givers providing
services to MSW
Others (Gatekeepers and Key
Persons with good understanding of
MSW
The Network of Indian Male Sex Workers
(NIMSW) assisted in recruiting participants
for both the quantitative as well as the
qualitative phase of the study through its
established contacts, CBOs in all the three
selected cities. In Kolkata, NIMSW roped
in PLUS, (People Like Us – a community
based organisation working among MSW.
Similarly, in Ahmedabad, Chuwal Trust was
the coordinating NGO and in Vijayawada,
SAATHI, another community based
Organisation working among MSM and
MSW coordinated the research study.
2.0 DESK RESEARCH
2.1 Introduction
India, the region's most populous country,
continues to dominate the HIV/AIDS
epidemic in South Asia. Although national
HIV prevalence is low (between 0.4% and
1.3% in 2003), there are serious epidemics
under way in several states, and a total of
5.1 million people were estimated to be
living with HIV in India at the end of 2003.1
Most infections are acquired sexually. In the
southern states of Andhra Pradesh,
Karnataka, Maharashtra, and Tamil Nadu,
HIV is transmitted mainly through
heterosexual sex, and is largely linked to sex
work. Infection levels of over 1% among
pregnant women in sentinel antenatal clinics
suggest that a significant number of sex
workers' clients may have passed on HIV to
their wives. HIV transmission through sex
between men is also a major cause for
concern in many areas of India. In a study
conducted in a poor area of Chennai in
2001, 7% of men who have sex with men
were HIV positive. A small proportion of
infections are acquired through injecting
drug use, particularly in the north-east of the
country. In Manipur and Nagaland, HIV
infection levels of 60-75% have been found
among injecting drug users using non-sterile
injecting equipment. Knowledge about HIV
is still incomplete--in a 2001 national
behavioral study of nearly 85,000 people,
only 75% of respondents had heard of
AIDS, and awareness was particularly low
among rural women in Bihar, Gujarat, and
West Bengal.
South Asia is faced with a narrow window
of opportunity to prevent AIDS from having
a more severe impact on the region. Failure
to target populations at high risk of HIV
exposure, such as sex workers, injecting
drug users, and men who have sex with men,
1
Regional Overview abstracted from ‘Report on
the Global AIDS Epidemic’ UNAIDS, July 2004
from http://hivinsite.ucsf.edu
will result in a full-fledged epidemic in
years to come.
The HIV/AIDS (human immunodeficiency
virus/acquired immune deficiency
syndrome) epidemic in India is a rapidly
escalating crisis. The government's estimate
that about 4 million persons in the country
are HIV-positive is widely thought to
understate the true figure. Throughout the
country, persons in traditionally high-risk
groups, including women in prostitution,
injecting drug users, and men who have sex
with men, have been shown to have
alarmingly high rates of infection. In several
states of India, such as Maharashtra and
Tamil Nadu, the epidemic has spread to the
general population. Programs that provide
information, condoms and HIV testing to
persons in high-risk groups are crucial to
preventing the further spread of the disease.
HIV/AIDS outreach workers who target
men who have sex with men suffer
widespread and serious abuses. The taboo in
Indian society against men who have sex
with men and the denial at all levels of their
existence create an environment of
moralistic judgmentalism against which
AIDS educators battle constantly. The
criminalization of homosexual practices
under the pre-colonial section 377 of the
Indian Penal Code on "unnatural offences"
contributes to the impunity with which
police harass these men and those who work
with them. Organizations that conduct AIDS
education activities in Lucknow, Mumbai,
Chennai, Sangli, Bangalore, and New Delhi
described serious incidents of police abuse
that had sometimes prevented them from
providing information and condoms to men
who have sex with men. Common to all
these accounts was the practice of police
extortion of money or sex directed against a
group of persons who are so marginalized in
society that they have nowhere to turn for
redress. Men who have sex with men and
women in prostitution are easy targets for
police extortion and physical abuse.
Discriminatory police practices that keep
them from filing complaints or seeking
redress, combined with the financial
difficulties of making bail, typically mean
long periods in detention facilities where
they are subject to further abuse.
Very little is known about the demand for
sex worker services. Sexuality is not a
subject that is much discussed in India.
Contrary to cultural ideals that stress
chastity before marriage and fidelity within
it, men commonly stray from this norm.
While this behaviour is generally not as
pronounced as in societies in East and
Southeast Asia there is consistent, although
largely anecdotal evidence to indicate that a
large minority of men are clients of sex
workers. Mobile groups of men: male
migrants in the cities; truck drivers; those in
the armed forces; and travelling
businessmen are frequently cited as
important client groups. Many young men
are initiated into their sexual lives by
prostitutes. Rapidly escalating prevalence
rates for HIV indicate that monogamy is not
necessarily practised. This applies to men
from all social classes.
Analysis of sex work in Asia concentrates
on FSW and child prostitution. Female sex
workers outnumber MSW in most Asian
societies. The failure to address the
incidence of men who sell sex – and
therefore the failure to meet their health
needs - derives from cultural patterns that do
not allow the social expression of male-male
desire. Homosexual behaviours are
commonplace. Frequently these behaviours
are non-commercial but they also take the
form of commercial encounters that fulfil
sexual desires whilst at the same time posing
no challenge to heterosexual norms and
family structures because of their fleeting
and anonymous nature.
Many men who sell sex will have a variety
of partners – some commercial, some non-
commercial, some male and some female.
They may not identify themselves as
homosexual. Crucially, just as with indirect
FSW they will not necessarily see
themselves as sex workers. Neither will
anyone else. Many will be married and will
have non-sex work occupations. In terms of
analysing sex work it is important not to
apply western categories defining sexual
identity to people in non-western cultures
and to recognise the fact that many of those
involved in sex work have overlapping
identities. This applies to both workers and
clients.2
Research on male sex workers is even more
limited. This is to be expected in a context in
which male-male sexual desire is a threat to
strong, family-oriented social patterns.
However, homosexual behaviours are
extremely common. Many of these are non-
commercial exchanges but many involve
material transactions. There are no clear
dividing lines separating the male sex
worker from the man who has sex with men.
In the same way there is no absolute
dividing line between the MSM and the
person who is a ‘regular’ family man with
wife and children. In many instances all
these behaviours and roles are found in the
same individual. 3
Male sex workers are often less visible than
female sex workers and are therefore more
difficult to reach. Their lack of visibility is
usually related to taboos on homosexuality.
However, it is very important not to assume
that male sex workers are homosexual.
Homosexuality is defined by identity and
lifestyle, not sexual behaviour on its own.
Many male sex workers do not identify as
2
From WHO Regional Office for Western
Pacific, STI/ HIV, ‘Sex Work in Asia’ July 2001.
3
Khan, Shivananda (1999) ‘Through a Window
Darkly: Men Who Sell Sex to Men in India and
Bangladesh’ in Aggleton, Peter (ed.) Men Who
Sell Sex: International Perspectives on Male
Prostitution and HIV/AIDS London: UCL Press.
gay. HIV prevention projects directed at gay
men may not reach male sex workers who
do not identify as gay. The term "men who
have sex with men" (often abbreviated to
MSM) is recommended to differentiate
between sexual identity and behaviour.
Terms like kothi and panthi to indicate
different sexual roles rather than one's
partner's sex those of penetrator or "fucker"
and receiver or "fuckee" and "double
decker" for someone who takes either role.
It is necessary to include male sex workers
who perform any of these roles with any
other person. Men also sell sexual services
to women. The most visible form of this
type of sex work can be found in tourist
resorts.
Cultural attitudes and the law shape the
conditions of male sex work and the quality
of support and services available to male sex
workers. For example, some men are able to
work with less interference from police if
the police concern themselves more with
female sex workers, while those in places
where sex between men is illegal may have
greater legal difficulties.4
Male Sex Workers in India are a
heterogeneous group characterised by many
sub-types that have specific needs and issues
that need appropriate programmes and
services. There cannot be one generic
intervention model for MSW in the country.
Currently there exists a lack of knowledge
about MSM and MSW among policy makers
and donors. The NACP-II (National AIDS
Control Programme –II) mentions only of
‘MSM’ (Men who have sex with Men’. The
National AIDS Control Organisation
(NACO) funds up to 76 Intervention
programmes for MSM to NGOs not CBOs
through State AIDS Control Societies
(SACS). ‘Hijras’ or ‘Transsexual/
transgender’ are not mentioned in NACP-II.
Similarly MSW are absent in NACP-II.
4
http://www.nswp.org/nswp/introduction.ht
ml
There is near lack of involvement of
community in design, implementation and
evaluation of programmes aimed at MSW/
transgender. In 2004, NACO had 3 sero-
surveillance centres for MSM in India. Most
Community Based Organisations (CBOs)
reach ut to and provide services to Koti
identified MSM. There is overlapping of
coverage by NGOs both in terms of
populations and area.5
Preliminary research conducted by The Naz
Foundation in India and Bangladesh among
MSM have found a range of issues that are
not easily visible or even acceptable for
socio-cultural reasons. These include the
issue of male rape, adolescent males as
sexual objects of older males, high levels of
anal sex between males and between males
and females, very early experiences of
sexual activity and sexual abuse among
males, inter-family male to male sex, with
sexual partners including brothers, uncles,
nephews, cousins, male-in-laws, sexual
encounters with servants, male to male sex
without identity constructions of
homosexual/ bisexual, identity structures
around marriage, penetration, age, family,
religion, caste and class, feminized identities
primarily of males who are penetrated,
Hijras as a socially constructed identity of
biological males who are "feminized"
through social/sexual interactions in pre-
pubescence, sexual desire of many males
based on discharge and activity not on
gender of partner, some male to male sexual
behaviours based on females being seen as
disease vectors, gender segregation and
limited sexual access to females within a
socio-cultural framework of homo-
sociability and homo-affectionism
increasing options for male to male sex.
Though limited in scope, it has brought out
5
Chakrapani Venkatesan ‘Programmes and
policies for Male Sex Workers in India: Current
Situation, gaps and recommendations’, 2004.
See also www.indianGLBThealth.info
certain vital clues to sex relations among
males that were hitherto unknown.6
The population of Male Sex Workers is
quite significant in India. They multiply
their sexual encounter as they cater to men
as homosexual as well as women clients.
Male sex workers are also a sexual minority
apart from the ‘hijra’ community, the
population as a community in India are a
heavily stigmatised group, and remain
socially and politically marginalized. HIV
prevention programme directed at MSM not
geared towards meeting the specific need of
male sex workers.7
In Bombay, according to health workers, an
estimated 40 percent of male sex workers
are said to be married, and the human
immunodeficiency virus is often passed to
children in utero or through breast feeding.
India has an estimated 2.3 million female
prostitutes in brothels and 1.2 million hijra,
an Urdu term for transsexuals, cross-
dressers, hermaphrodites and castrated men.
In medieval times, the original hijra --
eunuchs -- commanded a certain fear-
inspired respect as the guardians of royal
harems. Modern-day hijra are mostly
transsexuals who had the operations
voluntarily, although some were street
children mutilated by other hijra. They know
about AIDS, but most are working without
protection," says Khairati Lal Bhola, who
has worked with hijra health and legal issues
for 40 years. "Their customers want more
enjoyment, not condoms." Estimates on the
hijra community in Delhi estimate that as
many as 80 percent are HIV-positive and
complain that efforts to find them alternative
6 9
http://www.ilga.info/Information/Legal_sur
vey/Asia_Pacific/supporting%20files/sexual
_health_workshops_in_bangl.htm
7
National Strategic Meeting on Male Sex
Workers in India by Agniva Lahiri, India as
discussed in http://eforums.healthdev.org/
jobs are undermined by discrimination and
police harassment.8
Maitreya agrees that there are male sex
workers. In fact there are two types of male
sex workers – one catering to the men and
the other to the women clients. The MSW
catering to the men are not only
homosexuals but also may be bisexuals. It
is not voluntary work but paid work. There
are reportedly thousands of MSW in Kerala
alone. The MSW catering to women are
called gigolos. They are not many in
number in our country. They reside in big
cities and in tourist spots. Women who are
economically free are their clients,
especially from the upper class. The
relationship of the gigolo and woman client
is much better than the man and FSW
because of power relations.9
Hijras (Eunuchs) in India have virtually no
safe spaces, not even in their families, where
they are protected from prejudice and abuse.
The main factor behind the violence is that
society is not able to come to terms with the
fact that hijras do not conform to the
accepted gender divisions. In addition to
this, most hijras have a lower middle-class
background, which makes them susceptible
to harassment by the police. The
discrimination based on their class and
gender makes the hijra community one of
the most disempowered groups in Indian
society.10
8
“AIDS IN ASIA”, The Continent's
Growing Crisis, Fear on the front line in
India, by Juliette Terzieff, Chronicle Foreign
Service, Sunday, November 17, 2002 from
www.sfgate.com
http://www.ashanet.org/focusgroups/sanctu
ary/sanctuary/sex-work.pdf
10
“Being A Eunuch”, by Siddarth Narrain
in Frontline 14 October,2003 from
http://www.countercurrents.org/gen-
narrain141003.htm
 2.2 Some Definitions
A look at some of the definitions on sex
work and sex workers is inevitable. Here are
a few definitions propounded:
Sex worker is defined as “one who proffers
personal sexual services to a variety of
customers chosen primarily for what they
are prepared to pay”.11
Sex work is also defined as … “not as a
fixed state or identity, but rather as a
continuum ranging from organized
prostitution, through brothels, escort
agencies, and so on, through to unmediated
transactions resulting from chance
encounters…”. “For most it is a practice
enforced by poverty, degradation,
homelessness, hunger and powerlessness, a
form of slavery to economic, social and
cultural deprivation, stigmatization and
marginalization…”12
Another main defining theme examines
male prostitution thus: “young males
identify their involvement in prostitution
from an occupational perspective that down-
plays a “deviant self-perception” (the actors
define prostitution as part of a “hustle”);
young male prostitutes experience conflict
with colleagues, customers, and legal and
social service agents; and, prostitution
occurs within a variety of social relations.13
11
West, D.J. (1992). Male prostitution: Gay sex
services in London.London, England: Gerald
Duckworth & Co. Ltd.
12
Aggleton, P. (Ed.). (1999). Men who sell sex:
International perspectives on male prostitution
and AIDS. London: University College London
Press Limited.
13
Visano, L. (1987), ‘This idle trade: The
occupational patterns of male prostitution’.
Concord: Vista Sana Books.
2.3 Demographics and occupation
Literature suggests that young males
involved in the sex trade had run away from
physically and sexually abusive home
environments (Janus, Burgess and
McCormack, 1987; Tremble, 1993; Earls
and David, 1989a and 1990). Tremble’s
research on gay street youth revealed that a
majority of respondents had come from
abusive home environments or “placement
families.” Earls and David (1989a and 1990)
found that in comparison to control groups,
male prostitutes had experienced more
physical and sexual abuse while growing up,
and had witnessed more violence between
parents, more drug and alcohol use among
family members, and were more likely to
identify male partners as their first sexual
experience.
Janus, Burgess and McCormack (1987)
found that male runaways had experienced
more sexual and physical abuse than
“randomly sampled [male] populations.”
The literature also reveals several
characteristics that are unique to the male
sex trade. Weisberg (1985) noted that many
adolescent males involved in prostitution
exhibited homosexual preferences (also see
Earls and David, 1989a; Price, Scanlon and
Janus, 1984). Several items suggest that
many young males involved in prostitution
had run away from home because of anti-
homosexual/ homophobic sentiments in
mainstream society (e.g., family, friends,
school) (see, Kruks, 1991 and Visano, 1987)
– in essence, they were ridiculed and
ostracized for their homosexual preferences
(Badgley, 1984). In this respect,
discriminatory attitudes in “square society”
propelled some young males to the street
where situational factors contributed to their
decision to prostitute.14
14
‘Youth Involvement in Prostitution’, Steven
Bittle 2001, 13ed. Research and Statistics
Division April 2002.
 2.4 Social Issues
In a study by Cates and Markley, semi-
structured interviews were conducted with
15 male hustlers and 15 male non-hustlers to
examine male participation in the sex trade
by choice. Respondents were asked
questions about their “living status,
education, employment status, values,
relationships, use of drugs and alcohol,
knowledge of HIV and AIDS, and family
history.” Male hustlers were asked about
their entry into the sex trade and their
experience as prostitutes. Contrary to
previous studies, the data suggest that male
hustlers were involved in prostitution by
choice, “primarily to earn extra money.” The
data also suggest that male hustlers were
more likely to have substance abuse issues,
be more antisocial (limited support for this
finding), and have “limited vocational
aspirations”.15
Another research examines teenage male
prostitution on two levels: 1) different
methods of prostitution, and 2) patterns of
street behaviour. The authors conducted
interviews with teenage males involved in
prostitution to explore their “family history,
parental and sibling relationship patterns,
school involvement, and friendship
patterns.” Among the findings: the youth
indicate family problems, characterized by
memories of fights between parents, alcohol
abuse, and neglect. Poor relationships with
families, adults and friends were
commonplace. The youth identified
themselves as isolated, victimized, and
having negative experiences in school and
with peers.16
15
Cates, J., & Markley, J. (1992). Demographic,
clinical, and personality variables associated
with male prostitution by choice. Adolescence,
27, 107, 695-706.
16
Price, V., Scanlon, B., & Janus, M.D. (1984).
Social characteristics of adolescent male
prostitution. Victimology: An International
Journal, 9, 211-221.
Clarke views that “…child sexual abuse is a
result of our patriarchal social structure… an
overwhelming majority of those who
sexually assault, abuse and exploit children
and youth are males”. However, there is no
analytical recognition of this important
gender dynamic. Further, the Report
identifies child sexual abuse as repulsive,
however it ignores especially the role of the
family in protecting male interests. The
author concludes that male sexual
socialization and other patriarchal power
structures must be addressed if we are to
reduce the incidence of sexual offences
against children and youth.17
Male prostitutes under the age of 18 are
studied to reveal that many have the
necessities of food shelter and clothes, and
many “return to a family at the end of an
evening.” Two case studies explore reasons
for entry into adolescent male prostitution.
The author suggests that, contrary to
common assumptions, adolescent males
become involved in prostitution for
“emotional rather than economic needs.”
Adolescents who prostitute by choice appear
to be victimized by their feelings of
“inferiority, insecurity, and development of
peer-oriented or delinquent orientation”.18
Factors identified by Brown as precipitating
involvement in prostitution include: broken
homes, parental neglect and abuse,
educational difficulties, poor work prospects
and “psychological disorientation.” Once
exposed to deviant socialization, several
motives potentially draw youth into
prostitution (e.g., financial needs, the desire
for adventure, associating with delinquent
17
Clark, L. (1986). Boys will be boys: Beyond
the Badgley report: A critical review. In J.
Lowman, M. Jackson, T. Palys, & S. Gavigan
(Eds.).
18
Cates, J. (1989). ‘Adolescent male prostitution
by choice’. Child and Adolescent Social Work
Journal, 6, 151-56.
girls, situational factors associated with
being a runaway).19
2.5 Psychological Concerns
Coleman (1989) found that disruptions in
the psychosexual and psychological
development of young males may contribute
to their participation in “destructive and
non-ego enhancing prostitution activities.”
Dorais (1996) suggested that some male
victims of childhood sexual abuse might
become involved in “aggressive
prostitution” as a means of diverting revenge
against the true aggressor.20
Allen categorises male prostitutes into four
groups: 1) full-time street and bar hustlers;
2) full-time callboys or kept boys; 3) part-
time hustlers; 4) those involved in
prostitution as an “extension of other
delinquent acts.” The data suggests that part-
time male prostitutes, who remain in
educational or vocational programs, are the
only category of male prostitutes who
express the ability to achieve a “stable social
adjustment.” The author asserts that there is
no “typical” young male prostitute;
respondents had various backgrounds and
motives for becoming involved (and staying
involved) in prostitution.21
In another study, the subjects were matched
on age, sex and socio-economic status
(SES). Questions focused on family
background, sexual and criminal history,
present life circumstances, substance use,
and “sexual practices with clients.” The data
suggest that differences between the groups
do not support previous research on
demographic profiles of male prostitutes.
19
Brown, M. (1979). Teenage prostitution.
Adolescence, 14, 665-679.
20
Op. cit., Steven Bittle, April 2002.
21
Allen, D. (1980). Young male prostitutes: A
psychological study. Archives of Sexual
Behavior, 9, 339-426.
The authors argue that factors associated
with financial gain, homosexuality, and
early sexual experiences may be more
significant in determining entry into
prostitution than family background.22
The author asserts a relationship between
gay and bisexual adolescent psychosexual
and psychological development and
vulnerable situational variables. “More
severe disruptions in psychosexual and
psychological development seem to result in
more destructive and non-ego enhancing
prostitution activities.” The development of
this process is presented through a clinical
case study and incidence of “self-destructive
prostitution activity among male
adolescents” is also discussed.23
2.6 Criminalization
A study by Silbert and Pines reveal a cycle
of victimization, both before and after the
respondents entered prostitution. Most
subjects ran away from abusive (sexually
and physically) homes and subsequently
became involved in prostitution. Sixty
percent of the respondents indicated they
were victims of childhood sexual
exploitation, and everyone experienced
physical and emotional abuse. Once
involved in prostitution, respondents were
raped, beaten, robbed and abused by both
customers and pimps. Respondents were
victimized in non-prostitution related
situations. Most did not report their
victimization to authorities, and they did not
attempt to seek help for the “negative
emotional impact” of their abuse.24
22
Earls, C., & David, H. (1989a). A
psychosocial study of male prostitution. Archives
of Sexual Behavior, 18, 401-419.
23
Coleman, E. (1989). The development of male
prostitution activity among gay and bisexual
adolescents. Journal of Homosexuality, 17, 131-
149
24
Silbert, M. & Pines, A. (1982b). Victimization
of street prostitutes. Victimology, 7, 122-133.
 2.7 Risk
Authors Pennbridge et al. compare
participants involved in “survival sex” and
those involved in “recreational sex.” The
data reveal that 90% of the males in the
sample were sexually active; 27.1% had
prostituted in the last 3 months, and
participation in prostitution was most
common among older, gay males. The
authors identify several risk factors that
emerge from the data, including inconsistent
condom use, high-risk sexual activities
(during both survival and recreational sex),
numerous sexual partners, intravenous drug
use, and the consumption of alcohol and
drugs during sex.25
Closer home in Thailand the authors of a
study find that beliefs and attitudes toward
sexuality and prostitute patronage result in
higher risk-taking behaviours among Thai
citizens (men are traditionally expected to
have more than one woman to satisfy their
needs, whereas women are expected to
remain pure until marriage). This double
standard helps condone the use of prostitutes
by both single and married men, thereby
contributing to the spread of AIDS. Despite
increased knowledge of AIDS (especially
among university students) sexual practices
appear unaffected in Thailand – men
continue to engage in unsafe sex.26
Among the findings on Male Sex Work in
Canada: research suggests that a majority of
males entered prostitution before 18 years of
age; money is the ‘primary’ reason why
25
Pennbridge, J., Freese, T., & MacKenzie, R.
(1992). High risk behaviours among street youth
in Hollywood, California.AIDS Education and
Prevention(Suppl.), 24-33.
26
Belk, R. W., Ostergaard, P., & Groves, R.
(1998). Sexual consumption in the time of AIDS:
A study of prostitute patronage in Thailand.
Journal of Public Policy & Marketing, 17(2),
197-210.
young men enter prostitution; male sex
workers experience violence from
“homophobic onlookers who assault and/or
rob them”…According to the author,
although there is variation in the research on
condom use, the available evidence refutes
“…the label of male sex workers as AIDS
vectors.” “Instead, it suggests that
increasingly, male sex workers are
protecting themselves, their clients and their
sexual partners from STD and HIV infection
and transmission”.27
Sullivan reveals high-risk profiles among
these socially marginalized youth.
Community-based education programs may
have some impact on “lower-risk behaviour
among this population.” The author
identifies “cofactors of risk” that must be
addressed (i.e., sexuality and
marginalization), and argues for practical
educational programs to transform the living
conditions of street involved youth.28
2.8 Clients
Findings from a study of customers of male
prostitutes, as reported by male sex workers
in 3 Australian cities are interesting. Male
sex workers were asked to complete a brief
questionnaire (referred to as a diary)
following a sexual encounter with a client.
The largest proportion of clients were in
their 40s (31.7%), followed by those in their
30s (28.7%) and 16% who were in their 20s.
Most clients were perceived as being
“middle class.” “Rich” clients tended to use
services provided by an escort agency, while
“poor” clients used the services of street
workers. Most clients were identified as
being gay (45%) or bisexual (31.3%). Drug
and alcohol use by clients before the sexual
27
Allman, D. (1999). M is for mutual A is for
Acts: Male sex work and AIDS in Canada.
Ottawa: Health Canada.
28
Sullivan, T. (1996). The challenge of HIV
prevention among high-risk adolescents. Health
and Social Work, 21, 58-65.
encounter was uncommon. Sex workers
reported having some personal information
about their clients (61.2% of the cases).
Greater trust between the client and the sex
worker may result in increased risk-taking in
sexual practices (7% of the clients requested
unprotected intercourse). Customer violence
was reported infrequently (occurring more
frequently with street clients than with other
types of clients).29
2.9 Services
Snell’s study samples 70 young male
prostitutes to explore and analyze their
“help-seeking behaviour.” The authors
conducted in-person structured interviews
and direct observation of places where
young street males assemble. Most
respondents indicated they received high
levels of emotional and physical support
from family members. Friends supplied
emotional support, but were not identified as
offering physical support. Medical and legal
services and ministerial help were identified
as most accessible. The police and social
and mental health services were described as
less “available or useful.30
Back home the Indian experience in Chennai
as assessed by Chakrapani is revealing.
Services provided to MSM in general are
also usually accessed by MSW (mainly
Counselling/ Testing – STD/ HIV, Drop-In
facilities, Clinical centres, Outreach
education and Condoms). Specific needs/
services may not be understood by NGO/
CBO and not articulated by MSW who are
to access such services. Some important
services that are needed but not available in
29
Minichiello, V., Rodrigo, M., Browne, J.,
Jamieson, M., Peterson, K., Reuter, B.,
&Robinson, K. (1999). A profile of the clients of
male sex workers in three Australian cities.
Australian and New Zealand Journal of Public
Health,23(5), 511-518.
30
Snell, C. (1991). Help-seeking behavior
among young street males. Smith College Studies
in Social Work, 61, 293-305.
the Indian context for MSW include: Legal
services, especially about legal rights,
Psychosocial support counselling, referral
services for mental health and de-addiction
problems, assistance and support for
disclosure on HIV/ STD to steady partners,
condom negotiation skills, appropriate
‘empowerment’, counselling and referrals
for Sex Reassignment Surgery (SRS) among
transgender population, absence of advocacy
to challenge criminal assault and training
specific groups as ‘masseurs’ (massage
parlour workers) to lobby for their
protection.31
2.10 Discussion
A glimpse of the review of available
literature does throw some light on the role,
position and status of male sex workers
around the world though western societies
are different and Asian or Indian social
settings have unique characteristics within
which male sex workers need to blend into
in order to survive. An important issue that
emerges is that there exists a stark difference
between identity (defining a person as a
Male Sex Worker or MSM or Kot, Panthi,
Dubli or Hijra) than actual sexual behaviour
that are typical to each of these major
subtypes of MSW. Therefore, even though
a male sex worker may practice insertive
anal sex (classically Panthi), he may identify
himself as typically Koti or one who
conventionally engages in receptive anal
sex.
Another important issue is the thin line
dividing recreational sex and survival sex in
the Indian context. Moreover, many MSW
or even MSM engaging in sex where there is
no exchange of money or gifts, etc. do not
consider them to be homosexual. Added to
it is the fact that many MSW here lead lives
like any other male and go about their
business and their (sexual) behaviour or
orientation is largely hidden, so much so
many even get married due to familial
31
Op. cit.,Chakrapani Venkatesan, 2004. See
also www.indianGLBThealth.info
pressure but engage in sex with other men
after marriage, with or without the
knowledge of the spouse. This seemingly
discreet silence against same sex
relationships is because under Indian law
homosexuality is illegal and therefore it
attracts legal sanctions. Police and official
authorities take MSW and MSM to task
easily and this further gets these groups on
the run. No wonder then, that the
phenomenon of male sex work is dark and
hitherto hidden, affecting needed
programme interventions focussing on HIV
prevention, treatment and care.
Unlike the western model, male youth in
India are drawn into sex as they are
influenced by excessive social control where
sex is taboo, broken homes, violence
between parents, sibling rivalry, elders
physically assaulting youth and early sexual
abuse by other males within the family –
relatives, friends and peers. Another factor
contributing to male youth into sex is the
physical setting, poor living environments,
exposure to deviant social behaviour early in
life.
Patterns of sexual activity among male sex
workers reveal that many start off having
recreational sex but in due course, (mostly
when they are exposed and stigmatised)
move on to survival sex and, especially in
certain rapidly growing cities with
increasing migrant labour and growth of
slums, the demand for sex is high. Young
boys are easy to be drawn into the sex trade
by older men as none would doubt their
intentions. Getting a teenage girl into a
hotel room for instance would be impossible
in many cities. But getting a lad of 18 to 20
years into a room would go unnoticed and
this fuels increasing same sex behaviour
among males. In most instance, this ‘idle
profession’ does bring in the extra money
that young boys need to satisfy their ever
growing demands – watching movies,
drinking, smoking, drugs, etc. Many boys
are known to run the entire household on the
income obtained from sex work.
Family level influence indicates that many
MSW hail from larger families. With the
number of siblings beyond five or six, those
with little or no parental attention get drifted
and fall into isolation, victimization and
finally turn to commercial sex activity.
Moreover, not all MSW consider themselves
gay and there are a sizeable number of
MSW who are bisexual. This complex
scenario poses a nightmare for programme
planners and managers. Therefore, a holistic
and full-scale prevention and care
programme can be the answer to improving
the sexual health of MSW thereby
decreasing their risk of HIV infection and of
AIDS.
In the Indian context, MSW reportedly
select clients more based on his/ her ‘paying
capacity’. Many indications are that sex
workers will chose clients of their own
socio-economic milieu or better as they are
assured of payment at the end of the job. In
rare instances, if an MSW is lucky, he gets
overpaid by the client or when a rich client
feels he has been satisfied by the MSW.
However, in times of economic trouble, a
sex worker would not hesitate to sell sex to a
larger number of clients from poorer
backgrounds in order to sustain himself
economically.32
Photo courtesy: Srinivas Kurungati
32
Discussion based on readings from literature in
Asia and the country as well as from qualitative
data, depth interviews with MSW and key
influencers and FGD in the three cities.
3.0 KEY FINDINGS

The results of this study reveal that male sex workers are present in this country in quite good
number and they are engaged in sex work to augment their poor economic status. Though
there are socio-cultural differences between regions (cities) across the country, with specific
societal changes across geographic regions, a common thread knits the issues of MSW. The
risk factors, poor levels of correct knowledge and awareness on HIV/ AIDS, vulnerability due
to individual, societal and economic pressures as well as age and physical stamina (including
other demographic variables such as education, media habits, occupation and income, peer
group influence, disposable income and family support) play an important role with regard to
chances of (increased) HIV infection. It is also observed that they are by and large a hidden
group and hence very difficult to identify (that poses a challenge for interventions) that can be
more successful through community-based outreach. To begin with, testing and diagnostic
facilities are unknown to MSW and few who know such services are not motivated to test for
HIV even though they may be at increased risk of infection. As individuals, many MSW
suffer from a sense of low self-esteem, poor confidence fuelled by stigma when identified as a
sex worker. Decreased family support, economic hardship, non-availability of need-based
services put tremendous pressure on the Male Sex Workers across the country. Where
services exist, they are inadequate and out of reach of MSW owing to cost (of maybe even
reaching there), stigma, poor quality of service delivery, inconvenient timings/ place and most
significantly ignorance about existence of such services that contribute to poor access for
treatment as well as other services required by MSW.

Overall, it is observed that the Male Sex Workers in Kolkata are younger, better educated,
employed suitably, better informed with good media habits and indulge in sexual activities
both as recreational sex as well as in survival sex. The clientele is rather old with most clients
being older than MSW themselves and there is a good potential for sex work in the big
metropolis. Urbanization, increased migration, growth of slums, chaos in controlling the sex
industry that is hidden and rather unorganised (especially male sex industry) witness the rise
of male sex work.

Ahmedabad portrays a contrastingly different picture with many sex workers being
comparatively older, while their clientele are younger. Unemployment is rampant as
education and skills among male sex workers are poor, hence many are engaged in odd jobs
and barely manage to eke out a living. One does not see a thriving market for sex activity in
Ahmedabad unlike Kolkata and Vijayawada but the fact is that male sex workers have to
increasingly engage in sex work to supplement their income. Large numbers of MSW are
married and bisexuals may have increased risk of infection as well as transmitting it to their
spouses. Hence, service provision needs to be done appropriately with increased partner
treatment and so on.

Vijayawada is tastefully South Indian stereotype, closed family and social relationships, rigid
moral codes, taboo on even talking about sex (leave alone engaging in it!), and sex outside
marriage or with same sex partners viewed with contempt. Yet, the study reveals the setting
and behaviour of MSW is more akin to those in Kolkata. Being one of the most rapidly
growing cities in the country, with increased mobility and migration to and from the city, poor
growth of jobs, increasing competition and the need to earn more have compelled many youth
to take to sex work as they are lured into the industry by older males and the expanding
demand for sex. External influences as cinema, other media, increased connectivity with
other important places and rural areas have all propelled male sex industry in Vijayawada.
With respect to service access though, all cities indicate poor response.
3.1 The proposed working definition that MSW agreed that though there are several
subgroups among MSW, persons who have sex in exchange for money, favour and
gifts are defined as Male Sex Workers. The above definition is approved by
consensus across all the three cities studied. They also agreed that increasing
numbers of MSM who engaged in recreational sex move over to survival sex due to
economic reasons. The main sub-types of MSW known include Koti (feminised
males practicing receptive anal sex), Panthi (‘real’ males practising insertive anal
sex), Dubli (known to practice both receptive and insertive sex and Hijras (gender-
variant male as well as transvestites) considered more male than female in the
country. (In West Bengal and Gujarat, male sex workers are known to dress as
women and participate in cultural festivals, also buying sex from other males. Such
fairs and festivals are held regularly annually) MSW in Andhra Pradesh attend the
annual Koovakam festival (for gender-variant male) held every year in
neighbouring Tamil Nadu.

Male Sex Workers are known to constitute MSM who engage in sex in exchange of
money, favour and gifts, Koti – feminised males who practice receptive anal sex,
Panthi – masculine male persons who practice insertive anal sex, many of whom
also have sex with women, Dubli or double deckers who are known to engage in
both receptive and insertive sex and Hijras (to be read gender-variant males)

3.2 Across the country, the Sex Industry Network (SIN) is known to operate in two
types a) outdoors: more open and in public places predominantly, unconcerned of
the general public – in parks, streets, bus and railway stations and b) indoors: more
clandestine and discreet manner where only MSW and client are in the know of
things. Such encounters take place in houses, brothels, hotels and massage
parlours. While MSW from lower socio-economic classes are known to engage in
outdoor activities, closed and secret practices are engaged by MSW and their
clients from higher socio-economic strata. Other key stakeholders within the SIN
include pimps, madams, police, lodge and brothel owners, informers, drug and
liquor peddlers, petty shop keepers, older MSW, traditional and allopathic health
care givers and the general community in the vicinity of the hotspot who
accommodate MSW. All three cities are on banks of rivers that are an important
hotspot for increased MSW activity – Hoogly in Kolkata, Sabarmati in Ahmedabad
and Krishna in Vijayawada. MSW also reportedly known to operate in large
numbers in places such as army cantonments – Ahmedabad and Vijayawada have
military establishments and MSW are known to have clients from such places.
(Individual city reports have pinpointed areas where MSW can be reached).

3.3 Access to health facilities primarily rests on knowledge about such services and the
study indicates that those who are aware have accessed services. However, the
numbers of those who accessed are extremely low that indicates a serious barrier –
the lack of information among MSW. Other barriers identified include inadequate
infrastructure facilities in affordable centres, inconvenient location of such centres,
sustained affordability, and absence of the range of services that are needed – such
as condom programming or diagnostic and testing facilities. Inconvenient timings,
untrained personnel, non-availability of drugs and medicines and gels and
lubricants also contribute to their poor access. Moreover, it is observed that
professional services such as counselling and referrals are few and far between.
Many MSW refuse to access even known services for fear of exposure or
discrimination from general public. (A large majority of MSW cannot be identified
thus and live as other men do and so accessing a facility meant for and advertised
as a centre for MSW and MSM really puts them off.)

3.4 Male Sex Workers per se constitute a larger universe of male persons having sex in
exchange for money, favours, gifts, etc. (of economic value) into which may be
included Men who have Sex with Men as not all MSM may practice sex on a
 commercial scale. (Large numbers of MSM are known to engage in recreational sex
though at some point of time also receive money subscribing to engaging in
survival sex). It is important to note that neither all MSM nor all MSW consider
them as homosexual. Thus, there is a wide chasm between identity and behaviour,
and these are so often bundled up together, especially by those not belonging to the
community. It is also seen that overall, always MSM are in conflict with MSW as
both have their eyes pinned on the same client. However in some places (such as
Vijayawada), it is difficult to distinguish between the two. To make matters
complex, they also switch roles. However, programme planners understand that
whichever way, the element of risk and vulnerability make them the centre of HIV
prevention and care.

3.5 As far as risk perception is concerned, across the cities, MSW do not rightly
perceive them to be at risk of HIV infection indicated by poor condom use despite
awareness of HIV/ AIDS. MSW in Kolkata and Vijayawada understand and
reportedly adopt safer sex practices compared to Ahmendabad where perception of
risk is extremely low. The important myth that MSW have is that they consider
HIV infection can occur only by sex with a woman (heterosexual contact). As a
majority MSW practice anal sex, they do not understand the importance of
condoms. Moreover, even for anal sex condoms preferred are lubricated that are
either not available or unaffordable. Condom use during oral sex too is reportedly
very poor across the three cities.

3.6 Socio-demographic analysis on age factors of MSW indicates that the age of MSW
in Kolkata is the lowest, followed by Vijayawada, 47 percent and 41 percent
respectively in the 19-25 years age group. MSW in Ahmedabad are reportedly
older with a sizeable number aged above 40 years. Data on age at first sex is
similar in all 3 cities with 80 percent MSW in Kolkata and Vijayawada reporting
the same below 18 years while in Ahmedabad 93 percent first had sex during the
same time. However, with respect to having first sex in exchange for money, gifts,
etc, 55 percent respondents in Kolkata were below 18 years of age while in
Ahmedabad and Vijayawada, 50 percent and 70 percent reportedly had first
commercial s when they were between 19 and 25 years of age. Interestingly the
average age of the clients is different in each of the cities. While 33 percent clients
in Kolkata are 26-32 years of age, 45 percent clients of MSW in Ahmedabad are
below 18 years and the average age among 55 percent of clients of MSW in
Vijayawada is between 19-25 years.

3.7 The educational status of MSW is similar across the 3 cities with roughly 30 to 40
percent educated up to middle school followed by 20 to 30 percent with primary
education. As far as marital status is concerned, majority of the MSW interviewed
are unmarried, 71 percent in Kolkata, 60 percent in Ahmedabad and 56 percent in
Vijayawada and consequently 29 percent in Kolkata, 40 percent in Ahmedabad and
44 percent in Vijayawada were ever married. In Kolkata only 12 percent of MSW
are married and living with spouse. Educational data reveals low education – up to
middle/ primary level mainly with large numbers illiterate, hence unaware of
preventive measures. MSW in Kolkata are more aware of risks to HIV infection
followed by those in Vijayawada. In Ahmedabad, though awareness is there, many
myths and misconceptions also exist among MSW. In all three cities, mere
knowledge or awareness of safe sex practices has not indicated significant change
in behaviour of MSW. Condom use is still reportedly low and this points to
absence of specific communication needs of MSW. Marital status too indicates
large number of unmarried males though of marriageable age. Among married
MSW (bisexual) too, sexual practices indicate non-adoption of safe sex methods.
Many are known to delay marriages and several others remain single. In the south,
more emphasis is laid on marriage.
3.8 The occupational status of MSW indicates that majority in Kolkata, 63 percent are
employed in full time jobs, while in Ahmedabad, 80 percent MSWs work as part-
timers. In Vijayawada, 45 percent are in full-time jobs and 36 percent in part-time
jobs. Unemployment is high in Kolkata, 33 percent and Vijayawada, around 20
percent fuelling sex work as an alternative income generating avenue. Many sex
workers argue that disclosure of their status as MSW leads to being thrown out of
jobs and not being able to start their own businesses due to lack of finance and poor
or no skills and training.

3.9 The data on average monthly income of MSW reveals that majority of them, 64
percent earn below Rs.2500/- a significant number, 33 percent earn between
Rs.2501/- and Rs.5000/-. However, in Ahmedabad, an alarmingly high 93 percent
of MSW earn below Rs.2500/-. Comparatively, MSW in Vijayawada are
economically better off with a majority, 52 percent earning between Rs.2501/- and
Rs.5000/- and 40 percent earn below Rs.2500/-. This indicates that the economic
position of MSW in Ahmedabad is extremely poor and many are forced to engage
in increased sexual activity in order to earn more. (Such a trend points at increased
risk of infection when coupled with poor adoption of safe sex practices. Poor
economic status also has a bearing on accessing affordable, quality services, timely
treatment of STI and using (lubricated) condoms). Overall, it is observed that larger
number of MSW in Vijayawada earn on an average more than MSW in Kolkata or
Ahmedabad where MSW are poorly paid for sex work. In Kolkata, depending on
looks and demand with high-class clientele, there is potential for few MSW to earn
very high income but by and large many just manage to make a living.

3.10 Media habits of MSW across the 3 cities reveals that Television is the main media
channel followed by Newspapers and the Radio. Besides, magazines and cinema
are also prominent mass media accessed by MSW. As far as other personal habits
are concerned, in Kolkata and Ahmedabad, around 70 percent of the MSW and 46
percent MSW in Vijayawada have the habit of smoking, larger number of MSW, 73
percent in Vijayawada take alcohol, compared to 44 percent in Kolkata and
Ahmedabad. Media exposure is wide among MSW with TV, newspapers and radio
being the most important media channels. It is also noticed that MSW with higher
literacy levels have better media exposure and are able to understand messages
better than illiterate or poorly literate peers. However, with low education levels
and fast urban pace of living, it is doubtful if MSW are able to understand
preventive messages projected through such media (especially hoardings/ posters
that are in transit places such as bus stands and railway stations or wall paintings
that they have hardly time to read the message fully. Provision of leaflets and
handbills with pictures and information on preventive and curative measures (STI)
are welcome by MSW. Those who have seen such materials feel they create better
impact. A multi-pronged communications approach is warranted.

3.11 With regard to awareness on MSW genre, larger numbers of MSW in Vijayawada
have better clarity with regard to Koti, Panthi, Dubli and Hijras followed by
Ahmedabad and Kolkata. MSW in Kolkata are observed to have an identity
problem and there is so frequent changing of roles depending on the circumstances
that fluidity exists in terms of arriving at a definite definition. In terms of
identification with a particular group or subtype of MSW, many MSW in
Ahmedabad, 87 percent considered them as also being Koti compared to 61 percent
in Kolkata and 36 percent in Vijayawada. However, all MSW interviewed
identified them as Panthi too in Ahmedabad compared to only 24 percent in
Vijayawada and only 7 percent in Kolkata. Almost an equal number also identified
them as Dubli in Kolkata and Vijayawada, around 32 percent compared to only 12
percent in Ahmedabad. However, a reversal of trend is observed in MSW with 30
percent in Ahmedabad also identifying as Hijra compared to 10 percent in Kolkata
 and 8 percent in Vijayawada. There are also gender-variant male and transvestites
in all three cities with their distinct characteristics and culture. A majority of
MSW across all three cities consider them Koti and buy sex from other men.
However, in Vijayawada and Kolkata there are typical male sex workers catering to
female clients as well and there are bisexuals. In terms of role played during sex, a
lot depends on the demands of the clients. For instance, MSW reportedly play a
role of Panthi though he may always consider him as Koti. Some clients pay more
for demanding switching of roles and diverse sexual demands from sex workers.

3.12 Sexual practices and condom use behaviour indicate that condom use is
proportionate to extent of sex in exchange for money, gifts, etc. with condom use
reportedly high in Ahmedabad followed by Vijayawada and then Kolkata.
However, qualitative data indicates the opposite with MSW in Kolkata reporting
high condom use followed by Vijayawada and very poor condom adoption
practices in Ahmedabad. On the whole, it may be seen that condom use is lowest in
Ahmedabad. In Kolkata it is reportedly good and MSW from Vijayawada
reportedly use condoms extensively. However, the issue of availability and
affordability of lubricated condoms for anal sex and social marketing by NGO/
CBO are issues that alter condom use pattern. Ultimately, there is indication of the
absence of an effective condom programming strategy in any of the cities and few
MSW aware of the risks of HIV/ STI infection use condoms for self-protection.

3.13 The type of sex practices reveals that anal sex is very popular though oral sex is
also very common especially in Ahmedabad and Vijayawada. Vaginal sex is
practiced by married MSW and gigolo and thigh sex is popular among Hijras.
Though condom use is reported across all cities, it is not satisfactory. The socio-
economic condition of MSW too has a bearing on knowledge, risk perception, need
for and use of condoms. Thus, MSW in Ahmedabad report poor condom adoption
compared to Kolkata and Vijayawada where it is more a matter of choice and
depends on the clients.

3.14 Acts of physical violence and criminal assault are reported by about half the
number of total MSWs interviewed in the study (despite possible underreporting of
the same). Larger numbers of MSW in Vijayawada, 57 percent reported having
forced sex and physical violence such as thrashing, beating, burning with cigarette
ends and so on. In Ahmedabad, 48 percent and in Kolkata 45 percent reported
similar acts. However, more MSW in Kolkata around 50 percent compared to 45
percent in Ahmedabad and 20 percent in Vijayawada faced criminal assault. In all
three cities, police are known to exploit MSW, extortion, threat of arrest and
repeated harassment is reported. Here too, MSW in Kolkata and Vijayawada feel
more secure than those in Ahmedabad. Media sensitization and efforts at
increasing awareness of law-enforcing authorities can improve rights of MSW.
Local newspapers, regional media publicity have a strong negative opinion on male
sex workers and their occupation.

3.15 As far as awareness, availability and access to services by MSW is concerned,

across the 3 cities, a rather dismal picture emerges. Services provision is pathetic
and the range of services offered are grossly inadequate, facilities ill-equipped, with
untrained or unskilled personnel and non-user-friendly atmosphere that deters
MSW from accessing services. The indication of sources of awareness of various
services may be harnessed to evolve effective communication dissemination to
MSW and make available such services that are need-based, cost-effective and with
the right delivery mechanisms in place.
 A Tale of Three Cities
ANALYSIS OF MALE SEX WORKERS IN THE 3 CITIES
Age in completed years
KOLKATA

Age in completed years

14.7 2.7 6.7

29.3 46.7

< 18 Years 19-25 Years 26-32 Years

33-39 Years Above 40 Yrs.

AHMEDABAD

Age in completed years

13.3 1.3

17.3 41.3

18.7
< 18 Years 19-25 Years 26-32 Years
33-39 Years Above 40 Yrs.

VIJAYAWADA

Age in completed years

2.7
10.7 2.7

33.3 50.7

< 18 Years 19-25 Years 26-32 Years

33-39 Years Above 40 Yrs.
Age at first sex & age at first commercial sex
KOLKATA

Age at first sex & first commercial sex

81.3
100
80 54.6
60 40
40 18.7
20
0

19-25 Years
< 18 Years

Age at 1st sex Age at 1st com. Sex

AHMEDABAD

Age at first sex & first commercial sex

93.3
100
80
60 44 49.3

40
6.7 6.7
20 0

0
< 18 19-25 26-32
Years Years Years

Age at 1st sex Age at 1st com. Sex

VIJAYAWADA

Age in completed years

78.7
69.3
80

60
26.7
40 20
4
1.3
20

0
< 18 19-25 26-33
Years Years Years

Age at 1st sex Age at 1st com. Sex

 Average age of clients

KOLKATA

Average Age of clients of MSW

33.3
35 30.7
30 25.3
25
20
15
6.7
10
4
5
0
Avg. age of client

< 18 19-25 26-32 33-39 40 & >

AHMEDABAD

Average Age of clients of MSW

50 45.3 42.7
40

30

20
10.7
10
1.3 0
0
Avg. age of client

< 18 19-25 26-32 33-39 40 & >

VIJAYAWADA

Average Age of clients of MSW

60 54.7

50
36
40
30
20
8
10 1.3 0
0
Avg. age of client

< 18 19-25 26-32 33-39 40 &

 Educational status of MSW

KOLKATA
Education status of MSW

40
30.7
30 25.3
21.3
20
8
10 6.7 6.7
1.3
0
Education

Illiterate Primary Middle school

Hr. Sec. Technical Hr. Edu.
No Resp.

AHMEDABAD

Education status of MSW

40 36
29.3
30
20 13.3 13.3
10 5.3
0 2.7
0
Education

Illiterate Primary Middle school

Hr. Sec. Technical Hr. Edu.
No Resp.

VIJAYAWADA

Education status of MSW

50 41.3
40
30 20 21.3
20 9.3
10 6.7
1.3 0
0
Education

Illiterate Primary Middle school

Hr. Sec. Technical Hr. Edu.
No Resp.
 Marital status of MSW

KOLKATA

Marital Status of MSW

70.7
80
60
40
12
20 9.3
6.7 1.3

0
Marital status

Unmarried Married, living with spouse

Married, living without spouse Separated/ Divorced
No Response

AHMEDABAD

Marital Status of MSW

60
60
34.7
40

20
1.3 4 0
0
Marital status
Unmarried Married, living with spouse
Married, living without spouse Separated/ Divorced
No Response

VIJAYAWADA

Marital Status of MSW

56
60
37.3
40

20
2.7 4 0

0
Marital status

Unmarried Married, living with spouse

Married, living without spouse Separated/ Divorced
No Response
 Occupational status of MSW

KOLKATA

Occupation Status of MSW

80 62.7
60
33.3
40

20 4

0
Occupation

Unemployed Full-time employed

Part-time employed

AHMEDABAD

Occupation Status of MSW

80
80

60

40
13.3
20 6.7

0
Occupation
Unemployed
Full-time employed
Part time employed

VIJAYAWADA

Occupation Status of MSW

45.3
50
36
40
30 18.7
20
10
0
Occupation
Unemployed
Full-time employed
Part time employed
Average Monthly Income of MSW

KOLKATA

Average Monthly Income - all sources

2.7
33.3

64

< Rs.2500 Rs.2501 – Rs.5000 > Rs.5001

AHMEDABAD

Age in completed years

2.7 4

93.3
< Rs.2500 Rs.2501 – Rs.5000 > Rs.5001

VIJAYAWADA

Average Monthly Income - all sources

8
40

52

< Rs.2500 Rs.2501 – Rs.5000 > Rs.5001

 Media habits of MSW

KOLKATA

Media habits of MSW

94.7
100
70.7
80 65.3

60
40 22.7
21.3

20
0
Media channels

Television Radio Newspaper

Magazines Cinema

AHMEDABAD

Media habits of MSW

100 92
82
80 61.3
60
40
17.3 9.3
20
0
Media channels

Television Radio Newspaper

Magazines Cinema

VIJAYAWADA

Media habits of MSW

100
84
80

60
33.3 29.3
40

20 6.7 0
0
Media channels

Television Radio Newspaper

Magazines Cinema
 Other habits of MSW

KOLKATA

Other habits of MSW

80 68

60 44
40
40 25.3
18.7

20

0
Other habits

Smoking Alcoholism
Drugs Consuming tobacco
Other habits

AHMEDABAD

Other habits of MSW

80 68

60
44
40
40 25.3
18.7
20

0
Other habits

Smoking Alcoholism
Drugs Consuming tobacco
Other habits

VIJAYAWADA

Other habits of MSW

80 73.3

60
46.7
36
40

20 13.3
1.3
0
Other habits

Smoking Alcoholism
Drugs Consuming tobacco
Other habits
 Awareness of Male Sex Workers Genre

Awareness Male Sex Worker Subtypes (N=75)

Koti Panthi Dubli Hijra Gigolo Masseur Escort Londa Dancer
CITY
(%) (%) (%) (%) (%) (%) (%) (%) (%)
67 38 64 64 17 32 7 55 58
Kolkata
89.3 50.7 85.3 85.3 22.7 42.7 9.3 73.3 77.3
75 63 58 74 10 11 2 21 63
Ahmedabad
100.0 64.0 77.3 98.7 13.3 14.7 2.7 28.0 84.0
75 75 75 69 10 43 8
Vijayawada --- ---
100.0 100.0 100.0 92.0 13.3 57.3 10.7

Type of Male Sex Workers

MSW Type Male Sex Worker Subtypes (N=75)

Koti Panthi Dubli Hijra Gigolo Masseur Escort Londa Dancer
CITY
(%) (%) (%) (%) (%) (%) (%) (%) (%)
46 5 23 8 1 24 1 11 15
Kolkata
61.3 6.7 30.7 10.7 1.3 32.0 1.3 14.7 20.0
65 75 9 23 1 2 2
Ahmedabad --- ---
86.7 100.0 12.0 30.7 1.3 2.7 2.7
27 18 24 6
Vijayawada --- --- --- --- ---
36.0 24.0 32.0 8.0

Place of soliciting/ pickup/ aggregating by MSW

Pickup point Male Sex Worker soliciting/ pickup/ aggregating points (N=75)
Railway Stn.
parlour (%)

Public toilet

Chat room
Telephone
Bus stand
Massage

Internet
Brothel

House
Street

Hotel

Pimp
Park
(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)
CITY

50 23 39 45 48 9 25 32 25 27 6 1 4
Kolkata
66.7 30.7 52.0 60.0 64.0 12.0 33.3 42.7 33.3 36.0 8.0 1.3 5.3
65 4 61 45 55 35 35 26 6 1 38 1 1
Ahmedabad
86.7 5.3 81.3 60.0 73.3 46.7 46.7 34.7 8.0 1.3 50.7 1.3 1.3
64 6 62 41 67 13 28 27 58 10 4 7 9
Vijayawada
85.3 8.0 82.7 54.7 89.3 17.3 37.3 36.0 77.3 13.3 5.3 9.3 12.0

Sexual practices, behaviour and client profile of MSW by Age group

Sexual history Sexual practices, behaviour and client profile (N=75)

Sex for Clientele
Condom Condom
money/
use use High Low
CITY gifts
(6 months) (Last time) class class
(Last time)
(%) (%) (%) (%)
(%)
66 53 47 47 25
Kolkata
88.0 70.7 62.7 62.7 33.3
71 66 63 24 36
Ahmedabad
94.7 88.0 84.0 32.0 48.0
71 55 47 14 58
Vijayawada
94.7 73.3 62.7 18.7 77.3
 Type of sex by MSW by Age Group
Type of sex Type of Sex (N=75)
Oral Anal Vaginal Thigh Others
CITY
(%) (%) (%) (%) (%)
59 66 16 27 11
Kolkata
78.7 88.0 21.3 36.0 14.7
72 75 7 50 1
Ahmedabad
96.0 100.0 9.3 66.7 1.3
65 59 12 50 4
Vijayawada
86.7 78.7 16.0 66.7 5.3

Violence and criminal assault against MSW by Age group

Violence, Forced sex, violence and
etc. criminal assault (N=75)
Forced sex Criminal
CITY & violence assault
(percent) (percent)
34 35
Kolkata
45.3 46.7
36 33
Ahmedabad
48.0 44.0
43 15
Vijayawada
57.3 20.0

Awareness on HIV/AIDS of MSW by Age group

Awareness on
Awareness HIV/ AIDS
(N=75)
Age in Average
completed age of
CITY
years client
(Percent) (Percent)
62 62
Kolkata
82.7 82.7
75 75
Ahmedabad
100.0 100.0

Awareness on HIV/AIDS and sexual behaviour of MSW Kolkata

Awareness on HIV/AIDS and behaviour of MSW (N = 75)
Kolkata Ahmedabad Vijayawada
Sexual behaviour
(Percent) (Percent) (Percent)
53 71 59
Last time had sex for money/ gifts, etc. (MSW)
70.7 94.7 78.7
41 63 44
Last time used condoms while having sex
54.7 84.0 58.7

Awareness, Availability and Access to services by MSW by Age Group

Service access Awareness, Availability and Access to services (N=75)
Range of services
CITY Aware NGO Condom Clinic Drugs Jelly Access
(%) (%) (%) (%) (%) (%) (%)
49 48 6 7 3 2 15
Kolkata
65.3 64.0 8.0 9.3 4.0 2.7 20.3
75 19 56 38 54 55 75
Ahmedabad
100.0 25.3 74.7 50.7 72.0 73.3 100.0
24 18 1 24
Vijayawada --- --- ---
32.0 24.0 1.3 32.0
Sources of Awareness on HIV/AIDS of MSW Kolkata

Sources of aw areness on HIV/AIDS

88
90
80 69.3
66.7
70 58.7
60 53.3 54.7
45.3
50 42.7 42.7
40
30
20
10
0
Sources of aw areness
Telev ision Rad io Newspaper
Post er Pamphlet Doctor
NGO/ CBO Friends Other sources

Problems faced by MSW Kolkata

Problems face d by MSW

80 68
54.7 57.3 57.3
60 50.7 49.3 52
37.3 42.7
40 32 32

20

0
Problems faced

Jealousy Robbing clients Police harassment

Blackmailing Cheating/ free sex Switching loyalty
Hiding from family Fear of disclosure No co nsent to open
Expo sure Oth er problems
Sources of Awareness on HIV/AIDS of MSW Ahmedabad

Sources of awareness on HIV/AIDS

98.7
100 88

80 72
66.7
56 53.3
60 52
45.3

40

20
1.3
0
Sources of awareness
Television Radio Newspaper
Poster Pamphlet Doctor
NGO/ CBO Friends Other sources

Problems faced by MSW Ahmedabad

Problems faced by MSW

100 85.3
74
80 65.4
53.3 58.6
56
60 50.7 53.3
48
41.3
40
20
4
0
Problems faced

Jealousy Robbing clients Police harassment

Blackmailing Cheating/ free sex Switching loyalty
Hiding from family Fear of disclosure No consent to open
Exposure Other problems
Sources of Awareness on HIV/AIDS of MSW Vijayawada

Sources of awareness on HIV/AIDS

77.3
80 73.3
66.7
70
57.3 54.7
60 50.7
50
40 32
30
14.7
20
10 0
0
Sources of awareness
Television Radio Newspaper
Poster Pamphlet Doctor
NGO/ CBO Friends Other sources

Problems faced by MSW Vijayawada

Problems faced by MSW

100 88
70.7 68 72
80
60
60
40 29.3
20 21.3 24
20 16
1.3
0
Problems faced

Jealousy Robbing clients Police harassment

Blackmailing Cheating/ free sex Switching loyalty
Hiding from family Fear of disclosure No consent to open
Exposure Other problems
 Pilot Study on MSW in India

CITY REPORTS
4.0 MALE SEX WORKERS IN INDIA

KOLKATA CITY

The Victoria Memorial in Kolkata

Kolkata – The City of Joy, as it is known is one of the largest cities of India and the world.
Greater Kolkata has a population of over ten million. It is the capital of the Indian state of West
Bengal and the only metropolis of Eastern India. It is located on the east Banks of the Hoogly
River and lies 120 kilometres from the Bay of Bengal. With humid summers and pleasant
winters, it attracts a large number of people in eastern India. Light and heavy industries are the
main businesses. The various modes of transport range from the handcart to the tram and tube
rail. With industrial strikes (bandhs), processions (michlis) and leftists (bampanthis) and with
ever-growing population, pollution, traffic snarls, blackouts and water-logging, Kolkata offers a
perfect recipe of urban chaos. True to its cosmopolitan character, people of all communities
converge in the city with Bengali, Hindi, English being spoken as the main languages.

The analysis of the quantitative data begins with the socio-demographic profile of Male Sex
Workers in Kolkata in order to understand the physical and environmental conditions that affect
MSW and also lead to a better understanding of the respondents through a macro perspective. An
analysis of the socio-demographic profile of the MSW reveals that 47 percent are between 19 and
25 years of age, and 81 percent reported having their first sexual experience as well as involving
in sex first in exchange for money, gifts, etc., when they were below 18 years of age. Further, 33
percent opined that the average age of their clients is between 26 to 32 years. Education status
indicates that 31 percent have studied only up to middle school, and a majority comprising 71
percent are unmarried. Occupational status data shows that 63 percent are employed in full-time
jobs, with 64 percent earning below Rs.2500 a month from all sources with 55 percent earning up
to Rs.1500 from engaging in sex work. Statistics also reveal that 95 percent view television and
77 percent read the newspapers and that 68 percent are smokers and 44 percent have the habit of
consuming alcohol.

NIMSW 38
 Pilot Study on MSW in India

NIMSW 39
 Pilot Study on MSW in India

4.1 Socio-demographic characteristics

Figure – 1
Age of Male Sex Workers (MSW)

Age in completed years

14.7 2.7 6.7

29.3 46.7

< 18 Years 19-25 Years 26-32 Years

33-39 Years Above 40 Yrs.

According to the data presented in Figure-1 given above, the age of Male Sex Workers in Kolkata
City has been described.
It may be observed that a majority of the MSW, 47 percent are between 19 and 25 years of
age, followed by 29 percent who are older in the 26 to 32 years age group. While 15 percent of
the MSW interviewed in the study are between 33 and 39 years, 7 percent are below 18 years of
age. Hence, it may be concluded that a majority of the Male Sex Workers are below middle age
and therefore those below 30 years need to be targeted for any health or HIV/ AIDS related
initiatives.

Figure – 2
Age at first sex and Age at first Commercial Sex of Male Sex Workers (MSW)

Age at first sex & first commercial sex

81.3
100
80 54.6
40
60
40 18.7

20
0
< 18 19-25
Years Years

Age at 1st sex Age at 1st com. Sex

NIMSW 40
 Pilot Study on MSW in India

Figure-2 above portrays the age at first sex and age when MSW first had sex in exchange for
money, gifts, etc., of Male Sex Workers in Kolkata City. It is seen from Figure-2 that 81 percent
reported having their first sexual experience below 18 years of age while the remaining 19
percent said their first sex experience occurred when they were between 19 and 25 years old. A
similar trend can be observed with respect to the age at which the MSW had sex for the first time
in exchange for money, gifts, etc. While 55 percent reported such experience below 18 years of
age, 40 percent reported engaging in paid sex first when they were 19 to 25 years of age.

Figure – 3
Average Age of the clients of Male Sex Workers (MSW)

Average Age of clients of MSW

40 33.3
30.7
30 25.3

20
6.7
10 4

0
Avg. age of client

< 18 19-25 26-32 33-39 40 & >

Figure-3 analyses the average age of the clients of the Male Sex Workers that reveals a different
pattern. While majority of the MSW, 33 percent opined that the average age of the clients is
between 26 to 32 years, a marginally lesser number, 3I percent said their clients were 19 to 25
years old and a good percentage, 25 percent said their clients were older at 33 to 39 years of age.
This indicates that older clients prefer younger males as their partners and there is a large demand
for young boys.

The Howrah Bridge, also a hotspot for MSW activity

NIMSW 41
 Pilot Study on MSW in India

Figure – 4
Educational status of Male Sex Workers (MSW)

Education status of MSW

40
30.7
30 25.3
21.3
20
8
6.7 6.7
10
1.3
0
Education

Illiterate Primary Middle school

Hr. Sec. Technical Hr. Edu.
No Resp.

The educational status of the MSW is indicated in Figure-4 above. It is noticed that majority of
the MSW interviewed, 31 percent have completed only up to middle school followed by 25
percent who have had only primary education. A further 21 percent of the respondents were
educated up to higher secondary. This indicates poor education levels among male sex workers
that points out to the need to cater to information and education needs of respondents with respect
to health/ HIV/ AIDS efforts.

A typical market place in the heart of Kolkata

NIMSW 42
 Pilot Study on MSW in India

Figure – 5
Marital status of Male Sex Workers (MSW)

Marital Status of MSW

70.7
80

60

40
12 9.3
20 6.7 1.3
0
Marital status

Unmarried Married, living with spouse

Married, living without spouse Separated/ Divorced
No Response

Figure-5 describes the marital status of the MSW covered in the study. With a predominantly
large younger group, expectedly a large 71 percent are unmarried. Among ever-married
MSW, 12 percent are living with their spouse and close to 10 percent are living without their
spouse. Marriage is a crucial factor as it determines risk and vulnerability to HIV infection during
unprotected sex.
Figure – 6
Occupational status of Male Sex Workers (MSW)

Occupation Status of MSW

80 62.7
60
33.3
40

20 4

0
Occupation

Unemployed Full-time employed

Part-time employed

From Figure-6, the occupational status of the MSW may be ascertained. The data reveals that
majority of the respondents, 63 percent are employed in full-time jobs while 33 percent are
unemployed and only 4 percent engage in part-time jobs. The type of occupations that have been
observed include petty traders, rickshaw pullers, male commercial sex workers, vendors, drivers,

NIMSW 43
 Pilot Study on MSW in India

boatmen and the like. A few have taken up working with NGO/ CBO as peers and volunteers and
continue to engage in sex work. Many MSW are also reported to be working in blue collar and
white collared jobs in manufacturing companies, at the port and petty business.
Figure – 7
Average monthly income of Male Sex Workers (MSW) (All sources)

Average Monthly Income - all sources

2.7
33.3

64

< Rs.2500 Rs.2501 – Rs.5000 > Rs.5001

According to Figure-7, the gross Average Monthly Income of the MSW has been recorded. This
indicates that two-thirds, 64 percent earn below Rs.2500 a month from all sources while for
the remaining one-third, 33 percent the monthly income ranges between Rs.2501 and Rs.5000.
Only 3 percent reportedly earn more than Rs.5001 a month. It may therefore be concluded that
the economic condition of MSW is not very good and many are forced to work hard for a living.
Poor earnings also have an effect on expenditure on health care and prevention methods as
purchase of condoms, testing and treatment.
Figure – 8
Average monthly income of Male Sex Workers (MSW) (Sex work)

Average Monthly Income - sex work

8

37.3 54.7

<Rs.1500 Rs.1501-3000 >Rs.5001

The average monthly income of MSW from sex work is described in Figure-8. From the table, it
may be inferred that a large number, 55 percent earn up to Rs.1500 from engaging in sex work
followed by a sizeable percentage, 37 percent who earn between Rs.1501 and Rs.3000 from sex
work alone. This is done to augment their meagre income they earn from their full-time
employment. As observed in other studies and in qualitative phase of the study, many MSW are
forced to engage in sex work on commercial basis to support the family or need to earn more to
lead a better quality of life. It is also observed that in certain instances, clients offer money
willingly and when satisfied with sexual experience are reported to pay extra to MSW in
gratitude.

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 Pilot Study on MSW in India

4.2 Lifestyle, environmental influences

Figure - 9
Media habits of Male Sex Workers (MSW)

Media habits of MSW

94.7
100
70.7
80 65.3

60

40 22.7
21.3
20

0
M edia channels

Television Radio Newspaper

Magazines Cinema

The media habits of the MSW in this study may be gauged from the multiple response Figure-9
given above. It is observed that majority of the MSW, 95 percent view television and 77
percent read the newspapers. A large percentage, 65 percent also reportedly listen to the radio
and an equal percentage of 22 percent read magazines and watch movies. It may thus be
concluded that MSW are exposed to both electronic and print mass media and hence these may be
used for getting messages on prevention, education, treatment, care and support in relation to
HIV/ AIDS.
Figure – 10
Other habits of Male Sex Workers (MSW)

Other habits of MSW

68
70
60
50 44
40
40
25.3
30 18.7
20
10
0
Other habits
Smoking Alcoholism
Drugs Consuming tobacco
Other habits

NIMSW 45
 Pilot Study on MSW in India

Figure-10 presented above describes the other habits of MSW. It may be seen from the above
table that 68 percent are smokers and 44 percent have the habit of consuming alcohol. A
large number, 40 percent also reported chewing tobacco (local ‘paan’) and many are addicted to
locally available tobacco and ‘masalas’ with intoxicants. A significant number, 19 percent also
reported taking drugs. Such habits as alcoholism and drugs are known to induce to poor adoption
of protective measures leading to increased risk of HIV infection.

Comment

Profile of a typical MSW in Kolkata City

From a study of the overall socio-demographic profile of Male Sex Workers in Kolkata City, a
typical profile of an MSW may be constructed. Thus, a male Sex Worker in this city is young,
say around 20 years of age, who had his first sexual experience below the age of 18 years, and
also had sex in exchange of money, gifts, etc., below 18 years. This MSW caters to most clients
with an average age of 26-32 years. The typical MSW is educated up to middle school,
unmarried, employed in some full-time occupation and engages in sex work on a part-time basis.
The average gross monthly income from all sources is below Rs.2500/- and to augment income
earns an additional Rs.1500/- through sex work. The typical MSW is a keen TV viewer and also
reads newspaper regularly. Other habits include smoking, taking alcohol and usually chewing
tobacco in various forms. The MSW exhibits a casual attitude and is constantly on the move, in
keeping with the quick pace of the city and mostly runs into new clients through which he earns
more income from sex work.

One of thousands of handcart pullers, many of who are pimps or male sex workers themselves

NIMSW 46
 Pilot Study on MSW in India

4.3 Identity and sub-types

Awareness of MSW on types and subtypes of Male Sex Workers in Kolkata City

Table – 9
Awareness of Male Sex Workers Genre by MSW by Age Group

Awareness Male Sex Worker Subtypes (N=75)

Koti Panthi Dubli Hijra Gigolo Masseur Escort Londa Dancer
Age
(%) (%) (%) (%) (%) (%) (%) (%) (%)
67 38 64 64 17 32 7 55 58
TOTAL
89.3 50.7 85.3 85.3 22.7 42.7 9.3 73.3 77.3
4 1 2 4 3 4
< 18 --- --- ---
5.3 1.3 2.7 5.3 4.0 5.3
32 21 33 31 11 15 3 28 27
19-25
42.7 28.0 44.0 41.3 14.7 20.0 4.0 37.3 36.0
20 9 18 18 5 14 3 15 17
26-32
26.7 12.0 24.0 24.0 6.7 18.7 4.0 20.0 22.7
9 7 10 10 1 3 1 8 9
33-39
12.0 9.3 13.3 13.3 1.3 4.0 1.3 10.7 12.0
2 1 1 1 1
40 & > --- --- --- ---
2.7 1.3 1.3 1.3 1.3

The data in table - 9 presented above describes the Male Sex Workers awareness of the various
types and sub-types of MSW that are reportedly existing in society in various proportions with
respect to their age. It is seen that majority of the MSW know about groups such as ‘Koti’ (which
in common parlance means a person (biologically male) who is a recipient during a sexual act
also termed passive partner). Similarly ‘Panthi’ denotes a person who plays a dominant or active
role (read penetrative) during sexual act. ‘Dubli’ is a colloquial term (in Kolkata) used to describe
a person who performs both an active and passive role. It is observed that they are also popularly
called ‘Double Decker’ or ‘DD’. ‘Hijra’ are transgender or transsexual population and ‘Londa’ a
group popular in eastern parts of the country – mainly West Bengal and Bihar are mainly
transsexuals or males who attire in female clothing and dance during specific cultural festivities.
After the fair or festival, they engage in sex with other men or women and earn a living through
sex work.

‘Dancer’ is a term describing a typical dancer (usually entertaining people in public). After or
during the dance programme, he is approached by clients and negotiates an agreement for paid
sex. Masseur is a male ‘body massager’ who works in a massage parlour. Many massage
parlours are reportedly known to also provide sexual services for an additional sum and masseurs
engage in sex with clients who visit massage parlours. Some masseurs also service clients for
massage in the clients houses. A ‘Gigolo’ is a commercial male sex worker who caters to mainly
to women alone. An ‘Escort’ is a male sex partner who is usually kept by the client in his house/
workplace and is used for sexual activity when desired by the client. Escorts are known to
accompany clients on outstation trips and frequent travel.

Comment

The overall analysis of MSW on awareness pertaining to MSW genre indicates that a majority
of the MSW in Kolkata City is aware of predominantly main groups in the MSW network
in the city. While more than 85 percent respondents knew about Koti, 89 percent Dubli, 85

NIMSW 47
 Pilot Study on MSW in India

percent and Hijra, a similar 85 percent, a lesser percentage knew of Dancer, 77 percent followed
by Londa, 73 percent. However, only half the respondents, 51 percent mentioned knowledge
about Panthi and still lesser number, 43 percent about Masseur. Comparatively, while only 23
percent knew about Gigolo, only around 10 percent heard reportedly heard of Escort as a subtype
of MSW in Kolkata City.

An analysis of the age-wise classification of data reveals that majority of the MSW in the 19 to
25 age group are aware of the various types and sub-types of MSW existing in society.
Within this group, a majority, around 43 percent are aware of Koti, Dubli and Hijra. The other
sub-types known by MSW, around 30 to 35 percent of this age group are Londa, Dancer and
Panthi. However, Masseur, Gigolo and Escort are not very popular among these respondents,
only around 15 percent.

Next, most MSW in the 26 to 32 age group are aware of various types and sub-types of MSW.
The trends in knowledge about various sub-types is similar to the younger age group seen with
around 25 percent aware of Koti, Dubli and Hijra. However, fewer MSW knew about ‘Panthi’, 12
percent that indicates that more older MSW may not be playing the dominant or active role
during sexual act. Around 20 percent of MSW in this age group also were aware of Londa
Dancer and Masseur.

It is also observed from the table that an equal number of respondents, around 10 to 12 percent in
the older 33 to 39 age group knew about Koti, Dubli, Hijra, Panthi, Londa Dancer and Masseur.
However, many MSW in the young age group of less than 18 years do not seem to know about
the various types and sub-types within MSW. Similarly, among respondents aged above 40
years, only 1 or 2 knew about various sub-types.
It is observed that no clear definitions demarcate the various types and sub-types and there is
overlapping of context and meaning that leads to confusion among MSW in defining their genre.
This is compounded by the public having their own perspective of MSW.

Table – 10
Awareness of Male Sex Workers Genre by MSW by Education

Awareness Male Sex Worker Subtypes (N=75)

Koti Panthi Dubli Hijra Gigolo Masseur Escort Londa Dancer
Education
(%) (%) (%) (%) (%) (%) (%) (%) (%)
67 38 64 64 17 32 7 55 58
TOTAL
89.3 50.7 85.3 85.3 22.7 42.7 9.3 73.3 77.3
5 4 4 4 1 2 4 4
Illiterate ---
6.7 5.3 5.3 5.3 1.3 2.7 5.3 5.3
18 13 14 17 4 2 14 17
Primary ---
24.0 17.3 18.7 22.7 5.3 2.7 18.7 22.7
20 8 20 19 3 10 2 16 15
Middle
26.7 10.7 26.7 25.3 4.0 13.3 2.7 21.3 20.0
14 9 15 13 5 10 2 13 13
Hr. Sec.
18.7 12.0 20.0 17.3 6.7 13.3 2.7 17.3 17.3
5 2 6 5 2 4 1 4 5
Technical
6.7 2.7 8.0 6.7 2.7 5.3 1.3 5.3 6.7
4 2 4 5 2 3 2 3 3
Hr. Education
5.3 2.7 5.3 6.7 2.7 4.0 2.7 4.0 4.0
1 1 1 1 1 1
Others --- --- ---
1.3 1.3 1.3 1.3 1.3 1.3

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 Pilot Study on MSW in India

Table - 10 depicts the Male Sex Worker’s understanding of the various types and sub-types
prevalent with respect to their education. It may be deduced from the above data that majority of
the respondents aware of various types and sub-types within MSW are educated up to
middle school, around 25 percent followed by those educated up to higher secondary level, say
18 percent. This is followed by MSW who are educated only up to the primary level. More MSW
may be aware of types as a majority of the respondents are educated only up to this level.
Another explanation could be many educated up to primary level are in sex industry for longer
period and such experience has increased their awareness. It is also seen that MSW with
technical, higher education and those who are illiterate are not very conversant with various types
and subtypes. Responses from the field indicate that higher educated MSW are engaged in such
activity only occasionally or do so to fulfil immediate economic needs, and hence do not
understand nor are they keen on knowing various types and sub-types. On the other hand,
illiterate MSW neither know nor understand the dynamics of the MSW genre in society.

Table – 11
Awareness of Male Sex Workers Genre by MSW by Marital status

Awareness Male Sex Worker Subtypes (N=75)

Koti Panthi Dubli Hijra Gigolo Masseur Escort Londa Dancer
Marital status
(%) (%) (%) (%) (%) (%) (%) (%) (%)
67 38 64 64 17 32 7 55 58
TOTAL
89.3 50.7 85.3 85.3 22.7 42.7 9.3 73.3 77.3
47 31 44 44 14 19 7 38 41
Unmarried
62.6 41.9 58.6 58.6 18.7 25.3 9.3 50.7 54.7
9 2 8 9 1 6 7 6
Married living with spouse ---
12.0 2.7 10.7 12.0 1.3 8.0 9.3 8.0
6 1 6 6 6 5 6
Married living without spouse --- ---
8.0 1.3 8.0 8.0 8.0 6.7 8.0
4 4 5 4 2 4 4
Separated/ Divorced --- ---
5.3 5.3 6.7 5.3 2.7 5.3 5.3
1 1 1 1 1 1
No Response --- --- ---
1.3 1.3 1.3 1.3 1.3 1.3

Table - 11 provides an analysis of awareness of MSW genre in relation to their marital status. The
statistics reveals that most unmarried respondents are aware of various types and sub-types
among MSW, as majority of respondents are unmarried. Among them, a majority are aware of
Koti, Dubli and Hijra, around 60 percent followed by awareness about Londa and Dancers, 52
percent. While 40 percent unmarried MSW knew of Panthi, 25 percent knew Masseurs and close
to 20 percent heard of Gigolo. Among older, married respondents, roughly 20 percent knew about
all the main types and sub-types of MSW. This indicates that engagement in sexual male sex
work is important in knowing about types and defining sub-types within MSW.

NIMSW 49
 Pilot Study on MSW in India

Table – 12
Awareness of Male Sex Workers Genre by MSW by Occupation

Awareness Male Sex Worker Subtypes (N=75)

Koti Panthi Dubli Hijra Gigolo Masseur Escort Londa Dancer
Occupation
(%) (%) (%) (%) (%) (%) (%) (%) (%)
67 38 64 64 17 32 7 55 58
TOTAL
89.3 50.7 85.3 85.3 22.7 42.7 9.3 73.3 77.3
24 13 25 25 6 13 2 23 21
Unemployed
32.0 17.3 33.3 33.3 8.0 17.3 2.7 30.7 28.0
42 24 38 37 11 9 5 32 36
Full-time
56.0 32.0 50.7 49.3 14.7 12.0 6.7 42.7 48.0
1 1 1 2
Part-time --- --- --- ---
1.3 1.3 1.3 2.7

According to the data presented in Table -12, awareness of MSW on various types and subtypes
of MSW genre based on their occupation is analysed. It may be observed that most MSW
employed in full-time employment are aware of the various groups followed by a large
percentage of unemployed MSW who engage in sex for exchange of money, gifts, etc. A closer
examination of the data reveals that among full-time employed MSW, 56 percent are aware of
Koti, followed by 51 percent aware of Dubli, 49 percent knowing Hijra, 48 percent Dancer and
43 percent Londa. Only 32 percent reportedly knew of Panthi and very few MSW heard of
Gigolo, Masseur and Escort. A similar pattern is observed among MSW who are unemployed
though the percentage comprise only about a third of the total respondents, around 30 percent.
Table – 13
Awareness of Male Sex Workers Genre by MSW by Income

Awareness Male Sex Worker Subtypes (N=75)

Koti Panthi Dubli Hijra Gigolo Masseur Escort Londa Dancer
Average Income PM
(%) (%) (%) (%) (%) (%) (%) (%) (%)
67 38 64 64 17 32 7 55 58
TOTAL
89.3 50.7 85.3 85.3 22.7 42.7 9.3 73.3 77.3
Income (all sources)
43 25 39 41 9 16 3 33 35
< Rs.2500
57.3 33.3 52.0 54.7 12.0 21.3 4.0 44.0 66.7
22 12 23 21 8 14 4 20 21
Rs.2501 – Rs.5000
29.3 16.0 30.7 28.0 10.7 18.7 5.3 18.7 28.0
2 1 2 2 2 2 2
> Rs.5001 --- ---
2.7 1.3 2.7 2.7 2.7 2.7 2.7
Income (sex work)
34 18 30 32 5 15 25 30
< Rs.1500 ---
45.3 24.0 40.0 42.7 6.7 20.0 33.3 40.0
27 19 28 26 11 12 7 24 22
Rs.1501 – Rs.3000
36.0 25.3 37.3 34.7 14.7 16.0 9.3 32.0 29.3
6 1 6 6 1 5 6 6
> Rs.3001 ---
8.0 1.3 8.0 8.0 1.3 6.7 8.0 8.0

Table - 13 presents the awareness of respondents on various types and subtypes of MSW in
Kolkata City with regard to their monthly income. An overview of the data reveals that a
majority of MSW aware of their genre and subtypes earn a lower average monthly income

NIMSW 50
 Pilot Study on MSW in India

(from all sources) of up to Rs.2500 a month. While a higher number, 67 percent identified
Dancers first, other known MSW groups included Koti, Hijra and Dubli followed by Londa and
Panti. A comparatively higher awareness on part of poorer paid MSW may be an indication of the
fact that those with lower incomes engage in commercial sexual activity more often and hence are
better aware of such subtypes. A similar trend is observed across those who earned lesser from
sex work of up to Rs.1500 a month.

Type of Male Sex Workers as identified by MSW

The following analysis describes the manner in which Male Sex Workers define or identify
themselves. It also emphasises on their sexual orientation and gender.

From the data, it may be inferred that majority of the MSW in Kolkata, 61 percent identify
themselves as Koti, while 32 percent opine that they are typically masseurs working either in
massage parlours or independently followed by a similar number, 31 percent who consider
themselves as Dubli or those who engage in sex with other males or females as active or passive
sexual partners. While 20 percent stated they are Dancers, 15 percent identified themselves as
Londa and 11 percent as Hijras. Only 5 MSW said they are Panthis and one each identified
themselves as Gigolo and Escort. This indicates that in Kolkata, Koti are very common and so
are Dubli. Further, it can be seen that Masseurs are also common in Kolkata and many are male
sex workers. Dancers and Londa are also common though they may also pose as Koti, Dubli or
Panthi.

Table – 14
Type of Male Sex Workers by MSW by Age Group

MSW Type Male Sex Worker Subtypes (N=75)

Koti Panthi Dubli Hijra Gigolo Masseur Escort Londa Dancer
Age
(%) (%) (%) (%) (%) (%) (%) (%) (%)
46 5 23 8 1 24 1 11 15
TOTAL
61.3 6.7 30.7 10.7 1.3 32.0 1.3 14.7 20.0
3 1 1
< 18 --- --- --- --- --- ---
4.0 1.3 1.3
24 1 12 2 1 13 4 5
19-25 ---
32.0 1.3 16.0 2.7 1.3 17.3 5.3 6.7
12 4 9 3 11 1 3 7
26-32 ---
16.0 5.3 12.0 4.0 14.7 1.3 4.0 9.3
6 2 3 3 2
33-39 --- --- --- ---
8.0 2.7 4.0 4.0 2.7
1
40 & > --- --- --- --- --- --- --- ---
1.3

From Table-14 given above, MSW identity and orientation with regard to age-wise categorisation
may be ascertained. It is observed that majority of MSW who indicate they are Koti, 32
percent Masseur, 17 percent and Dubli, 16 percent are in the 19 to 25 age group. This is
followed by many MSW, 16 percent Koti, Masseur, 15 percent and Dubli, 12 percent who are
older, aged between 26 and 32 years of age. Hence it may be concluded that younger MSW and
very old MSW are either not aware of their identity or switch roles often or do not conform to
such categorisation but prefer to engage in sex activity in exchange of money, gifts, etc. on a
casual basis.

NIMSW 51
 Pilot Study on MSW in India

Table – 15
Type of Male Sex Workers by MSW by Occupation

MSW Type Male Sex Worker Subtypes (N=75)

Koti Panthi Dubli Hijra Gigolo Masseur Escort Londa Dancer
Occupation
(%) (%) (%) (%) (%) (%) (%) (%) (%)
46 5 23 8 1 24 1 11 15
TOTAL
61.3 6.7 30.7 10.7 1.3 32.0 1.3 14.7 20.0
18 3 10 4 9 5 2
Unemployed --- ---
24.0 4.0 13.3 5.3 12.0 6.7 2.7
27 2 11 4 1 14 1 5 11
Full-time
36.0 2.7 14.7 5.3 1.3 18.7 1.3 6.7 14.7
1 2 1 1 2
Part-time --- --- --- ---
1.3 2.7 1.3 1.3 2.7

The occupational classification of MSW with respect to their identity is examined in Table-15. It
may be observed that majority of the MSW who are employed in full-time jobs are also Koti,
36 percent, Masseur, 19 percent and an equal number as Dubli and Dancers, 15 percent. It is
also however interesting to note that a significant number of unemployed male sex workers also
identify them as typical Koti, 24 percent Dubli, 13 percent and Masseur, 12 percent who usually
don the role of Panthi.

Comment

It may thus be concluded that majority of the Male Sex Workers understand the dynamics of
MSW industry and terminology as well as classification. They are able to identify individually
based on their role in sexual activities as Koti, Panthi, Hijra or Masseur and as observed in
discussions with respondents, their perception of their identity and placing into a particular
subtype also depends on how others (people in society in general) view them, through their
actions, gesticulations and behaviour.

Understanding Sex Industry Network (SIN) –

Place of soliciting/ pickup/ aggregating by Male Sex Workers.

The following analysis provides an understanding into the Sex Industry Network by pinpointing
the locations or places where Male Sex Workers solicit their clientele, pickup them for sexual
activities or indicates where such MSW aggregate to attract clients and engage in sex for
exchange of money, gifts, etc. It is important to identify such ‘hotspots’ as that would provide
vital clues in approaching this otherwise hidden community for long-term healthcare
interventions around HIV/ AIDS.

NIMSW 52
 Pilot Study on MSW in India

Table – 16
Place of soliciting/ pickup/ aggregating by MSW by Age Group

Pickup point Male Sex Worker soliciting/ pickup/ aggregating points (N=75)

Railway Stn.
parlour (%)

Chat room
Telephone
Bus stand
Massage

Internet
Brothel

House
Street

Advt.
Hotel

Pimp
Park
(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)
Age

50 23 39 45 48 9 25 32 25 27 6 1 4
TOTAL
66.7 30.7 52.0 60.0 64.0 12.0 33.3 42.7 33.3 36.0 8.0 1.3 5.3
5 --- 3 4 3 --- ---
< 18 --- --- --- --- --- ---
6.7 4.0 5.3 4.0
21 12 18 23 27 4 10 17 15 17 1 2
19-25 ---
28.0 16.0 24.0 30.7 36.0 5.3 13.3 22.7 20.0 22.7 1.3 2.7
12 11 9 14 12 4 13 10 10 10 5 1 2
26-32
16.0 14.7 12.0 18.7 16.0 5.3 17.3 13.3 13.3 13.3 6.7 1.3 2.7
10 --- 7 7 4 1 2 1 --- ---
33-39 --- --- ---
13.3 9.3 9.3 5.3 1.3 2.7 1.3
2 --- 2 1 1 1 --- ---
40 & > --- --- --- --- ---
2.7 2.7 1.3 1.3 1.3

Table - 16 describes the age-wise classification of places where MSW solicit and pickup their
clients or places where they aggregate to attract clients for sex work. From the data, it can be seen
that most MSW soliciting, picking and aggregating in public places are younger in the 19 to
25 years age group compared to a lesser number who are 26 to 32 years old. A further detailed
analysis reveals that among MSW who operate on the streets, 28 percent are younger in the 19-25
age group followed by 16 percent in the 26-32 years age group and 13 percent in the 33-39 age
range. Similarly, among those who solicit/ pickup clients in the park, many MSW, 36 percent are
in the young age group of 19-25 years compared to 16 percent aged between 26 and 32 years of
age. In railway stations, bus stands and massage parlours too, a similar pattern emerges.

Table – 17
Place of soliciting/ pickup/ aggregating by MSW by Occupation

Pickup point Male Sex Worker soliciting/ pickup/ aggregating points (N=75)
Railway Stn.
parlour (%)

Chat room
Telephone
Bus stand
Massage

Internet
Brothel

House
Street

Advt.
Hotel

Pimp
Park
(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)

Occupation

50 23 39 45 48 9 25 32 25 27 6 1 4
TOTAL
66.7 30.7 52.0 60.0 64.0 12.0 33.3 42.7 33.3 36.0 8.0 1.3 5.3
18 10 14 19 16 6 13 14 11 9 3 1
Unemployed ---
24.0 13.3 18.7 25.3 21.3 8.0 17.3 18.7 14.7 12.0 4.0 1.3
30 12 24 26 32 3 12 18 14 18 3 4
Full-time ---
40.0 16.0 32.0 34.7 42.7 4.0 16.0 24.0 18.7 24.0 4.0 5.3
2 1 1 --- ---
Part-time --- --- --- --- --- --- --- ---
2.7 1.3 1.3

NIMSW 53
 Pilot Study on MSW in India

According to the data in Table - 17 the occupation-wise classification of place of soliciting/

picking up clients by MSW is analysed. It is observed that in the street, railway station, park,
bus stand, house, telephone and pimp, the number of MSW engaged in full-time jobs is
higher than unemployed. However, in the case of soliciting, picking up or aggregating for sex
work, hotels are preferred by unemployed MSW than full-time employed ones. It is important to
note that many MSW employed in industries, hotels, petty trade, vendors, drivers and massage
parlours use the premises to pick clients and even have sex with peers and others.

Table – 18
Place of soliciting/ pickup/ aggregating by MSW by Income

Pickup point Male Sex Worker soliciting/ pickup/ aggregating points (N=75)

Railway Stn.
parlour (%)

Chat room
Telephone
Bus stand
Massage

Internet
Brothel

House
Street

Advt.
Income

Hotel

Pimp
Park
(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)
(all sources)

50 23 39 45 48 9 25 32 25 27 6 1 4
TOTAL
66.7 30.7 52.0 60.0 64.0 12.0 33.3 42.7 33.3 36.0 8.0 1.3 5.3
36 11 29 26 30 2 13 19 9 12 3 3
< Rs.2500 ---
48.0 14.7 38.7 34.7 40.0 2.7 17.3 25.3 12.0 16.0 4.0 4.0
13 11 10 18 17 7 11 13 15 13 2 1 1
Rs.2501 – Rs.5000
17.3 14.7 13.3 24.0 22.7 9.3 14.7 17.3 20.0 17.3 2.7 1.3 1.3
1 1 --- 1 1 1 1 2 1
> Rs.5001 --- --- --- ---
1.3 1.3 1.3 1.3 1.3 1.3 2.7 1.3

The income-wise classification of pickup points for sex work is presented in Table 18. From the
above table, it is evident that while MSW earning up to Rs.2500/- per month solicit clients in
streets, 48 percent park, 40 percent bus stand, 39 percent and railway station, 35 percent, MSW
earning between Rs.2501/- and Rs.5000/- a month solicit customers more through telephone,
20 percent pimp, 17 percent, massage parlours, 15 percent and close to 10 percent through
brothels.

Comment

This indicates that the sex industry has two modus operandi – indoors network and outdoors
network. The indoors network is popular among more affluent MSW who earn more through
full-time employment as well as through sex work, are younger in age (in the 19-25 age bracket),
and operate through network of pimps, contacts over phone, e-mail and chatting, as well as
brothels and houses. On the other hand, economically poorer MSW stalk parks, railway stations,
bus stands, theatres, parks, public toilets and other public places looking for clients.

NIMSW 54
 Pilot Study on MSW in India

5.0 SEXUALITY, SEXUAL PRACTICES AND VULNERABILITY

5.1 Sexual encounters, partners, commercial sex

Sexual practices, behaviour and client profile of MSW

The tables presented below describe the sexual practices in terms of encounters with clients,
sexual behaviour including condom use and seek to capture client profile as seen by Male Sex
Workers. A bird’s eye view of the sexual practices among MSW reveals that MSW had paid sex
consistently over the last 6 months. More specifically, a large number, 88 percent reported
engaging in sex in exchange for money, gifts, etc., during the last time they had sex. This
relates to increased sex activity on commercial basis. Data also points out that a large number in
Kolkata City, 71 percent reportedly used condoms consistently over the last 6 months when
they had paid sex. Further, 63 percent reported using a condom during the last time they
had sex in exchange for money, gifts, etc. Finally, a question posed on who their sexual partner
was on their last paid sexual encounter revealed a rough profile of the clients of MSW. While it
is assumed that 63 percent clients are of high class – defined thus as being either equal to or
economically better than MSW themselves. To this group belong mostly peers, students,
teachers, office goers, blue collared workers, petty businessmen and the like. On the other hand,
33 percent reported that their clients are low class – meaning those hailing from lower socio-
economic strata – mainly rickshaw pullers, boatmen, unorganised workers, construction labour,
unemployed youth, slum populations and so on.

This reinforces the fact that not all men who have sex with men (MSM) do so only for physical or
psychological stimulation. Observations from the field validate the fact that many MSW started
as MSM but in due course, on pressing economic grounds they engage in sex on commercial
basis for sheer survival. Hence is visible both survival sex and recreational sex in most cities
though it is very difficult to differentiate the two. MSW have also reiterated that there is a huge
potential for male sex partners among both men and women and demand for young boys cannot
be underestimated. The mixed clientele of MSW makes it an ardent task in identifying specific
client groups. Overall, however, it is seen that two distinct levels operate. One male sex work
circuit caters to the economically richer segment in society and operate in houses, brothels, hotels
and massage parlours while the other sex circuit is carried on at the street level and public places,
demanding the sexual needs of people in the lower socio-economic milieu such as those in slums
and poor housing colonies operating in parks, railway stations, bus stands, public toilets, and
roadside shanties.

Table – 19
Sexual practices, behaviour and client profile of MSW by Age group

Sexual history Sexual practices, behaviour and client profile (N=75)

Sex for Clientele
Condom Condom
money/
use use High Low
Age group gifts (6 months) (Last time) class class
(Last time)
(%) (%) (%) (%)
(%)
66 53 47 47 25
TOTAL
88.0 70.7 62.7 62.7 33.3
5 2 2 3 1
< 18
6.7 2.7 2.7 4.0 1.3

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 Pilot Study on MSW in India

29 25 24 23 11
19-25
38.7 33.3 32.0 30.7 14.7
19 17 15 16 6
26-32
25.3 22.7 20.0 21.3 8.0
11 7 6 4 6
33-39
14.7 9.3 8.0 5.3 8.0
2 2 1 1
40 & > ---
2.7 2.7 1.3 1.3

An analysis of the data in Table - 19 provides insight into the sexual practices and behaviour of
MSW with respect to their age. It is evident from the data that majority of the MSW, 39 percent
who had sex in exchange for money during the last sexual encounter were 19-25 years of age
followed by 25 percent who were older between 26 and 32 years old. A sizeable number of 15
percent were also in the age range of 33 to 39 years of age. This indicates that though MSW are
generally younger, many middle-aged MSW too are engaged in paid sex activities. Condom use
consistently in the last 6 months has been reported by majority of MSW, 33 percent in the same
19-25 age group followed by 23 percent in the older 26-32 age group. The trend is similar
pertaining to condom use during last sexual encounter where 32 percent in 19-25 age range
reported condom use and 20 percent between 26 and 32 years said they used condoms during
their last sexual encounter. It is interesting to note that more clients of MSW, 31 percent are
reported to belong to high class and are younger in the 19-25 age group.

Table – 20
Sexual practices, behaviour and client profile of MSW by Education

Sexual history Sexual practices, behaviour and client profile (N=75)

Sex for Clientele
Condom Condom
money/
use use High Low
Education gifts (6 months) (Last time) class class
(Last time)
(%) (%) (%) (%)
(%)
66 53 47 47 25
TOTAL
88.0 70.7 62.7 62.7 33.3
5 3 3 3 1
Illiterate
6.7 4.0 4.0 4.0 1.3
18 14 10 10 9
Primary
24.0 18.7 13.3 13.3 12.0
20 16 14 17 5
Middle
18.7 21.3 18.7 22.7 6.7
11 12 12 7 8
Hr. Sec.
14.7 16.0 16.0 9.3 10.7
6 5 5 5 1
Technical
8.0 6.7 6.7 6.7 1.3
5 2 2 4 1
Hr. Education
6.7 2.7 2.7 5.3 1.3
1 1 1 1
Others ---
1.3 1.3 1.3 1.3

Table 20 describes the sexual practices, behaviour and client profile of MSW by education status.
It is important to note from the above table that though involvement in sex for exchange of
money, gifts, etc., is high by educated MSW, that may be a result of rising unemployment and
resulting ‘survival sex’, higher education also indicates consistent condom use, 21 percent by

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 Pilot Study on MSW in India

those educated up to middle school (majority of respondents in the study) and a high 16 percent
by those who studied up to higher secondary. Similarly, larger number of educated MSW, 19
percent educated up to middle school and 16 percent up to higher secondary reported condom use
during last sexual encounter compared to only 13 percent who studied up to primary level and 4
percent illiterate MSW. The educational profile of clients indicates that they are similar to that of
the MSW and sex workers prefer clients of equal educational and economic status or better that
ensures more earning through sex work. Though safe sex practices adoption among those
engaging in recreational sex has not been directly recorded, indications are that even among such
male sex workers, condom use is high and depends on education status of sex worker as well as
client.

This therefore indicates that education is an important factor in determining safe sex practices
among male sex workers. Uneducated MSW are neither aware of safe sexual practices nor have
the appropriate perception of risk. This also points to the fact that educated MSW are in a better
position to read and understand HIV/ AIDS related prevention messages and one-to-one rapport
with educated clients and NGO/ community workers that reflects on better adoption of safe sex
practices.

Table – 21
Sexual practices, behaviour and client profile of MSW by Marital status

Sexual history Sexual practices, behaviour and client profile (N=75)

Sex for Clientele
Condom Condom
money/
use use High Low
Marital status gifts (6 months) (Last time) class class
(Last time)
(%) (%) (%) (%)
(%)
66 53 47 47 25
TOTAL
88.0 70.7 62.7 62.7 33.3
49 38 37 34 17
Unmarried
65.3 50.7 48.3 45.3 22.7
6 8 5 7 2
Married living with spouse
8.0 10.7 6.7 9.3 2.7
6 3 1 4 3
Married living without spouse
8.0 4.0 1.3 5.3 4.0
5 4 4 2 3
Separated/ Divorced
6.7 5.3 5.3 2.7 4.0

According to the data presented in Table – 21, the sexual behaviour and practices of MSW are
highlighted based on their marital status. The data reveals that 65 percent of MSW who
engaged in sex in exchange for money, gifts, etc. are unmarried while the remaining 23
percent were ever-married. Condom use data indicates that 51 percent of unmarried respondents
reportedly used condoms consistently during the last 6 months and a similar number, 48 percent
reported condom use during their last sexual encounter. Data on client profile reveals that among
so-called high class clients, majority are unmarried, 45 percent though a good number, 18 percent
are also ever-married. However, among low class clients, a majority, 23 percent are unmarried
indicating that MSW get clients who are unmarried. Marital status does not appear to be an
important variable in accepting or adopting safe sex practices though it is viewed as important in
the case of bisexual MSW.

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Table – 22
Sexual practices, behaviour and client profile of MSW by Occupation

Sexual history Sexual practices, behaviour and client profile (N=75)

Sex for Clientele
Condom Condom
money/
use use High Low
Occupation gifts (6 months) (Last time) class class
(Last time)
(%) (%) (%) (%)
(%)
66 53 47 47 25
TOTAL
88.0 70.7 62.7 62.7 33.3
24 22 22 15 9
Unemployed
32.0 29.3 29.3 20.0 12.0
39 30 25 30 15
Full-time
52.0 40.0 33.3 40.0 20.0
3 1 2 1
Part-time ---
4.0 1.3 2.7 1.3

The occupation-wise classification of sexual practices of clients may be observed in Table - 22

given above. It may be observed that as majority MSW are employed in full-time jobs, larger
number among such MSW, 52 percent said they had sex in exchange for money, gifts, etc.,
followed by 32 percent who are unemployed who said they had such paid sex. Condom use, both
consistent use over 6 months and use during last time are reportedly high by full-time employed
MSW, 40 percent and 33 percent respectively compared to unemployed MSW, an equal 30
percent reporting condom use (consistent use as well as use during last time). Among clients of
MSW, larger numbers of both high and low class clients are employed in full-time jobs.

Table – 23
Sexual practices, behaviour and client profile of MSW by Income

Sexual history Sexual practices, behaviour and client profile (N=75)

Sex for Clientele
Condom Condom
money/
use use High Low
Average Income PM gifts (6 months) (Last time) class class
(Last time)
(%) (%) (%) (%)
(%)
66 53 47 47 25
TOTAL
88.0 70.7 62.7 62.7 33.3
Income (all sources)
41 34 28 34 12
< Rs.2500
54.7 45.3 37.3 45.3 16.0
23 18 18 12 12
Rs.2501 – Rs.5000
30.7 24.0 24.0 16.0 16.0
2 1 1 1 1
> Rs.5001
2.7 1.3 1.3 1.3 1.3
Income (sex work)
33 27 22 24 15
< Rs.1500
44.0 36.0 29.3 32.0 20.0
28 21 20 19 8
Rs.1501 – Rs.3000
37.3 28.0 26.7 25.3 10.7
5 5 5 4 2
> Rs.3001
6.7 6.7 6.7 5.3 2.7

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 Pilot Study on MSW in India

According to the data presented in Table – 23, the sexual practices, behaviour and client profile of
MSW by income is analysed. The data reveals that majority of MSW, 54.7 percent who had
sex in exchange for money during last time earn below Rs.2500/- a month and 30 percent of
those reporting similar behaviour earn between Rs.2501 and Rs.5000/- per month. It is also
important to note that larger number of MSW, 44 percent who engaged in paid sex during last
sexual encounter earn up to Rs.1500/- from sex work. A high 37 percent who earned between
Rs.2501 and Rs.5000/- per month had sex in exchange for money, gifts etc. A similar pattern is
observed with regard to condom use. Income levels of clients match those of MSW and therefore
they may be said to be of the same economic class.
It is noteworthy that those MSW who earn higher incomes adopt safer sex practices as they can
afford them. With respect to condoms, discussions revealed that MSW are not satisfied with
cheap or freely distributed condoms that tear or break on use. MSW prefer to use well lubricated
condoms especially during anal sex. Condom use during oral sex is not popular as risk perception
of spread of infection through the mouth is reportedly unheard of among MSW though a few
insist that their clients use condoms during oral sex too. MSW know about and prefer flavoured
condoms for oral sex but are concerned about the cost of use. (A pack of 3’s of good lubricated/
flavoured condoms costs at least Rs.15/- that cannot be afforded by all MSW). Many reportedly
carry condoms at all times (powdered/ jelly filled) and are known to negotiate condom use with
clients. However, it has been noticed that intimacy of relationships (especially recreational sex)
may lead to increased instances of unprotected sex.

Downtown Kolkata, where one can bump into a male sex worker

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5.2 Type of sex, condom use and risk

Sexual practices

The tables given below provide an analysis of the type of sex popular among MSW in Kolkata
City. An overview of the type of sex indicates that a large number of MSW, 88 percent engage
in anal sex followed by 79 percent in oral sex and 36 percent ‘thigh’ sex where clients use the
thighs of MSW to have sex. Further, 21 percent reported having vaginal sex (presumably
bisexuals) and 15 percent engage in other sex acts (‘rolling sex’ where two sexual partners roll on
the cot or ground while having sex, ‘body sex’, also involving licking the whole body of the
sexual partner and ‘group sex’ where more than three to four sex partners fondle and have sex
together). Other sexual practices include ‘Rimming’ or licking the anal portions of sex partners
that is reportedly popular among MSW.

Table – 24
Type of sex by MSW by Age Group

Type of sex Type of Sex (N=75)

Oral Anal Vaginal Thigh Others
Age
(%) (%) (%) (%) (%)
59 66 16 27 11
TOTAL
78.7 88.0 21.3 36.0 14.7
4 5
< 18 --- --- ---
5.3 6.7
30 18 5 13 7
19-25
40.0 24.0 6.7 17.3 9.3
17 9 10 10 4
26-32
22.7 12.0 13.3 13.3 5.3
8 2 1 4
33-39
10.7 2.7 1.3 5.3
1
40 & > --- --- --- ---
1.3

The age-wise distribution of type of sex by MSW is depicted in Table –24. It is observed that a
majority of those involved in oral sex, 40 percent are in the 19-25 age group followed by 23
percent who are 26 to 32 years old. A similar pattern is visible in the case of MSW engaging
in anal sex with 24 percent in the 19-25 age group and around half that number, 12 percent
having anal sex are older (26-32 years of age) and 17 percent involved in thigh sex also are in the
younger age group compared to 13 percent in the older age range. However, in the case of
vaginal sex, more number of MSW, 13 percent belonged to the older age group of 26-32 years
while only half that number, 7 percent who had vaginal sex were 19 to 25 years of age.

This indicates that oral and anal sex is very popular among MSW. This has also to be seen in the
light of the identity that they perceive. As observed earlier, many MSW view themselves as Koti
(playing a passive role and receiving sex) and this may explain for higher preference for anal sex.

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 Pilot Study on MSW in India

Table – 25
Type of sex by MSW by Marital Status

Type of sex Type of Sex (N=75)

Oral Anal Vaginal Thigh Others
Marital status
(%) (%) (%) (%) (%)
59 66 16 27 11
TOTAL
78.7 88.0 21.3 36.0 14.7
43 47 9 18 6
Unmarried
57.3 62.7 12.0 24.0 8.0
8 8 3 3
Married living with spouse ---
10.7 10.7 4.0 4.0
6 8 2 5 5
Married living without spouse
8.0 10.7 2.7 6.7 6.7
2 5 2 1
Separated/ Divorced ---
2.7 6.7 2.7 1.3

Table -25 given above describes the type of sex activity preferred by MSW in relation to their
marital status. Expectedly, larger number of unmarried MSW, 57 percent reportedly engage
in anal and oral sex compared to ever-married respondents, 22 percent. Further, it is
observed that MSW who also have sex with their female sex partners, up to 27 percent ever-
married MSW have anal sex engage in anal and or oral sex. This is important from the
prevention point of view as unprotected anal sex with male partner may lead to chances of
infection on subsequent unprotected sex with spouse.

Comment

The type of sex that is popular among male sex workers is definitely anal sex though a large
number also engage in oral sex, especially the transgender community. Moreover, the younger
age group are known to enjoy variations in different kinds of sex though there is a preference for
anal sex. As mentioned earlier, anal sex activity may be attributed to more number of MSW
identifying themselves as Koti. Bisexual partners are known to engage in both anal and vaginal
sex and the need to educate them on having protected sex always is key to prevention of HIV
among this risk group. Owing to the fact that majority of MSW are unmarried, it is important they
are informed about risks in anal sex as many are of marriageable age and many are mere
‘hustlers’ who may go back into mainstream sex life after a brief spell of commercial sex activity.
It has also been observed that MSW do not consider having sex with other males (predominantly
anal sex) as posing risk of HIV infection reflected in poor condom use. Therefore prevention
efforts need to be directed at making MSW realise appropriate perception of risk.

5.3 Violence, criminalisation

Violence and criminal assault

The following tables depict the extent of sex-related violence that MSW faced from their clients
and others as a result of engaging in sex work. It is important to note that around half the
number of MSWs interviewed, 45 percent experienced acts of violence committed against
them and so did a similar number, 47 percent face criminal assault – booked by police and
law enforcing authorities on false charges of being public nuisance, petty theft cases and the like
and harassed in custody.

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Table – 26
Violence and criminal assault against MSW by Age group

Forced sex, violence and

Violence, etc.
criminal assault (N=75)
Forced sex Criminal
Age group & violence assault
(percent) (percent)
34 35
TOTAL
45.3 46.7
1 1
< 18
1.3 1.3
13 16
19-25
17.3 21.3
11 10
26-32
14.7 13.3
8 7
33-39
10.7 9.3
1 1
40 & >
1.3 1.3

The age-wise distribution of forced sex and violence as well as criminal assault is described in
Table – 26. From the above table, it may be observed that a majority of the younger MSW, 17
percent in the age group of 19 to 25 years were forced to have sex with their clients and acts
of violence were perpetrated against them. Comparatively, 15 percent in the 26 to 32 age group
said they faced such sex-related violence. Moreover, 11 percent of older respondents in the 33-39
age group also reported such violence. This indicates that age is not a factor and sex related
violence occurs among all MSW for which they have no recourse as they are unorganised and
most instances go unreported. Many described about being burnt over the body with cigarette
buts, thrashed and beaten on their backs and sex organs, made to indulge in painful sex acts,
gagged and forced to have sex. Many MSW however view such acts as rare instances by a few
clients whom they consider facing a psychological problem. It is also seen that clients who pay
more indulge in such harsh treatment while having sex.

With regard to criminal assault too, a similar pattern is visible with majority of younger MSW in
the 19-25 years age group reporting such experiences more often than 13 percent of those in
the 26 to 32 years age group. Around 10 percent of older MSW in the 33-39 age group also faced
criminal charges piled against them.

Table – 27
Violence and criminal assault against MSW by Income

Forced sex, violence and

Violence, etc.
criminal assault (N=75)
Income Forced sex Criminal
(all sources) & violence assault
(percent) (percent)
34 35
TOTAL
45.3 46.7
21 23
< Rs.2500
28.0 30.7
13 12
Rs.2501 – Rs.5000
17.3 16.0

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 Pilot Study on MSW in India

According to the data given in Table - 27 above, violence and criminal assault against MSW with
respect to their average monthly income from all sources is analysed. It may be noticed from the
above data that incidence of forced sex and sexual violence is higher among more number of
the MSW, 28 percent earning lower income of up to Rs.2500/- a month, compared to that of
MSWs earning between Rs.2501 and Rs.5000 a month, 17 percent. Similar trends can be
witnessed in the case of criminal assault by police and goondas whereby 31 percent of MSW
earning lower monthly incomes are victimised compared to 16 percent who earn higher income.

Comment

Discussions indicated that MSW earning more are considered to be hailing from better socio-
economic backgrounds and hence clients as well as others fear from harming them. However,
poorer MSW have to face the brunt of physical violence and assault. With regard to criminal
cases, MSW opine that first-timers always face problems from police. Many are forced to have
sex with policemen and their henchmen. However, in due course when they become
acquaintances, police only harass them and demand money. They then go after younger or new
entrants into the sex trade. Many hijras maintain good rapport with police personnel and though
they are caught initially in a raid, on the way to the police station or even in the police jeep, they
have sex or demand money and release the sex workers.

Old Railway station in Kolkata, an important hotspot for male sex work activity

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6.0 HIV/ AIDS PREVENTION, TREATMENT, CARE AND SUPPORT SERVICES

6.1 Awareness, sources and sexual behaviour

The tables given below provide information on the extent of awareness of MSW on HIV/ AIDS,
source of awareness and resultant sexual behaviour. Indications are that there is good awareness
with 83 percent of respondents stating they are aware about HIV/AIDS.

Table – 28
Awareness on HIV/AIDS of MSW by Age group

Awareness on
Awareness HIV/ AIDS
(N=75)
Age in Average
completed age of
Age group
years client
(Percent) (Percent)
62 62
TOTAL
82.7 82.7
4 2
< 18
5.3 2.7
31 21
19-25
41.3 28.0
18 20
26-32
24.0 18.7
8 17
33-39
10.7 22.7
1 2
40 & >
1.3 2.7

The age-wise distribution of HIV/AIDS awareness among MSW and their clients is described in Table - 28
above. It may be seen that while majority of the MSW, 41 percent in the 19-25 years age group are
aware of HIV/ AIDS, only 24 percent in the 26-32 year age group are aware of the same and only 11
percent of those in the 33-39 years are range are aware of HIV/ AIDS. Among clients, a different pattern
emerges. Though majority of clients, 28 percent aware of HIV/ AIDS are in the 19-25 year age group, 23
percent of older clients in the 33-39 age group are aware of HIV/ AIDS compared to only 19 percent of
clients in the 26-32 years age group.

Table – 29
Awareness on HIV/AIDS of MSW by Education

Education status of MSW (N = 75)

Responses
Education
(Percent)
62
TOTAL
82.7
4
Illiterate
5.3
14
Primary
18.7
Middle school 19

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 Pilot Study on MSW in India

25.3
13
Higher Secondary
17.3
6
Technical
8.0
5
Higher Education
6.7
1
No Response
1.3

The data presented in Table - 29 above describes the awareness of MSW on HIV/ AIDS with
respect to their educational status. It may be observed from the data that education plays an
important role to play in increased awareness on HIV/ AIDS. As evident from the table,
majority of the respondents, 25 percent who were aware of HIV/ AIDS were educated up to
middle school level followed by 19 percent who had primary education and 17 percent who were
educated up to higher secondary level. Awareness among MSW with technical and higher
education is high with almost all respondents being aware of HIV/ AIDS. Hence, education is an
important factor in enhancing knowledge and awareness, more so because educated MSW are
able to read and respond to IEC and prevention or behaviour change communication messages
displayed by grassroots level HIV/AIDS interventions.
Figure – 11
Sources of Awareness on HIV/AIDS of MSW

Sources of awareness on HIV/AIDS

88
90
80 69.3
66.7
70 58.7
60 53.3 54.7 45.3
50 42.7 42.7
40
30
20
10
0
Sources of aw areness
Television Radio Newspaper
Poster Pamphlet Doc tor
NGO/ CBO Friends Ot her sources

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 Pilot Study on MSW in India

The main sources of awareness of HIV/ AIDS messages is depicted in Figure-11 given above.
From the same, it may be observed that Television is an important media, 88 percent followed
by friends, peers or colleagues, 69 percent and NGO/ CBO, 68 percent. Other important
sources of awareness include Radio, 59 percent Posters, hoarding and messages displayed in
public places followed by newspapers, 53 percent. Around 42 to 45 percent MSW also mentioned
pamphlets, doctors and other sources as sources of awareness on HIV/ AIDS. Hence, in
disseminating prevention messages, it is important to focus on the popular mass and electronic as
well as print media such as Television, Radio, Newspapers, Posters and Pamphlets. Besides one-
to-one communication by NGO/CBO workers, doctors and peers are also seen as important
channels to provide vital information to the hidden male sex worker community.

Table – 30
Awareness on HIV/AIDS and sexual behaviour of MSW

Awareness on HIV/AIDS and

behaviour of MSW (N = 75)
Responses
Sexual behaviour
(Percent)
53
Last time had sex for money/ gifts, etc. (MSW)
70.7
41
Last time used condoms while having sex
54.7

Awareness of MSW on HIV/AIDS and resultant sexual behaviour is analysed in Table -30 given
above. From the table, it may be observed that among MSW who are aware of HIV/ AIDS, a
high 71 percent reportedly had sex in exchange for money, gifts, etc. during the last time and
among MSW aware of HIV/ AIDS, 55 percent reported using condoms during the last time they
had sex. This indicates that though awareness on HIV/ AIDS is high and engaging in sex in
exchange for money is prevalent (indicating high level of multi-partner sexual activity) such
knowledge is not translated into changed behaviour as unprotected sex is high. This points at the
need to strengthen Behaviour Change Communication measures among the target audience –
MSW in order to enhance knowledge and awareness and result in adoption of safe sex methods to
prevent HIV infection. As seen earlier, MSW do not also perceive risk of infection as a result of
anal or oral sex. (Many simply have the misconception that HIV infection can be spread only
through vaginal sex with female commercial sex workers).

The Kolkata tram, an important mode of transport and a landmark

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 Pilot Study on MSW in India

6.2 Availability and access to services

Awareness, Availability and Access to services by MSW

The following tables provide an understanding of the awareness on HIV/ AIDS related services
provided by NGOs/ CBOs by the Male Sex Workers in Kolkata city, availability of such services
and accessibility of such services by MSW. The overall scenario on service awareness,
availability and access reveals that a large number of MSW in the city are aware of such
services, 65 percent though fewer numbers are aware of the range of services offered such as
condoms, medicines, clinical facilities (testing and treatment), counselling and referral services
and are neither aware where such services are offered and by whom (NGO/ CBO/ Government/
private/ traditional systems). Hence, overall access to available services is a low 20 percent
among all MSW.

Table – 31
Awareness, Availability and Access to services by MSW by Age Group

Service access Awareness, Availability and Access to services (N=75)

Range of services
Age Aware NGO Condom Clinic Drugs Jelly Access
(%) (%) (%) (%) (%) (%) (%)
49 48 6 7 3 2 15
TOTAL
65.3 64.0 8.0 9.3 4.0 2.7 20.3
3 3 1
< 18 --- ---
4.0 4.0 --- --- 1.3
24 24 5 3 6
19-25
32.0 32.0 6.7 4.0 --- --- 8.0
14 14 3 2 1 4
26-32
18.7 18.7 --- 4.0 2.7 1.3 5.3
7 6 1 1 1 1 3
33-39
9.3 8.0 1.3 1.3 1.3 1.3 4.0
1 1 1
40 & > --- ---
1.3 1.3 --- --- 1.3

Table -31 provides an insight into the awareness, availability and access to health and related
services for MSW with respect to their age. It may be seen that majority of MSW aware of
such services, 32 percent are in the 19-25 age group followed by older MSW in the 26-32 age
group, 19 percent. Almost all aware of services said they knew only of NGO/ CBO providing
such services. The range of services is not known to many respondents and only few mentioned
of condoms, clinical services, drugs and provision of jelly as part of treatment services available
to MSW in the city. Accessibility to services is very low even among those who are aware of
such services and is proportionately spread across age groups that are aware of such services,
though data indicates that older respondents aware of such services are more likely to use such
services.

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Table – 32
Awareness, Availability and Access to services by MSW by Education

Service access Awareness, Availability and Access to services (N=75)

Range of services
Education Aware NGO Condom Clinic Drugs Jelly Access
(%) (%) (%) (%) (%) (%) (%)
49 48 6 7 3 2 15
TOTAL
65.3 64.0 8.0 9.3 4.0 2.7 20.3
1 1
Illiterate --- --- --- --- ---
1.3 1.3
11 12 2 2 5
Primary --- ---
14.7 16.0 2.7 2.7 6.7
14 14 4 1 5
Middle school --- ---
18.7 18.7 5.3 1.3 6.7
13 11 1 1 1 4
Higher Secondary ---
17.3 14.7 1.3 1.3 1.3 5.3
6 6 1 1 1
Technical --- ---
8.0 8.0 1.3 1.3 1.3
3 3 2 1 1
Higher Education --- ---
4.0 4.0 2.7 1.3 1.3
1 1
No Response --- --- --- --- ---
1.3 1.3

From the above Table – 32, the education-wise distribution of service awareness, availability and
access may be ascertained. It is evident from the above data that more educated MSW, 19
percent educated up to middle school level and 17 percent with higher secondary education
are aware of treatment services and also access such services. Though the numbers indicate
that service access is poor despite good awareness, among those who have accessed such
services, it is observed that they are more educated and therefore education and increased
awareness is an important variable in improving service access.

Table – 33
Awareness, Availability and Access to services by MSW by Marital status

Service access Awareness, Availability and Access to services (N=75)

Range of services
Marital status Aware NGO Condom Clinic Drugs Jelly Access
(%) (%) (%) (%) (%) (%) (%)
49 48 6 7 3 2 15
TOTAL
65.3 64.0 8.0 9.3 4.0 2.7 20.3
36 32 4 4 2 2 12
Unmarried
48.0 46.7 5.3 5.3 2.7 2.7 16.0
8 8 1 1 3
Married, living with spouse --- ---
10.7 10.7 1.3 1.3 4.0
3 3 1 2 1
Married, living without spouse --- ---
4.0 4.0 1.3 2.7 1.3
2 2
Separated/ Divorced --- --- --- --- ---
2.7 2.7

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The data in Table -33 presented above describes the awareness, availability and access to services
with respect to marital status of the MSW in Kolkata City. It may be seen that as more number of
respondents are unmarried, so are more unmarried MSW aware of such services, around half
the respondents, 48 percent and many know only of NGOs offering such services. It may
however be observed that most married respondents know of such services. However, access to
such services is poor even among bisexual MSW.

6.3 Barriers in accessing services and suggestions

Only few respondents were able to directly mention various barriers faced in accessing services in
the quantitative study. However, from the discussions and qualitative phase, inputs reveal that
there are several barriers that male sex workers need to overcome to access services even if
awareness levels are high. The key issue is availability of such services. Not all range of
services are offered that are needed by MSW. The only services that MSW seem to know include
condoms, clinics, drugs and provision of jelly for pain in sex organs. However, they opine that
services not available readily are counselling, diagnosis and testing and provision of free
medicines for all sex-related diseases (including STI and HIV infection). Moreover, such
services are not easily accessible, as they are located in inconvenient locations where
respondents have to cover long distances for access. Respondents have complained of ill-
equipped centres with poor infrastructure and non-availability of personnel.

Male sex workers would prefer services that are within reach for cheap and easy reach –
availability of cheap public transport is also important to access such services. The next issue
is regarding timing of service centres. Many services are available only between 10:00 a.m. and
6:00 p.m. in clinics, hospitals or NGO outreach centres. These timings are inconvenient for
majority of the MSW who are employed full-time or even may be engaged in sex work during
these hours. MSW preferred clinics that are open late in the evenings or even early in the day that
they could access. Another important concern is the non-availability of qualified medical
personnel as doctors or para-medical staff. Where there are few personnel, their attitude puts the
MSW away and hence MSW shy away from accessing these centres.

Other important barriers in accessing services include cost of treatment and medicines that are
provided by private and supported medical centres and where free treatment is available, quality
of services is reportedly very poor. Hence MSW prefer that medical, psychological and referral
services be affordable, easily available at all places and at convenient times and of good quality.
Many MSWs also preferred that condoms be distributed free of cost and there is a need for a ‘safe
space’ for MSW to share their experiences with others and also cater to their recreational needs.
Other factors for poor access besides lack of knowledge and information mentioned include
stigma and discrimination in accessing such services located in populous surroundings or fear of
identification by known persons.

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6.4 Problems faced by Male Sex Workers

Figure – 12
Problems faced by MSW

Problems faced by MSW

80 68
54.7 57.3 57.3
60 50.7 49.3 52
37.3 42.7
40 32 32

20

0
Problems faced

Jealousy Robbing clients Police harassment

Blackmailing Cheating/ free sex Switching loyalty
Hiding from family Fear of disclosure No consent to open
Exposure Other problems

According to Figure-12 portrayed above, the problems faced by MSW in Kolkata City is
examined. The data indicates that Male Sex Workers face a host of problems. The most pressing
problems that surface are jealousy between sex workers themselves, 68 percent that points out
to intra-community (among Kotis, Dublis, Masseurs for clients and money) and inter-
community (between hijras and others for control of areas/ leadership) conflicts prevalent
among male sex workers. Most of the other problems identified are on an individual basis such
as harassment and forced sex by police, 57 percent cheating by customers or not paying
agreed sum after sex, 57 percent and robbing of clients from friends/ other MSW. Here, it is
important to note that older MSW see younger MSW as their rivals as clients prefer younger
(stronger) male sex workers. This also indicates that younger sex workers are paid better than
older ones and hence this develops into conflict between sex workers. Other reasons for concern
among MSW include hiding their behaviour from family members, 51 percent as many carry
on the sex work without knowledge of the family with sisters of marriageable age and younger
siblings whom they have to support economically. Many are worried about being ostracised
when discovered that they are sex workers. Another 49 percent opined that it is difficult to hide
their behaviour and are under constant threat of being exposed in society by friends/ peers or
even clients in public. While 43 percent feared that they might disclose their sex-related
behaviour to their families, 32 percent said they were afraid that others would reveal their
involvement in sex activity without their consent. Around 52 percent MSW said they faced
other problems as being betrayed by own community, threats from relatives and fear of goondas
or rowdies.

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7.0 MALE SEX WORKERS IN INDIA

AHMEDABAD CITY

Mahatma Gandhi Ashram, the most significant landmark in Ahmedabad city

Ahmedabad is known for its rich past and its association with the Mahatma Gandhi. The city
offers the traveler a unique style of architecture, which is a blend of Hindu and Islamic styles.
Ahmedabad has been known for its industry since medieval times. It is famous for its textile mills
and for this reason is often referred to as the 'Manchester of the East'. The city is located in the
state of Gujarat, in the western part of India. It lies along the Sabarmati River and is 440 km
north of Mumbai. The climate of Ahmedabad is hot and moist. Winters are cool and pleasant
(November-February) but summers (April-June) are extremely dry, hot with the mercury rising
above 46°C at times. With a population of over 60,48,000 people, spread over 236 sq. km., the
city attracts thousands of workers from nearby towns and villages. Gujarati, Hindi and English
are the main languages and is famed for the Gandhi Ashram, Kankaria lake, Shaking Minarets,
Jama Masjid and Akshardham temple which are major tourist attractions.

The analysis of the quantitative data begins with the socio-demographic profile of Male Sex
Workers in Ahmedabad in order to understand the physical and environmental conditions that
affect MSW and also lead to a better understanding of the respondents through a macro
perspective.

An analysis of the socio-demographic profile of the MSW reveals that 41 percent are between 19
and 25 years of age, and 93 percent reported having their first sexual experience when they were
below 18 years of age. However, in the case of involving in sex first in exchange for money, gifts,
etc., it is seen that majority of the respondents, 50 percent had done it when they were between 19
and 25 years of age. Interestingly, 45 percent opined that the average age of their clients is below
18 years. Education status indicates that 36 percent have studied only up to middle school, and a
majority comprising 60 percent are unmarried. Occupational status data shows that 80 percent are
employed in part-time jobs, with 93 percent earning below Rs.2500 a month from all sources with
55 percent earning up to Rs.1500 from engaging in sex work. Statistics also reveal that 92 percent
view television and 82 percent read the newspapers and that 27 percent are smokers and 44
percent have the habit of consuming alcohol.

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7.1 Socio-demographic characteristics

Figure – 1
Age of Male Sex Workers (MSW)

Age in completed years

13.3 1.3

17.3 41.3

18.7
< 18 Years 19-25 Years 26-32 Years
33-39 Years Above 40 Yrs.

According to the data presented in Figure-1 given above, the age of Male Sex Workers in
Ahmedabad City has been described.

It may be observed that a majority of the MSW, 41 percent are between 19 and 25 years of
age, followed by 19 percent who are older in the 26 to 32 years age group. While 17 percent of
the MSW interviewed in the study are between 33 and 39 years, 13 percent are above 40 years of
age and the remaining only 1 percent are below 18 years of age. Hence, it may be concluded that
a majority of the Male Sex Workers are in the middle aged category. However, Ahmedabad city
points out at a higher average age and even older MSWs can be found. Hence the need to target
all ages of MSW for any health or HIV/ AIDS related initiatives.

Figure – 2
Age at first sex and Age at first Commercial Sex of Male Sex Workers (MSW)

Age at first sex & first commercial sex

93.3

100

80
44 49.3
60

40
6.7 6.7
0
20

0
< 18 19-25 26-32
Years Years Years

Age at 1st sex Age at 1st com. Sex

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Figure-2 above portrays the age at first sex and age when MSW first had sex in exchange for
money, gifts, etc., of Male Sex Workers in Ahmedabad City. It is seen from Figure-2 that a high
93 percent reported having their first sexual experience below 18 years of age while the
remaining 7 percent said their first sex experience occurred when they were between 19 and 25
years old. However, a different trend is observed with respect to the age at which the MSW had
sex for the first time in exchange for money, gifts, etc. While around 50 percent reported such
experience when they were 19 to 25 years of age, 44 percent reported engaging in paid sex first
below 18 years of age.
Figure – 3
Average Age of the clients of Male Sex Workers (MSW)

Average Age of clients of MSW

50 45.3 42.7

40

30

20
10.7
10
1.3 0
0
Avg. age of client

< 18 19-25 26-32 33-39 40 & >

Figure-3 analyses the average age of the clients of the Male Sex Workers in Ahmedabad City. It
is seen that majority of the MSW, 45 percent opined that the average age of the clients is
below 18 years while 43 percent said that the average age of their clients was between 26 to 32
years, only 11 percent said their clients were 26 to 32 years old and according to the remaining 1
percentage, their clients were older at 33 to 39 years of age. This indicates that in Ahmedabad, a
large number of younger clients are there and they prefer other males of their age.

A typical street in Ahmedabad

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Figure – 4
Educational status of Male Sex Workers (MSW)

Education status of MSW

40 36
29.3
30

20
13.3 13.3

10 5.3
0 2.7

0
Education

Illiterate Primary Middle school

Hr. Sec. Technical Hr. Edu.
No Resp.

The educational status of the MSW is indicated in Figure-4 above. It is noticed that majority of
the MSW interviewed, 36 percent have completed only up to middle school followed by 29
percent who have had only primary education. An equal percentage of respondents, 13 percent
are illiterate or are educated up to higher secondary. This indicates extremely low level of
education among male sex workers here that points out to the need to cater to information and
education needs of respondents with respect to health/ HIV/ AIDS efforts.
Figure – 5
Marital status of Male Sex Workers (MSW)

Marital Status of MSW

60
60
34.7
40

20
1.3 4 0
0
Marital status

Unmarried
Married, living with spouse
Married, living without spouse
Separated/ Divorced
No Response

Figure-5 describes the marital status of the MSW covered in the study. With a predominantly
large younger group, expectedly a large 60 percent are unmarried. Among ever-married
MSW, 35 percent are living with their spouse and only 1 percent are living without their spouse.
This shows that there may be large number of bisexuals in Ahmedabad and sex with males is also

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common among married partners. Marriage is a crucial factor as it determines risk and
vulnerability to HIV infection during unprotected sex. Thus the need to ensure that risk of
infection is not transmitted to the married spouse.
Figure – 6
Occupational status of Male Sex Workers (MSW)

Occupation Status of MSW

80
80

60

40
13.3
20 6.7

0
Occupation
Unemployed
Full-time employed
Part time employed

From Figure-6, the occupational status of the MSW may be ascertained. The data reveals that
majority of the respondents, 80 percent are employed in part-time jobs while 13 percent are
engaged in full-time jobs and remaining 7 percent are unemployed. The type of occupations that
have been observed include rickshaw pullers, vendors, drivers, boatmen and those belonging
predominantly to lower rungs of the socio-economic ladder. A few have taken up working with
NGO/ CBO as peers and volunteers and continue to engage in sex work.
Figure – 7
Average monthly income of Male Sex Workers (MSW) (All sources)

Age in completed years

2.7 4

93.3
< Rs.2500 Rs.2501 – Rs.5000 > Rs.5001

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According to Figure-7, the gross Average Monthly Income of the MSW has been recorded. This
indicates that almost all respondents, 93 percent earn below Rs.2500 a month from all sources
while for only 3 percent the monthly income ranges between Rs.2501 and Rs.5000. Only 4
percent reportedly earn more than Rs.5001 a month. It may therefore be concluded that the
economic condition of MSW is comparatively very poor and many are forced to take up sex work
as an alternative for a living. Poor earnings also have an effect on expenditure on health care and
prevention methods as purchase of condoms, testing and treatment.
Figure – 8
Average monthly income of Male Sex Workers (MSW) (Sex work)

Age in completed years

10.7

34.7 54.7

<Rs.1500 Rs.1501-3000 >Rs.3001

The average monthly income of MSW from sex work is described in Figure-8. From the table, it
may be inferred that a large number, 55 percent earn up to Rs.1500 from engaging in sex work
followed by a sizeable percentage, 35 percent who earn between Rs.1501 and Rs.3000 from sex
work. This is done to augment their meagre income they earn from their full-time employment.
As observed in other studies and in qualitative phase of the study, many MSW are forced to
engage in sex work on commercial basis to support the family or need to earn more to lead a
better quality of life. It is also observed that in certain instances, clients offer money willingly
and when satisfied with sexual experience are reported to pay extra to MSW in gratitude.

Men and women in a ‘Dandiya dance’

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7.2 Lifestyle, environmental influences

Figure - 9
Media habits of Male Sex Workers (MSW)

Media habits of MSW

100 92
82
80
61.3
60

40
17.3 9.3
20

0
Media channels

Television Radio Newspaper

Magazines Cinema

The media habits of the MSW in this study may be gauged from the multiple response Figure-9
given above. It is observed that majority of the MSW, 92 percent view television and 82
percent read the newspapers. A large percentage, 61 percent also reportedly listen to the radio
and an equal percentage of 17 percent read magazines and watch movies. It may thus be
concluded that MSW are exposed to both electronic and print mass media and hence these may be
used for getting messages on prevention, education, treatment, care and support in relation to
HIV/ AIDS.
Figure – 10
Other habits of Male Sex Workers (MSW)

Other habits of MSW

68
70
60
50 44
40
40
25.3
30
18.7
20
10
0
Other habits
Smoking Alcoholism
Drugs Consuming tobacco
Other habits

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Figure-10 presented above describes the other habits of MSW. It may be seen from the above
table that a large number of respondents 44 percent consume tobacco chewing tobacco (local
‘paan’) and many are addicted to locally available tobacco and ‘masalas’ with intoxicants and 27
percent have the habit of smoking. A large number, 13 percent also reported to consume
alcohol regularly. Though habits as alcoholism and drugs are known to induce to poor adoption
of protective measures leading to increased risk of HIV infection, in Ahmedabad it does not seem
to be significant and probably owing to much poorer economic conditions, respondents do not
take alcohol/ drugs and consume tobacco.

Comment

Profile of a typical MSW in Ahmedabad City

From a study of the overall socio-demographic profile of Male Sex Workers in Ahmedabad City,
a typical profile of an MSW may be constructed. Overall, it may be seen that an average Male
Sex Worker in this city is between 26 to 32 years, has had his first sexual experience below 18
years of age, experienced first sexual encounter in exchange for money, gifts, etc, when he was
between 19 and 25 years of age and the average age of his client is below 18 years though many
may also have clients between 19 to 25 years of age. The other socio-demographic characteristics
reveal that the Male sex worker here is educated up to the middle school level, mostly unmarried
and employed mainly in part-time occupations – petty jobs such as daily wage labour/
construction and so on. This poor occupational status induces him into sex work as an alternative
source of income. A typical MSW earns reportedly less than Rs.2500/- a month from all sources
and less than Rs.1500/- from sex work. The media habits of MSW reveal that television is the
most influential media followed by newspaper and the radio. He also is a smoker and probably
an occasional drinker.

Old buildings line the streets in the city

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7.3 Identity and sub-types

Awareness of MSW on types and subtypes of Male Sex Workers in Ahmedabad City

Table – 9
Awareness of Male Sex Workers Genre by MSW by Age Group

Awareness Male Sex Worker Subtypes (N=75)

Koti Panthi Dubli Hijra Gigolo Masseur Escort Londa Dancer
Age
(%) (%) (%) (%) (%) (%) (%) (%) (%)
75 63 58 74 10 11 2 21 63
TOTAL
100.0 64.0 77.3 98.7 13.3 14.7 2.7 28.0 84.0
1 4
< 18 --- --- --- --- --- --- ---
1.3 5.3
31 25 21 31 2 3 7 25
19-25 ---
41.3 33.3 28.0 41.3 2.7 4.0 9.3 33.3
20 17 17 20 5 4 1 4 15
26-32
26.7 22.7 22.7 26.7 6.7 5.3 1.3 5.3 20.0
13 11 12 12 2 2 5 13
33-39 ---
17.3 14.7 16.0 16.0 2.7 2.7 6.7 17.3
10 10 8 10 1 2 1 5 10
40 & >
13.3 13.3 10.7 13.3 1.3 2.7 1.3 6.7 13.3

The data in table - 9 presented above describes the Male Sex Workers awareness of the various
types and sub-types of MSW that are reportedly existing in society in various proportions with
respect to their age. It is seen that majority of the MSW know about groups such as ‘Koti’ (which
in common parlance means a person (biologically male) who is a recipient during a sexual act
also termed passive partner). Similarly ‘Panthi’ denotes a person who plays a dominant or active
role (read penetrative) during sexual act. ‘Dubli’ is a colloquial term (in Ahmedabad also) used to
describe a person who performs both an active and passive role. It is observed that they are also
popularly called ‘Double Decker’ or ‘DD’. ‘Hijra’ are transgender or transsexual population and
‘Londa’ a group popular in eastern parts of the country – mainly West Bengal and Bihar are
mainly transsexuals or males who attire in female clothing and dance during specific cultural
festivities. After the fair or festival, they engage in sex with other men or women and earn a
living through sex work.

‘Dancer’ is a term describing a typical dancer (usually entertaining people in public). After or
during the dance programme, he is approached by clients and negotiates an agreement for paid
sex. Masseur is a male ‘body massager’ who works in a massage parlour. Many massage
parlours are reportedly known to also provide sexual services for an additional sum and masseurs
engage in sex with clients who visit massage parlours. Some masseurs also service clients for
massage in the clients houses. A ‘Gigolo’ is a commercial male sex worker who caters to mainly
to women alone. An ‘Escort’ is a male sex partner who is usually kept by the client in his house/
workplace and is used for sexual activity when desired by the client. Escorts are known to
accompany clients on outstation trips and frequent travel.
Comment

The overall analysis of MSW on awareness pertaining to MSW genre indicates that a majority
of the MSW in Ahmedabad City is aware of predominantly main groups in the MSW
network in the city. All respondents knew about Koti, 100 percent and a large number heard of
Hijra, 99 percent followed by Dancer, 84 percent Dubli, 77 percent and Panthi, 64 percent.

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Comparatively very few, 28 percent heard about Londa and Masseur, 15 percent Gigolo, 14
percent and Escort, 3 percent as a subtype of MSW in Ahmedabad City.

An analysis of the age-wise classification of data reveals that majority of the MSW in the 19 to
25 age group are aware of the various types and sub-types of MSW existing in society.
Within this group, an equal number, 41 percent are aware of Koti and Hijra while another equal
number of respondents, 33 percent are aware of Panthi and Dancer. Only 28 percent in this age
group knew about Dubli and numbers aware of other subtypes are insignificant.

Next, most MSW in the 26 to 32 age group are aware of various types and sub-types of MSW.
The trends in knowledge about various sub-types is similar to the younger age group seen with
around 27 percent aware of Koti, and Hijra. However, fewer MSW knew about ‘Panthi’, and
Dubli, 23 percent. While 20 percent in this age group were aware of Dancers, knowledge of other
sub-groups is very poor.

In the older age group of 33 to 39 years too, knew 16 percent to 20 percent of the respondents had
heard about Koti, Dubli, Hijra, Panthi, and Dancer. Similarly, among respondents aged above 40
years, there is knowledge on only these sub-types. However, many MSW in the young age group
of less than 18 years do not seem to know about the various types and sub-types within MSW. It
is observed that no clear definitions demarcate the various types and sub-types and there is
overlapping of context and meaning that leads to confusion among MSW in defining their genre.

Table – 10
Awareness of Male Sex Workers Genre by MSW by Education

Awareness Male Sex Worker Subtypes (N=75)

Koti Panthi Dubli Hijra Gigolo Masseur Escort Londa Dancer
Education
(%) (%) (%) (%) (%) (%) (%) (%) (%)
75 63 58 74 10 11 2 21 63
TOTAL
100.0 64.0 77.3 98.7 13.3 14.7 2.7 28.0 64.0
10 8 7 10 1 3 9
Illiterate --- ---
13.3 10.7 9.3 13.3 1.3 4.0 12.0
22 19 15 22 2 3 7 20
Primary ---
29.3 25.3 20.0 29.3 2.7 4.0 9.3 26.7
27 24 24 26 5 4 2 7 22
Middle
36.0 32.0 32.0 34.7 6.7 5.3 2.7 9.3 29.3
10 7 7 10 1 1 2 7
Hr. Sec. ---
13.3 9.3 9.3 13.3 1.3 1.3 2.7 9.3
Technical --- --- --- --- --- --- --- --- ---
2 1 2 2 1 1 1
Hr. Education --- ---
2.7 1.3 2.7 2.7 1.3 1.3 1.3
4 4 3 4 2 1 1 4
Others ---
5.3 5.3 4.0 5.3 2.7 1.3 1.3 5.3

Table - 10 depicts the Male Sex Worker’s understanding of the various types and sub-types
prevalent with respect to their education. It may be deduced from the above data that majority of
the respondents aware of various types and sub-types within MSW are educated up to
middle school, followed by those educated up to primary, then higher secondary level. This is
followed by MSW who are illiterate. More MSW may be aware of types as a majority of the
respondents are educated only up to some level. It is also seen that MSW with primary, higher
education and those who are illiterate are not very conversant with various types and subtypes.

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Responses from the field indicate that higher educated MSW are engaged in such activity only
occasionally or do so to fulfil immediate economic needs, and hence do not understand nor are
they keen on knowing various types and sub-types. On the other hand, illiterate MSW neither
know nor understand the dynamics of the MSW genre in society.

Table – 11
Awareness of Male Sex Workers Genre by MSW by Marital status

Awareness Male Sex Worker Subtypes (N=75)

Koti Panthi Dubli Hijra Gigolo Masseur Escort Londa Dancer
Marital status
(%) (%) (%) (%) (%) (%) (%) (%) (%)
75 63 58 74 10 11 2 21 63
TOTAL
100.0 64.0 77.3 98.7 13.3 14.7 2.7 28.0 64.0
45 38 35 44 6 7 2 10 37
Unmarried
60.0 50.7 66.7 58.6 8.0 9.3 2.7 13.3 49.3
26 23 21 26 4 3 9 23
Married living with spouse ---
34.7 30.7 28.0 34.7 5.3 4.0 12.0 30.7
1 1 1 1 1
Married living without spouse --- --- --- ---
1.3 1.3 1.3 1.3 1.3
3 1 1 3 1 2 2
Separated/ Divorced --- ---
4.0 1.3 1.3 4.0 1.3 2.7 2.7

Table - 11 provides an analysis of awareness of MSW genre in relation to their marital status. The
statistics reveals that most unmarried respondents are aware of various types and sub-types
among MSW, as majority of respondents are unmarried. Among MSW, majority of the
respondents aware of Koti are unmarried, 60 percent followed by those married and living with
spouse, 35 percent. Similar trends can be witnessed among those aware of Panthi, 51 and 31
percent Dubli 68 and 28 percent and Hijra 59 and 35 percent as well as Dancer, 49 and 31
percent.

This indicates that larger number of unmarried MSW are aware of various sub-types among
MSW. However, it is also to be noted that majority of the respondents are unmarried. Thus, an
analysis of awareness among married respondents indicates that awareness among both married
as well as unmarried MSWs is significant.

Table – 12
Awareness of Male Sex Workers Genre by MSW by Occupation

Awareness Male Sex Worker Subtypes (N=75)

Koti Panthi Dubli Hijra Gigolo Masseur Escort Londa Dancer
Occupation
(%) (%) (%) (%) (%) (%) (%) (%) (%)
75 63 58 74 10 11 2 21 63
TOTAL
100.0 64.0 77.3 98.7 13.3 14.7 2.7 28.0 64.0
5 5 5 5 2 5
Unemployed --- --- ---
6.7 6.7 6.7 6.7 2.7 6.7
10 10 10 10 2 3 1 5 10
Full-time
13.3 13.3 13.3 13.3 2.7 4.0 1.3 6.7 13.3
60 48 43 59 8 8 1 14 48
Part-time
80.0 64.0 57.3 78.7 10.7 10.7 1.3 18.7 64.0

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According to the data presented in Table -12, awareness of MSW on various types and subtypes
of MSW genre based on their occupation is analysed. It may be observed that in Ahmedabad,
most MSW are employed in part-time employment and they are aware of the various
groups followed by a large percentage of full-time employed MSW who also engage in sex for
exchange of money, gifts, etc. A closer examination of the data reveals that among those
respondents aware of Koti, Panthi, Dubli, Hijra and Dancer, constituting roughly 64 to 80 percent
of the respondents are employed in part-time jobs compared to only around 14 percent of the
respondents aware of these major sub-types who are engaged in full-time employment. This
indicates that occupation is an important factor in the sense that as more MSW are found to be in
part-time employment, their awareness on the various sub-types is better than those engaged in
full-time or unemployed respondents.

Table – 13
Awareness of Male Sex Workers Genre by MSW by Income

Awareness Male Sex Worker Subtypes (N=75)

Koti Panthi Dubli Hijra Gigolo Masseur Escort Londa Dancer
Average Income PM
(%) (%) (%) (%) (%) (%) (%) (%) (%)
75 63 58 74 10 11 2 21 63
TOTAL
100.0 64.0 77.3 98.7 13.3 14.7 2.7 28.0 64.0
Income (all sources)
41 32 27 41 3 4 1 8 33
< Rs.2500
54.7 42.7 36.0 54.7 4.0 5.3 1.3 10.7 44.0
26 23 23 26 4 5 1 9 23
Rs.2501 – Rs.5000
34.7 30.7 30.7 34.7 5.3 6.7 1.3 12.0 30.7
8 8 8 7 3 2 4 7
> Rs.5001 ---
10.7 10.7 10.7 9.3 4.0 2.7 5.3 9.3
Income (sex work)
70 58 30 69 10 11 2 18 59
< Rs.1500
93.3 77.3 40.0 92.0 13.3 14.7 2.7 24.0 78.6
2 2 2 2 1 2
Rs.1501 – Rs.3000 --- --- ---
2.7 2.7 2.7 2.7 1.3 2.7
3 3 3 3 2 2
> Rs.3001 --- --- ---
4.0 4.0 4.0 4.0 2.7 2.7

Table - 13 presents the awareness of respondents on various types and subtypes of MSW in
Ahmedabad City with regard to their monthly income. An overview of the data reveals that a
majority of MSW aware of their genre and subtypes earn a lower average monthly income
(from all sources) of up to Rs.2500 a month. The data reveals that among those who are aware
of Koti and Hijra, 55 percent earn below Rs.2500 a month while 35 percent earn a month.
Among those who know about dancers, 44 percent are in the low income category while 31
percent earn Rs.2501 to Rs.5000. A similar trend may be observed among respondents who are
aware of Panthi 43 and 31 percent and Dubli 36 and 31 percent respectively. Overall, even
among other groups it may be seen that those aware of major sub-types earn lesser than the
others. This may also point to the fact that majority of the respondents earn lower incomes.

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Type of Male Sex Workers as identified by MSW

The following analysis describes the manner in which Male Sex Workers define or identify
themselves. It also emphasises on their sexual orientation and gender.
From the data, it may be inferred that majority of the MSW in Ahmedabad, almost all
respondents identify thenselves as Panthi, 100 percent, while 87 percent also identify
themselves as Koti, and 31 percent opine that they are typically Hijras followed by a smaller
number, 12 percent who consider themselves as Dubli or those who engage in sex with other
males or females as active or passive sexual partners. MSW who consider themselves as Londa,
Escorts and Gigolo are very few and no MSW consider themselves as Masseur or Dancer. This
indicates that in Ahmedabad, Panthi are very common and so are Koti. However, Hijras can also
be found and many consider themselves as Dubli.

Table – 14
Type of Male Sex Workers by MSW by Age Group

MSW Type Male Sex Worker Subtypes (N=75)

Koti Panthi Dubli Hijra Gigolo Masseur Escort Londa Dancer
Age
(%) (%) (%) (%) (%) (%) (%) (%) (%)
65 75 9 23 1 2 2
TOTAL --- ---
86.7 100.0 12.0 30.7 1.3 2.7 2.7
1 1
< 18 --- --- --- --- --- --- ---
1.3 1.3
26 31 4 9 1 1 1
19-25 --- ---
34.7 41.3 5.3 12.0 1.3 1.3 1.3
17 20 1 5 1 1
26-32 --- --- ---
22.7 18.7 1.3 6.7 1.3 1.3
12 13 4 4
33-39 --- --- --- --- ---
16.0 17.3 5.3 5.3
9 10 5
40 & > --- --- --- --- --- ---
12.0 13.3 6.7

From Table-14 given above, MSW identity and orientation with regard to age-wise categorisation
may be ascertained. It is observed from the data that among those who identify as Koti, majority,
35 percent are in the 19-25 age group followed by 23 percent in the 26-32 age group and 16
percent in the 33-39 age group. A similar trend is seen among respondents who consider
themselves as Panthi with 41 percent in the younger age group of 19-25 years followed by 19
percent in 26-32 age group and 17 percent in 33-39 age range. Among Hijras though, it is
observed that while 12 percent are in the 19–25 age group, 7 percent are in 26-32 age group and
above 40 years age group followed by 5 percent who are in the 33-39 age group.

Table – 15
Type of Male Sex Workers by MSW by Occupation

MSW Type Male Sex Worker Subtypes (N=75)

Koti Panthi Dubli Hijra Gigolo Masseur Escort Londa Dancer
Occupation
(%) (%) (%) (%) (%) (%) (%) (%) (%)
65 75 9 23 1 2 2
TOTAL --- ---
86.7 100.0 12.0 30.7 1.3 2.7 2.7
5 5 1
Unemployed --- --- --- --- --- ---
6.7 6.7 1.3

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10 10 2 1
Full-time --- --- --- --- ---
13.3 13.3 2.7 1.3
50 65 7 21 1 2 2
Part-time --- ---
60.7 86.7 9.3 28.0 1.3 2.7 2.7

The occupational classification of MSW with respect to their identity is examined in Table-15. It
may be observed that majority of the MSW who identified themselves as Panthi, Koti, Hijra
and Dubli are employed in part-time work compared to those in full-time employment.
Thus, it may be seen that 87 percent of Panthi, 61 percent Koti and 28 percent Hijras are
employed in part-time jobs compared to 13 percent Koti and Panthi and 1 percent Hijra in full-
time jobs. This indicates that majority of the MSW are not economically well off and hence take
to sex work in order to enhance their incomes.

Comment

It may be observed in Ahmedabad that MSW are aware of only the main traditional types and
sub-types of MSW such as Koti, Panthi, Hijra and Dubli. They are aware of the complexity
governing each of these sub-types and also identify typically with one or more groups.
Predominantly however, many consider themselves as Panthi and a large hijra population also
exists in Gujarat with their typical hierarchical structure and norms. Most of the well informed
Male Sex Workers are in the younger age group and earn less and hence have to take up multiple
jobs including sex work to augment their incomes. Education does not seem to be a critical factor
in becoming a Male Sex worker but more educated sex workers are aware of various dynamics
and are able to attract richer clients.

Main Market Street in Ahmedabad where one can find ‘hustlers’

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Understanding Sex Industry Network (SIN) –

Place of soliciting/ pickup/ aggregating by Male Sex Workers.

The following analysis provides an understanding into the Sex Industry Network by pinpointing
the locations or places where Male Sex Workers solicit their clientele, pickup them for sexual
activities or indicates where such MSW aggregate to attract clients and engage in sex for
exchange of money, gifts, etc. It is important to identify such ‘hotspots’ as that would provide
vital clues in approaching this otherwise hidden community for long-term healthcare
interventions around HIV/ AIDS.

The overall analysis of the place of soliciting/ picking up clients and places of aggregating of
MSW in Ahmedabad City reveals that majority of the MSW operate in the street, 87 percent
followed by those in Bus stand, 81 percent and Park, 73 percent. The other prominent places of
contact are railway station, 60 percent, public toilet, 51 percent, 47 percent brothel and hotel and
35 percent houses. It has been observed that in most instances, the places where clients are
solicited are also the places where they have sex in exchange for money. It is seen that in
Ahmedabad city, outdoor sex among MSW groups is more common and majority of the MSW
and clientele interviewed belong to the lower socio-economic ladder.

Table – 16
Place of soliciting/ pickup/ aggregating by MSW by Age Group

Pickup point Male Sex Worker soliciting/ pickup/ aggregating points (N=75)
Railway Stn.
parlour (%)

Public toilet

Chat room
Telephone
Bus stand
Massage

Internet
Brothel

House
Street

Hotel

Pimp
Park
(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)
Age

65 4 61 45 55 35 35 26 6 1 38 1 1
TOTAL
86.7 5.3 81.3 60.0 73.3 46.7 46.7 34.7 8.0 1.3 50.7 1.3 1.3
1 1
< 18 --- --- --- --- --- --- --- --- --- --- ---
1.3 1.3
28 25 19 22 16 15 9 4 1 17 1 1
19-25 ---
37.3 33.3 25.3 29.3 21.3 20.0 12.0 5.3 1.3 22.7 1.3 1.3
16 3 17 16 14 10 10 7 11
26-32 --- --- --- ---
21.3 4.0 22.7 21.3 18.7 13.3 13.3 9.3 14.7
12 1 9 5 9 5 6 7 2 5
33-39 --- --- ---
16.0 1.3 12.0 6.7 12.0 6.7 8.0 9.3 2.7 6.7
8 10 5 9 4 4 3 5
40 & > --- --- --- --- ---
10.7 13.3 6.7 12.0 5.3 5.3 4.0 6.7

Table - 16 describes the age-wise classification of places where MSW solicit and pickup their
clients or places where they aggregate to attract clients for sex work. From the data, it can be seen
that most MSW soliciting, picking and aggregating in public places are younger in the 19 to
25 years age group compared to a lesser number who are 26 to 32 years old. A further detailed
analysis reveals that among MSW who operate on the streets, 37 percent are younger in the 19-25
age group followed by 21 percent in the 26-32 years age group and 16 percent in the 33-39 age
range. In the bus stands, 33 percent are in the 19-25 age group followed by 23 percent in the 26 –
32 years age group and 13 percent in the above 40 years age group. Similarly, among those who
solicit/ pickup clients in the park, many MSW, 29 percent are in the young age group of 19-25

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years compared to 19 percent aged between 26 and 32 years of age and 12 percent in the older
age group. In public toilets, brothels, hotels and houses too, a similar pattern emerges.

Table – 17
Place of soliciting/ pickup/ aggregating by MSW by Occupation

Pickup point Male Sex Worker soliciting/ pickup/ aggregating points (N=75)

Railway Stn.
parlour (%)

Public toilet

Chat room
Telephone
Bus stand
Massage

Internet
Brothel

House
Street

Hotel

Pimp
Park
(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)
Occupation

65 4 61 45 55 35 35 26 6 1 38 1 1
TOTAL
86.7 5.3 81.3 60.0 73.3 46.7 46.7 34.7 8.0 1.3 50.7 1.3 1.3
5 1 5 2 4 3 3 1 2
Unemployed --- --- --- ---
6.7 1.3 6.7 2.7 5.3 4.0 4.0 1.3 2.7
7 10 9 9 8 7 8 2 1 4
Full-time --- --- ---
9.3 13.3 12.0 12.0 10.7 9.3 10.7 2.7 1.3 5.3
53 3 46 34 42 24 25 17 4 32 1 1
Part-time ---
70.7 4.0 61.3 45.3 56.0 32.0 33.3 22.7 5.3 42.6 1.3 1.3

According to the data in Table - 17 the occupation-wise classification of place of soliciting/

picking up clients by MSW is analysed. It is observed that in the street, bus stand, park,
railway station, Public toilet, brothel, hotel and house, the number of MSW engaged in
part-time jobs is higher than those in full-time followed by unemployed MSWs. It is
important to note that though many MSW may be employed in petty trades, mostly in
Ahmedabad city as construction workers, load carriers, in transport industry, as drivers, truckers,
vendors and agricultural labour, they use the pick up points also to have sex which may not be the
place of work. It is seen that MSWs here prefer public places such as toilets, bus stands, railway
stations and parks to get the attention of clients as well as to escape law enforcing authorities
including local police.

Table – 18
Place of soliciting/ pickup/ aggregating by MSW by Income

Pickup point Male Sex Worker soliciting/ pickup/ aggregating points (N=75)
Railway Stn.
parlour (%)

Public toilet

Chat room
Telephone
Bus stand
Massage

Internet
Brothel

House
Street

Income
Hotel

Pimp
Park
(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)

(all sources)

65 4 61 45 55 35 35 26 6 1 38 1 1
TOTAL
86.7 5.3 81.3 60.0 73.3 46.7 46.7 34.7 8.0 1.3 50.7 1.3 1.3
34 3 33 25 32 19 18 10 1 25
< Rs.2500 --- --- ---
45.3 4.0 44.0 33.3 42.6 25.3 24.0 13.3 1.3 33.3
24 1 22 14 19 12 12 13 2 1 11
Rs.2501 – Rs.5000 --- ---
32.0 1.3 29.3 18.7 25.3 16.0 16.0 17.3 2.7 1.3 14.7
7 6 6 4 4 5 3 3 2 1 1
> Rs.5001 --- ---
9.3 8.0 8.0 5.3 5.3 6.7 4.0 4.0 2.7 1.3 1.3

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The income-wise classification of pickup points for sex work is presented in Table 18. From the
above table, it is evident that while MSW earning up to Rs.2500/- per month mostly solicit
clients in streets, 45 percent bus stand, 44 percent park, 43 percent and railway station, 33
percent, majority of MSW soliciting in other places also have lower incomes. However,
proportionately, it may be seen that those earning between Rs.2501 and Rs.5000 a month also
solicit and have sex with customers in brothels, houses and hotels, roughly 16 percent of the
respondents.

Comment

The Male Sex Work industry in Ahmedabad is not organised on the lines that are in other cities –
such as commercial sex activity through pimps and in brothels/ houses. Here such a system is
either non-existent or not popular. Sex workers prefer to contact their clients directly than
through networks. In Ahmedabad the profile of sex workers is very low and therefore soliciting
and having sex in streets, public places such as toilets and railway stations or bus stands during
nights is very common. Neither MSW nor their clients can afford to go to a brothel or engage in
sex at homes/ other places. Moreover, their occupational profile indicates that many are engaged
in petty jobs and during their leisure time, especially in evenings and nights, they visit parks,
toilets for younger boys who are willing to pay them for sexual favours. This explains the lower
age of majority of the clients in Ahmedabad. Overall, it may be seen that sex industry in
Ahmedabad is very unorganised and operates more on an individual basis. Many hijras have their
exclusive clients and prefer to go back to same clients. MSW have mentioned that they face
competition from younger persons who enter the field as clients prefer younger and stronger male
sex workers.

The banks of the Sabarmati River, which is also a hotspot for MSWs

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8.0 SEXUALITY, SEXUAL PRACTICES AND VULNERABILITY

8.1 Sexual encounters, partners, commercial sex

Sexual practices, behaviour and client profile of MSW

The tables presented below describe the sexual practices in terms of encounters with clients,
sexual behaviour including condom use and seek to capture client profile as seen by Male Sex
Workers. A bird’s eye view of the sexual practices among MSW reveals that MSW had paid sex
consistently over the last 6 months. More specifically, a large number, 95 percent reported
engaging in sex in exchange for money, gifts, etc., during the last time they had sex. This
relates to increased sex activity on commercial basis. Data also points out that a large number in
Ahmedabad City, 88 percent reportedly used condoms consistently over the last 6 months
when they had paid sex. Further, 84 percent reported using a condom during the last time
they had sex in exchange for money, gifts, etc. Finally, a question posed on who their sexual
partner was on their last paid sexual encounter revealed a rough profile of the clients of MSW.
While it is assumed that 32 percent clients are of high class – defined thus as being either equal to
or economically better than MSW themselves. To this group belong mostly peers, students,
teachers, office goers, blue collared workers, petty businessmen and the like. On the other hand,
48 percent reported that their clients are low class – meaning those hailing from lower socio-
economic strata – mainly rickshaw pullers, boatmen, unorganised workers, construction labour,
unemployed youth, slum populations and so on.

Ahmedabad city witnesses MSW activity predominantly at the street level and public places,
catering to the economic as well as sexual needs of people in the lower socio-economic milieu
such as those in slums and poor housing colonies operating in parks, railway stations, bus stands,
public toilets, and roadside shanties. Observations from the field validate the fact that many MSW
started as MSM but in due course, on pressing economic grounds they engage in sex on
commercial basis for sheer survival. Therefore, compared to other cities where survival sex is to
be found with recreational sex, in Ahmedabad, only survival sex may be found.

Table – 19
Sexual practices, behaviour and client profile of MSW by Age group

Sexual history Sexual practices, behaviour and client profile (N=75)

Sex for Clientele
Condom Condom
money/
use use High Low
Age group gifts (6 months) (Last time) class class
(Last time)
(%) (%) (%) (%)
(%)
71 66 63 24 36
TOTAL
94.7 88.0 84.0 32.0 48.0
1 1 1 7
< 18 ---
1.3 1.3 1.3 9.3
30 27 26 14 13
19-25
40.0 36.0 35.7 18.7 17.3
19 20 18 3 10
26-32
25.3 18.7 24.0 4.0 13.3
13 11 10 4 7
33-39
17.3 14.7 13.3 5.3 9.3
8 7 8 3 5
40 & >
10.7 9.3 10.7 4.0 6.7

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An analysis of the data in Table - 19 provides insight into the sexual practices and behaviour of
MSW with respect to their age. It is evident from the data that majority of the MSW, 40 percent
who had sex in exchange for money during the last sexual encounter were 19-25 years of age
followed by 25 percent who were older between 26 and 32 years old. A sizeable number of 17
percent were also in the age range of 33 to 39 years of age. This indicates that though MSW are
generally younger, many middle-aged MSW too are engaged in paid sex activities. Condom use
consistently in the last 6 months has been reported by majority of MSW, 36 percent in the same
19-25 age group followed by 19 percent in the older 26-32 age group. The trend is similar
pertaining to condom use during last sexual encounter where 36 percent in 19-25 age range
reported condom use and 24 percent between 26 and 32 years said they used condoms during
their last sexual encounter. It is interesting to note that an almost equal number of clients of
MSW, 18 percent who may be considered belonging to high class or low class and are younger in
the 19-25 age group. However, it is also noticed that many MSW considered low class are in the
older age group of 26-32 years.
Table – 20
Sexual practices, behaviour and client profile of MSW by Education

Sexual history Sexual practices, behaviour and client profile (N=75)

Sex for Clientele
Condom Condom
money/
use use High Low
Education gifts (6 months) (Last time) class class
(Last time)
(%) (%) (%) (%)
(%)
71 66 63 24 36
TOTAL
94.7 88.0 84.0 32.0 48.0
8 8 8 2 7
Illiterate
10.7 10.7 10.7 2.7 9.3
20 20 19 8 11
Primary
18.7 18.7 25.3 10.7 14.7
27 22 22 11 9
Middle
36.0 29.3 29.3 14.7 12.0
10 10 10 1 6
Hr. Sec.
13.3 13.3 13.3 1.3 8.0
Technical --- --- --- --- ---
2 2 2 1
Hr. Education ---
2.7 2.7 2.7 1.3
4 4 2 1 3
Others
5.3 5.3 2.7 1.3 4.0

Table 20 describes the sexual practices, behaviour and client profile of MSW by education status.
It is important to note from the above table that though involvement in sex for exchange of
money, gifts, etc., is high by educated MSW, that may be a result of rising unemployment and
resulting ‘survival sex’, higher education also indicates consistent condom use, 29 percent by
those educated up to middle school (majority of respondents in the study) and a high 13 percent
by those who studied up to higher secondary. Similarly, larger number of educated MSW, 29
percent educated up to middle school and 13 percent up to higher secondary reported condom use
during last sexual encounter. Interestingly, better condom use is being reported by respondents
educated up to primary level compared to those with higher secondary education. This may be

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attributed to the intervention efforts of grassroots NGO/ CBO in prevention and control activities
through effective behaviour change communication programmes and other interventions.

This therefore indicates that education is an important factor in determining safe sex practices
among male sex workers. Uneducated MSW are neither aware of safe sexual practices nor have
the appropriate perception of risk. This also points to the fact that educated MSW are in a better
position to read and understand HIV/ AIDS related prevention messages and one-to-one rapport
with educated clients and NGO/ community workers that reflects on better adoption of safe sex
practices. All the same, grassroots interventions can also help in enhancing condom adoption and
lesser risk taking by Male Sex Workers.

Table – 21
Sexual practices, behaviour and client profile of MSW by Marital status

Sexual practices, behaviour

Sexual history
and client profile (N=75)
Sex for
Condom Condom
money/
use use
Marital status gifts (6 months) (Last time)
(Last time)
(%) (%)
(%)
71 66 63
TOTAL
94.7 88.0 84.0
44 40 39
Unmarried
58.6 53.3 52.0
23 22 21
Married living with spouse
30.7 29.3 28.0
1 1 1
Married living without spouse
1.3 1.3 1.3
3 3 2
Separated/ Divorced
4.0 4.0 2.7

According to the data presented in Table – 21, the sexual behaviour and practices of MSW are
highlighted based on their marital status. The data reveals that 59 percent of MSW who
engaged in sex in exchange for money, gifts, etc. are unmarried while 36 percent were ever-
married. Condom use data indicates that 53 percent of unmarried respondents reportedly used
condoms consistently during the last 6 months and a similar number, 52 percent reported condom
use during their last sexual encounter. This may be due to the fact that majority of the respondents
are unmarried. However, it is also of concern to note that only about half the respondents use
condoms and this needs to be scaled up to reduce risk of HIV infection.
Table – 22
Sexual practices, behaviour and client profile of MSW by Occupation

Sexual practices, behaviour

Sexual history
and client profile (N=75)
Sex for
Condom Condom
money/
use use
Occupation gifts (6 months) (Last time)
(Last time)
(%) (%)
(%)
71 66 63
TOTAL
94.7 88.0 84.0

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5 4 5
Unemployed
6.7 5.3 6.7
10 10 9
Full-time
13.3 13.3 12.0
56 52 49
Part-time
77.9 69.3 65.3

The occupation-wise classification of sexual practices of clients may be observed in Table - 22

given above. It may be observed that as majority MSW are employed in part-time jobs,
larger number among such MSW, 78 percent said they had sex in exchange for money,
gifts, etc., followed by 13 percent who are in full-time jobs who said they had such paid sex.
Condom use, both consistent use over 6 months and use during last time are reportedly high by
part-time employed MSW, 69 percent and 65 percent respectively compared to MSW with full-
time jobs, around 12 to 13 percent reporting condom use (consistent use as well as use during last
time).
Table – 23
Sexual practices, behaviour and client profile of MSW by Income

Sexual practices, behaviour

Sexual history
and client profile (N=75)
Sex for
Condom Condom
money/
use use
Average Income PM gifts (6 months) (Last time)
(Last time)
(%) (%)
(%)
71 66 63
TOTAL
94.7 88.0 84.0
Income (all sources)
37 35 35
< Rs.2500
49.3 46.7 46.7
26 23 22
Rs.2501 – Rs.5000
34.7 30.7 29.3
6 8 6
> Rs.5001
8.0 10.7 8.0
Income (sex work)
66 62 58
< Rs.1500
88.0 82.7 77.4
2 1 2
Rs.1501 – Rs.3000
2.7 1.3 2.7
3 3 3
> Rs.3001
4.0 4.0 4.0

According to the data presented in Table – 23, the sexual practices, behaviour and client profile of
MSW by income is analysed. The data reveals that majority of MSW, 50 percent who had sex
in exchange for money during last time earn below Rs.2500/- a month and 35 percent of those
reporting similar behaviour earn between Rs.2501/- and Rs.5000/- per month. It is also important
to note that larger number of MSW, 88 percent who engaged in paid sex during last sexual
encounter earn up to Rs.1500/- from sex work. A similar pattern is observed with regard to
condom use. Income levels of clients match those of MSW and therefore they may be said to be
of the same economic class. Consistent condom use and condom use during last encounter are
reportedly high among those earning low incomes though the same may be as mentioned earlier

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due to better interventions at grassroots by NGO/ CBO. MSW with higher incomes too, exhibit
better condom use patterns that point out to affordability of condoms.

It is noteworthy that those MSW who earn higher incomes adopt safer sex practices as they can
afford them. With respect to condoms, discussions revealed that MSW are not satisfied with
cheap or freely distributed condoms that tear or break on use. MSW prefer to use well lubricated
condoms especially during anal sex. Condom use during oral sex is not popular as risk perception
of spread of infection through the mouth is reportedly unheard of among MSW though a few
insist that their clients use condoms during oral sex too. MSW know about and prefer flavoured
condoms for oral sex but are concerned about the cost of use. (A pack of 3’s of good lubricated/
flavoured condoms costs at least Rs.15/- that cannot be afforded by all MSW). Many reportedly
carry condoms at all times (powdered/ jelly filled) and are known to negotiate condom use with
clients. However, it has been noticed that intimacy of relationships (especially recreational sex)
may lead to increased instances of unprotected sex.

8.2 Type of sex, condom use and risk

Sexual practices

The tables given below provide an analysis of the type of sex popular among MSW in
Ahmedabad City. An overview of the type of sex indicates that all MSW, 100 percent engage in
anal sex followed by 96 percent in oral sex and 67 percent ‘thigh’ sex where clients use the
thighs of MSW to have sex. Further, 9 percent reported having vaginal sex (presumably
bisexuals) and 1 percent engage in other sex acts (‘rolling sex’ where two sexual partners roll on
the cot or ground while having sex, ‘body sex’, also involving licking the whole body of the
sexual partner and ‘group sex’ where more than three to four sex partners fondle and have sex
together). Other sexual practices include ‘Rimming’ or licking the anal portions of sex partners
that is reportedly popular among MSW.

Table – 24
Type of sex by MSW by Age Group

Type of sex Type of Sex (N=75)

Oral Anal Vaginal Thigh Others
Age
(%) (%) (%) (%) (%)
72 75 7 50 1
TOTAL
96.0 100.0 9.3 66.7 1.3
1 1 1
< 18 --- ---
1.3 1.3 1.3
28 31 1 17
19-25 ---
37.3 41.3 1.3 22.7
20 20 3 17 1
26-32
18.7 18.7 4.0 22.7 1.3
13 13 3 9
33-39 ---
17.3 17.3 4.0 12.0
10 10 6
40 & > --- ---
13.3 13.3 8.0

The age-wise distribution of type of sex by MSW is depicted in Table –24. It is observed that a
majority of those involved in oral sex, 37 percent are in the 19-25 age group followed by 19
percent who are 26 to 32 years old. A similar pattern is visible in the case of MSW engaging in

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anal sex with 41 percent in the 19-25 age group and around half that number, 19 percent having
anal sex are older (26-32 years of age) and an equal number of 23 percent involved in thigh sex
also are in the age group of 19-25 years and 26-32 years However, in the case of vaginal sex,
more number of MSW, 4 percent belonged to the older age group of 26-32 years and an equal
percent in the 33-39 age group.

This indicates that oral and anal sex is very popular among MSW. In Ahmedabad city, many
MSW perceive themselves as Panthi and hence play the role of the penetrative partner during sex
act. Thus, they may have a preference for anal sex compared to other sexual types though oral
and thigh sex are also very popular.

Table – 25
Type of sex by MSW by Marital Status

Type of sex Type of Sex (N=75)

Oral Anal Vaginal Thigh Others
Marital status
(%) (%) (%) (%) (%)
72 75 7 50 1
TOTAL
96.0 100.0 9.3 66.7 1.3
5 5 4
Unmarried --- ---
6.7 6.7 5.3
10 10 8
Married living with spouse --- ---
13.3 13.3 10.7
57 60 7 38 1
Married living without spouse
82.0 80.0 9.3 50.7 1.3

Table -25 given above describes the type of sex activity preferred by MSW in relation to their
marital status. It is interesting to note from the data that among MSW engaging in oral sex, 82
percent are married but living without spouse compared to 13 percent married with spouse and 7
percent unmarried respondents. Similar patterns can be observed in other sex type of MSW – 80
percent engaging in anal sex are married living without spouse, in contrast to 13 percent married
and with spouse and 7 percent unmarried. Among respondents engaging in thigh sex, 51 percent
are married living without spouse, 11 percent married living with spouse and only 5 percent
unmarried.

Comment

The type of sex that is popular among male sex workers is definitely anal sex though a large
number also engage in oral sex, especially the transgender community. Moreover, the younger
age group are known to enjoy variations in different kinds of sex though there is a preference for
anal sex. As mentioned earlier, anal sex activity may be attributed to more number of MSW
identifying themselves as panthi. Ahmedabad may not have classic ‘hustlers’ and many men
having sex with men in lower socio-economic strata engage in sex work when employed in part-
time jobs.

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8.3 Violence, criminalisation

Violence and criminal assault

The following tables depict the extent of sex-related violence that MSW faced from their clients
and others as a result of engaging in sex work. It is important to note that around half the
number of MSWs interviewed, 48 percent experienced acts of violence committed against
them and so did a similar number, 44 percent reportedly faced criminal assault – booked by
police and law enforcing authorities on false charges of being public nuisance, false petty cases
and the like and harassed in custody.

Table – 26
Violence and criminal assault against MSW by Age group

Forced sex, violence and

Violence, etc.
criminal assault (N=75)
Forced sex Criminal
Age group & violence assault
(percent) (percent)
36 33
TOTAL
48.0 44.0
1
< 18 ---
1.3
12 9
19-25
16.0 12.0
10 11
26-32
13.3 14.7
7 8
33-39
9.3 10.7
6 5
40 & >
8.0 6.7

The age-wise distribution of forced sex and violence as well as criminal assault is described in
Table – 26. From the above table, it may be observed that a majority of the younger MSW, 16
percent in the age group of 19 to 25 years were forced to have sex with their clients and acts
of violence were perpetrated against them. Comparatively, 13 percent in the 26 to 32 age group
said they faced such sex-related violence. Moreover, 9 percent of older respondents in the 33-39
age group also reported such violence. This indicates that age is not a factor and sex related
violence occurs among all MSW for which they have no recourse as they are unorganised and
most instances go unreported. Many described about being burnt over the body with cigarette
buts, thrashed and beaten on their backs and sex organs, made to indulge in painful sex acts,
gagged and forced to have sex. Many MSW however view such acts as rare instances by a few
clients whom they consider facing a psychological problem. It is also seen that clients who pay
more indulge in such harsh treatment while having sex.

With regard to criminal assault however, majority of the respondents, 15 percent were in the
26 to 32 years age group followed by 12 percent in the younger age group of 19-25 years.
Around 11 percent of older MSW in the 33-39 age group also faced criminal charges against
them.

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Table – 27
Violence and criminal assault against MSW by Income
Forced sex, violence and
Violence, etc.
criminal assault (N=75)
Income Forced sex Criminal
(all sources) & violence assault
(percent) (percent)
36 33
TOTAL
48.0 44.0
21 15
< Rs.2500
28.0 20.0
10 13
Rs.2501 – Rs.5000
13.3 17.3
5 5
> Rs.5001
6.7 6.7

According to the data given in Table - 27 above, violence and criminal assault against MSW with
respect to their average monthly income from all sources is analysed. It may be noticed from the
above data that incidence of forced sex and sexual violence is higher among more number of
the MSW, 28 percent earning lower income of up to Rs.2500/- a month, compared to that of
MSWs earning between Rs.2501 and Rs.5000 a month, 13 percent. Similar trends can be
witnessed in the case of criminal assault by police and goondas whereby 20 percent of MSW
earning lower monthly incomes are victimised in contrast to 17 percent who earn comparatively
higher income.
Comment
Male Sex Workers in Ahmedabad acknowledge that many are harassed, forced to have sex and
unwanted sexual acts as well as face false criminal charges levelled against them by the police
and public. Hence, their self-esteem is very low and they are not confident of facing such
problems as others brand them as morally wrong doers. Male sex workers are known to be
especially dejected when they face problems by people they move with very closely -–such as
clients and their own mates. Economic concerns precede over other issues and MSW are left to
face problems by themselves. It is also observed that because of such disorganisation among
them, it is very difficult to target them or organise them to fight for their rights. Similarly,
targeting them for interventions thus becomes a Herculean task and only through community
based organisations of MSW themselves can succeed in outreach activities. Moreover, proper
sensitisation among police force and law enforcing authorities, media and general public is
viewed as critical to the betterment of conditions of MSW in Ahmedabad.

Unique Ahmedabad!

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9.0 HIV/ AIDS Prevention, Treatment, Care and Support Services

9.1 Awareness, sources and sexual behaviour

The tables given below provide information on the extent of awareness of MSW on HIV/ AIDS,
source of awareness and resultant sexual behaviour. Indications are that there is total awareness
with all 100 percent of respondents stating they are aware about HIV/AIDS. Statistics also
reveals that awareness on HIV/ AIDS is 100 percent among clients of MSW in Ahmedabad City.

Table – 28
Awareness on HIV/AIDS of MSW by Age group

Awareness on
Awareness HIV/ AIDS
(N=75)
Age in Average
completed age of
Age group
years client
(Percent) (Percent)
75 75
TOTAL
100.0 100.0
1
< 18 ---
1.3
31 34
19-25
41.3 45.3
20 32
26-32
18.7 46.7
13 8
33-39
17.3 10.7
10 1
40 & >
13.3 1.3

The age-wise distribution of HIV/AIDS awareness among MSW and their clients is described in
Table - 28 above. It may be seen that while majority of the MSW, 41 percent in the 19-25
years age group are aware of HIV/ AIDS, only 19 percent in the 26-32 year age group are
aware of the same and only 17 percent of those in the 33-39 years are range are aware of HIV/
AIDS. Among clients, a different pattern emerges. Though majority of clients, 45 percent aware
of HIV/ AIDS are in the 19-25 year age group, 47 percent of older clients in the 26-32 years age
group are aware of HIV/ AIDS.

Table – 29
Awareness on HIV/AIDS of MSW by Education

Education status of MSW (N = 75)

Responses
Education
(Percent)
75
TOTAL
100.0
10
Illiterate
13.3
Primary 22

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29.3
27
Middle school
36.0
10
Higher Secondary
13.3
2
Technical
2.7
4
Higher Education
5.3

The data presented in Table - 29 above describes the awareness of MSW on HIV/ AIDS with
respect to their educational status. It may be observed from the data that education plays an
important role to play in increased awareness on HIV/ AIDS. As evident from the table,
majority of the respondents, 36 percent who were aware of HIV/ AIDS were educated up to
middle school level followed by 29 percent who had primary education and 13 percent who were
educated up to higher secondary level. Awareness among MSW with technical and higher
education is high with almost all respondents being aware of HIV/ AIDS. Hence, education is an
important factor in enhancing knowledge and awareness, more so because educated MSW are
able to read and respond to IEC and prevention or behaviour change communication messages
displayed by grassroots level HIV/AIDS interventions.
Figure – 11
Sources of Awareness on HIV/AIDS of MSW

Sources of awareness on HIV/AIDS

98.7
100 88

80 72
66.7
56 53.3
60 52
45.3

40

20
1.3
0
Sources of awareness
Television Radio Newspaper
Poster Pamphlet Doctor
NGO/ CBO Friends Other sources

The main sources of awareness of HIV/ AIDS messages is depicted in Figure-11 given above.
From the same, it may be observed that NGO/ CBO, is an important media, 74 percent
followed by friends, peers or colleagues, 66 percent Television 54 percent and Posters,
hoarding and messages displayed in public places 50 percent. Other important sources of
awareness on HIV/ AIDS include Pamphlets, 42 percent, Doctor, 40 percent, Newspapers, 39
percent and Radio, 34 percent Posters. Hence, in disseminating prevention messages, it is
important to focus one-to-one communication by NGO/CBO workers, doctors and peers are also

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seen as important channels to provide vital information to the hidden male sex worker
community. Besides popular mass and electronic as well as print media such as Television,
Radio, Newspapers, Posters and Pamphlets may be effectively used to improve awareness on
HIV/ AIDS.
Table – 30
Awareness on HIV/AIDS and sexual behaviour of MSW

Awareness on HIV/AIDS and

behaviour of MSW (N = 75)
Responses
Sexual behaviour
(Percent)
71
Last time had sex for money/ gifts, etc. (MSW)
94.7
63
Last time used condoms while having sex
84.0

Awareness of MSW on HIV/AIDS and resultant sexual behaviour is analysed in Table -30 given
above. From the table, it may be observed that among MSW who are aware of HIV/ AIDS, a
high 95 percent reportedly had sex in exchange for money, gifts, etc. during the last time and
among MSW aware of HIV/ AIDS, 84 percent reported using condoms during the last time they
had sex. This indicates that though awareness on HIV/ AIDS is high and engaging in sex in
exchange for money is prevalent (indicating high level of multi-partner sexual activity) such
knowledge is not translated into changed behaviour as unprotected sex is high. This points at the
need to strengthen Behaviour Change Communication measures among the target audience –
MSW in order to enhance knowledge and awareness and result in adoption of safe sex methods to
prevent HIV infection. As seen earlier, MSW do not also perceive risk of infection as a result of
anal or oral sex. (Many simply have the misconception that HIV infection can be spread only
through vaginal sex with female commercial sex workers).

Transvestite dancing with boy during a cultural festival that is very popular during specific seasons

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9.2 Availability and access to services

Awareness, Availability and Access to services by MSW

The following tables provide an understanding of the awareness on HIV/ AIDS related services
provided by NGOs/ CBOs by the Male Sex Workers in Ahmedabad city, availability of such
services and accessibility of such services by MSW. The overall scenario on service awareness,
availability and access reveals that all MSW in the city are aware of such services, 100 percent
though fewer numbers are aware of the range of services offered such as condoms, 75 percent
medicines, 72 percent clinical facilities (testing and treatment), 51 percent counselling and
referral services and are neither aware where such services are offered and by whom, 25 percent
(NGO/ CBO/ Government/ private/ traditional systems). However, overall access to available
services among those who are aware is high with all MSW stating that they access services
they are aware of.

Table – 31
Awareness, Availability and Access to services by MSW by Age Group

Service access Awareness, Availability and Access to services (N=75)

Range of services
Age Aware NGO Condom Clinic Drugs Jelly Access
(%) (%) (%) (%) (%) (%) (%)
75 19 56 38 54 55 75
TOTAL
100.0 25.3 74.7 50.7 72.0 73.3 100.0
1 1 1 1 1
< 18 --- ---
1.3 1.3 1.3 1.3 1.3
31 6 5 3 31
19-25
41.3 8.0 6.7 4.0 --- --- 41.3
20 14 3 2 1 20
26-32
18.7 18.7 --- 4.0 2.7 1.3 18.7
13 6 6 1 6 6 13
33-39
17.3 8.0 8.0 1.3 8.0 8.0 17.3
10 4 6 6 6 10
40 & > ---
13.3 5.3 8.0 8.0 8.0 13.3

Table -31 provides an insight into the awareness, availability and access to health and related
services for MSW with respect to their age. It may be seen that majority of MSW aware of
such services, 41 percent are in the 19-25 age group followed by older MSW in the 26-32 age
group, 19 percent and those in 33-39 age group, 17 percent. However, only 25 percent said they
knew only of NGO/ CBO providing such services. The entire range of services is not known to
many respondents and only few mentioned of condoms, clinical services, drugs and provision of
jelly as part of treatment services available to MSW in the city. Accessibility to services is high
among those who are aware of such services and is proportionately spread across age groups that
are aware of such services, and data indicates that information or increased awareness of
availability of services is more likely to enhance use of such available services.

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Table – 32
Awareness, Availability and Access to services by MSW by Education

Service access Awareness, Availability and Access to services (N=75)

Range of services
Education Aware NGO Condom Clinic Drugs Jelly Access
(%) (%) (%) (%) (%) (%) (%)
75 19 56 38 54 55 75
TOTAL
100.0 25.3 74.7 50.7 72.0 73.3 100.0
10 5 5 3 4 5 10
Illiterate
13.3 6.7 6.7 4.0 5.3 6.7 13.3
22 6 17 11 17 17 22
Primary
29.3 8.0 22.7 14.7 22.7 22.7 29.3
27 5 21 15 21 20 27
Middle school
36.0 6.7 28.0 20.0 28.0 18.7 36.0
10 1 9 6 9 9 10
Higher Secondary
13.3 1.3 12.0 8.0 12.0 12.0 13.3
2 2 1 1 2 2
Higher Education ---
2.7 2.7 1.3 1.3 2.7 2.7
4 2 2 2 2 2 4
No Response
5.3 2.7 2.7 2.7 2.7 2.7 5.3

From the above Table – 32, the education-wise distribution of service awareness, availability and
access may be ascertained. It is evident from the above data that more educated MSW, 36
percent educated up to middle school level and 13 percent with higher secondary education
are aware of treatment services and also access such services. It is also evident that many
respondents educated only up to primary level, 29 percent are aware of services and all those who
access services access the same. Though the numbers indicate that service access is poor despite
good awareness, among those who have accessed such services, it is observed that they are more
educated and therefore education and increased awareness is an important variable in improving
service access.
Table – 33
Awareness, Availability and Access to services by MSW by Marital status

Service access Awareness, Availability and Access to services (N=75)

Range of services
Marital status Aware NGO Condom Clinic Drugs Jelly Access
(%) (%) (%) (%) (%) (%) (%)
75 19 56 38 54 55 75
TOTAL
100.0 25.3 74.7 50.7 72.0 73.3 100.0
45 9 36 26 34 36 45
Unmarried
60.0 12.0 48.0 34.7 45.3 48.0 60.0
26 10 16 10 16 15 26
Married, living with spouse
34.7 13.3 21.3 13.3 21.3 20.0 34.7
1 1 1 1 1 1
Married, living without spouse ---
1.3 1.3 1.3 1.3 1.3 1.3
3 3 1 3 3 3
Separated/ Divorced ---
4.0 4.0 1.3 4.0 4.0 4.0

The data in Table -33 presented above describes the awareness, availability and access to services
with respect to marital status of the MSW in Ahmedabad City. It may be seen that as more
number of respondents are unmarried, so are more unmarried MSW aware of such services,

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more than half the respondents, 60 percent and all who know of such services access the same.
It may also be observed that proportionately most married respondents know of such services and
knowledge is equal to access of services.

9.3 Barriers in accessing services and suggestions

Only few respondents were able to directly mention various barriers faced in accessing services in
the quantitative study. However, from the discussions and qualitative phase, inputs reveal that
there are several barriers that male sex workers need to overcome to access services even if
awareness levels are high. The key issue is availability of such services. Not all range of
services are offered that are needed by MSW. The only services that MSW seem to know include
condoms, clinics, drugs and provision of jelly for pain in sex organs. However, they opine that
services not available readily are counselling, diagnosis and testing and provision of free
medicines for all sex-related diseases (including STI and HIV infection). Moreover, such
services are not easily accessible, as they are located in inconvenient locations where
respondents have to cover long distances for access. Respondents have complained of ill-
equipped centres with poor infrastructure and non-availability of personnel.
Male sex workers in Ahmedabad have mentioned about poor range of services among service
providers. The extent of services provided by Non-Governmental Organisations/ CBOs is either
not substantial or is unknown to a large target audience. This calls for establishing effective
linkages and networking of institutions to disseminate information on available services that may
be accessed by MSW in the city. MSW living or working in outer areas and in the suburbs face
specific problems in commuting to the main city and accessing prominent health care facilities.
They are also concerned about issues such as stigma and discrimination or identification by
known friends/ family members. Thus such issues need to be addressed to provide services at
convenient locations where MSW aggregate, work or solicit clients. With regard to services, they
also prefer to access free services and would like to receive even drugs and medicines free of
charge for sexually transmitted infections (STIs), HIV prevention and Opportunistic Infections
(OIs). This is because many of the MSW hail from weaker socio-economic strata and therefore
are unable to afford money for drugs and medicines. Many are known to take self-medication and
seek medical help from friends/ peers as well as in the pharmacy. Many MSW are known to
access free treatment at government hospitals and clinics but are unhappy with the quality of
services and attention given to them by the personnel. Not many are aware of the numerous
NGOs/ CBOs and services they offer in the city. Besides, interventions focussing on condom
promotion are lacking explaining for poor condom use among many MSW. This enhances risk
but many MSW do not perceive appropriate risk in engaging in unprotected sex mainly with other
men or women.

Kankaria Lake, at the heart of Ahmedabad City that is also an MSW hotspot

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9.4 Problems faced by Male Sex Workers

Figure – 12
Problems faced by MSW

Problems faced by MSW

100 85.3
74
80 65.4
53.3 58.6
56 53.3
60 50.7 48
41.3
40
20
4
0
Problems faced

Jealousy Robbing clients Police harassment

Blackmailing Cheating/ free sex Switching loyalty
Hiding from family Fear of disclosure No consent to open
Exposure Other problems

According to Figure-12 portrayed above, the problems faced by MSW in Ahmedabad City is
examined. The data indicates that Male Sex Workers face a host of problems. The most pressing
problems that surface are jealousy between sex workers themselves, 85 percent that points out
to intra-community (among Kotis, Dublis, Masseurs for clients and money) and inter-
community (between hijras and others for control of areas/ leadership) conflicts prevalent
among male sex workers, such as robbing of clients from friends/ other MSW, 74 percent. Most
of the other problems identified are on an individual basis such as cheating by customers or not
paying agreed sum after sex, 65 percent, switching customers/ clients. Here, it is important to
note that older MSW see younger MSW as their rivals as clients prefer younger (stronger) male
sex workers. This also indicates that younger sex workers are paid better than older ones and
hence this develops into conflict between sex workers. Other reasons for concern among MSW
include hiding their behaviour from family members, 56 percent as many carry on the sex
work without knowledge of the family with sisters of marriageable age and younger siblings
whom they have to support economically, harassment and forced sex by police, 53 percent and
constant threat of being exposed in society by friends/ peers or even clients in public, an
equal 53 percent. Many are worried about being ostracised when discovered that they are sex
workers, being blackmailed, 50 percent. While 41 percent feared that they might disclose their
sex-related behaviour to their families, 48 percent said they were afraid that others would reveal
their involvement in sex activity without their consent. Around 4 percent MSW said they
faced other problems as being betrayed by own community, threats from relatives and fear of
goondas or rowdies.

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10.0 MALE SEX WORKERS IN INDIA

VIJAYAWADA CITY

A bird’s eye view of Vijayawada City from atop the hill

Vijayawada, in Andhra Pradesh is located at the head of the Krishna delta, 70km from the sea.
Earlier known as Bezwada it has a long and glorious history and is famous for traditional
handcrafted wooden toys. The present name is derived from the presiding deity, Kanakdurga also
called Vijaya. The city, a major railway Junction is picturesquely surrounded by hills on three
sides, with the swiftly flowing waters of the Krishna river on the south. Today it is a thriving
business centre and a convenient base from which to visit varied historical sites. With a
population of over 8,45,300 people, it is a growing city and is one of the important cities after the
capital Hyderabad in Andhra Pradesh. Telugu, Hindi and English are the main languages
though one can find many people speaking Tamil and Kannada as these are languages of
neighbouring states.

The analysis of the quantitative data begins with the socio-demographic profile of Male Sex
Workers in Vijayawada in order to understand the physical and environmental conditions that
affect MSW and also lead to a better understanding of the respondents through a macro
perspective.

An analysis of the socio-demographic profile of the MSW reveals that 51 percent are between 19
and 25 years of age, and 79 percent reported having their first sexual experience and 69 percent
reportedly involved in sex first in exchange for money, gifts, etc., when they were below 18 years
of age. Further, 55 percent opined that the average age of their clients is between 19 and 25
years. Education status indicates that 41 percent have studied only up to middle school, and a
majority comprising 56 percent are unmarried. Occupational status data shows that 45 percent are
employed in full-time jobs, with 52 percent earning below Rs.2500 a month from all sources and
81 percent earning up to Rs.1500 from engaging in sex work. Statistics also reveal that 84 percent
view television and 33 percent listen to the radio and 29 percent read the newspapers and that 73
percent have the habit of consuming alcohol and 47 percent are smokers.

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10.1 Socio-demographic characteristics

Figure – 1
Age of Male Sex Workers (MSW)

Age in completed years

10.7 2.7 2.7

33.3 50.7

< 18 Years 19-25 Years 26-32 Years

33-39 Years Above 40 Yrs.

According to the data presented in Figure-1 given above, the age of Male Sex Workers in
Vijayawada City has been described.

It may be observed that a majority of the MSW, 51 percent are between 19 and 25 years of
age, followed by 33 percent who are older in the 26 to 32 years age group. While 11 percent of
the MSW interviewed in the study are between 33 and 39 years, 3 percent are below 18 years of
age. An equal 3 percent are above 40 years of age. Hence, it may be concluded that a majority of
the Male Sex Workers in Vijayawada are younger.

Figure – 2
Age at first sex and Age at first Commercial Sex of Male Sex Workers (MSW)

Age in completed years

78.7
69.3
80

60
26.7
40 20
4
1.3
20

0
< 18 19-25 26-33
Years Years Years

Age at 1st sex Age at 1st com. Sex

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Figure-2 above portrays the age at first sex and age when MSW first had sex in exchange
for money, gifts, etc., of Male Sex Workers in Vijayawada City. It is seen from Figure-2
that 79 percent reported having their first sexual experience below 18 years of age
while 20 percent said their first sex experience occurred when they were between 19 and
25 years old. However with respect to the age at which the MSW had sex for the first
time in exchange for money, gifts, etc., it is seen that while 69 percent reported such
experience when they were were between 19 and 25 years of age, 27 percent reported
engaging in paid sex first when they were below 18 years of age.
Figure – 3
Average Age of the clients of Male Sex Workers (MSW)

Average Age of clients of MSW

54.7
60
50
36
40
30
20
8
10 1.3 0
0
Avg. age of client

< 18 19-25 26-32 33-39 40 & >

Figure-3 analyses the average age of the clients of the Male Sex Workers that reveals a different
pattern. While majority of the MSW, 55 percent opined that the average age of the clients is
between 19 to 25 years, a sizeable number, 36 percent said their clients were old 26 to 32 years
of age. Only 8 percent reported that their clients were older in the 33 to 39 years age group. This
indicates that older clients prefer younger persons as their partners and there is a large demand for
young boys.

The deity at Kanaka Durga Temple

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Figure – 4
Educational status of Male Sex Workers (MSW)

Education status of MSW

50 41.3
40
30
20 21.3
20
9.3
10 6.7
1.3 0
0
Education

Illiterate Primary Middle school

Hr. Sec. Technical Hr. Edu.
No Resp.

The educational status of the MSW is indicated in Figure-4 above. It is noticed that majority of
the MSW interviewed, 41 percent have completed only up to middle school followed by 22
percent who are educated up to higher secondary and 20 percent have had only primary
education. This indicates poor education levels among male sex workers that points out to the
need to cater to information and education needs of respondents with respect to health/ HIV/
AIDS efforts.
Figure – 5
Marital status of Male Sex Workers (MSW)

Marital Status of MSW

56
60
50
37.3
40
30
20
10 2.7 4 0
0
Marital status

Unmarried
Married, living with spouse
Married, living without spouse
Separated/ Divorced
No Response

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Figure-5 describes the marital status of the MSW covered in the study. With a predominantly
large younger group, expectedly a large 56 percent are unmarried. Among ever-married
MSW, a high 37 percent are living with their spouse and only 3 percent are living without their
spouse. Marriage is a crucial factor as it determines risk and vulnerability to HIV infection during
unprotected sex.
Figure – 6
Occupational status of Male Sex Workers (MSW)

Occupation Status of MSW

45.3
50
36
40
30 18.7
20
10
0
Occupation
Unemployed
Full-time employed
Part time employed

From Figure-6, the occupational status of the MSW may be ascertained. The data reveals that
majority of the respondents, 45 percent are employed in full-time jobs while 36 percent are
engaged in part-time jobs and 19 percent are unemployed. The type of occupations that have
been observed include petty traders, rickshaw pullers, male commercial sex workers, vendors,
drivers, and the like. A few have taken up working with NGO/ CBO as peers and volunteers and
continue to engage in sex work.
Figure – 7
Average monthly income of Male Sex Workers (MSW) (All sources)

Average Monthly Income - all sources

8
40

52

< Rs.2500 Rs.2501 – Rs.5000 > Rs.5001

According to Figure-7, the gross Average Monthly Income of the MSW has been recorded. This
indicates that abouth half the number of respondents, 52 percent earn between Rs.2501 and
Rs.5000 from all sources while 40 percent earn below Rs.2500 a month. Only 8 percent
reportedly earn more than Rs.5001 a month. It may therefore be concluded that the economic
condition of MSW is not very good and many are forced to work hard for a living. This may be a
motivating factor for MSW to take up sex work as alternate means of income generation.

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Figure – 8
Average monthly income of Male Sex Workers (MSW) (Sex work)

Average Monthly Income - sex work

14.7 4

81.3

<Rs.1500 Rs.1501-3000 >Rs.5001

The average monthly income of MSW from sex work is described in Figure-8. From the table, it
may be inferred that a large number, 81 percent earn up to Rs.1500 from engaging in sex work
followed by only 15 percent who earn between Rs.1501 and Rs.3000 from sex work alone. This
is done to augment their meagre income they earn from their full-time employment It is also
observed that in certain instances, clients offer money willingly and when satisfied with sexual
experience are reported to pay extra to MSW in gratitude. In Vijayawada typically, many MSW
hail from middle class or lower middle class families, live with parents and siblings but engage in
sex work too in addition to regular employment without the knowledge of the family.
10.2 Lifestyle, environmental influences

Figure - 9
Media habits of Male Sex Workers (MSW)

Media habits of MSW

100
84
80

60
33.3
40 29.3

20 6.7 0
0
Media channels

Television Radio Newspaper

Magazines Cinema

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The media habits of the MSW in this study may be gauged from the multiple response Figure-9
given above. It is observed that majority of the MSW, 84 percent view television and 33
percent listen to the radio. A lesser number, 29 percent also reportedly read the newspapers.
Only 7 percent read magazines and none keenly watch movies. It may thus be concluded that
MSW are exposed to both electronic and print mass media and hence these may be used for
getting messages on prevention, education, treatment, care and support in relation to HIV/ AIDS.
Figure – 10
Other habits of Male Sex Workers (MSW)

Other habits of MSW

80 73.3

70
60
46.7
50
36
40
30
20 13.3

10 1.3

0
Other habits
Smoking Alcoholism
Drugs Consuming tobacco
Other habits

Figure-10 presented above describes the other habits of MSW. It may be seen from the above
table that 73 percent have the habit of consuming alcohol and 47 percent are smokers. A
large number, 36 percent also reported chewing tobacco (local ‘paan’) and many are addicted to
locally available tobacco and ‘masalas’ with intoxicants. A good number, 13 percent also
reported taking drugs. Such habits as alcoholism and drugs are known to induce to poor adoption
of protective measures leading to increased risk of HIV infection.

Comment

Profile of a typical MSW in Vijayawada City

From a study of the overall socio-demographic profile of Male Sex Workers in Vijayawada City,
a typical profile of an MSW may be constructed. Thus, a male Sex Worker in this city is young,
say around 22 years of age, who had his first sexual experience below the age of 18 years, and
had sex in exchange of money, gifts, etc., for the first time when between 19 and 25 years of age.
This MSW caters to most clients in the age group of 26-32 years. The typical MSW is educated
up to middle school, unmarried, employed in some full-time occupation and also engages in sex
work on a part-time basis. The average gross monthly income from all sources is between
Rs.2501/- to Rs.5000/- and to augment income earns up to Rs.1500/- through sex work. The
typical MSW is a keen TV viewer, listens to the radio and also reads newspaper regularly. Other

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habits include taking alcohol, smoking, and usually chewing tobacco in various forms. The
MSW exhibits a casual attitude and is always looking for new clients and engaging in sex in
exchange for money whenever possible.

The Bridge spanning the Krishna River

10.3 Identity and sub-types

Awareness of MSW on types and subtypes of Male Sex Workers in Vijayawada City

Table – 9
Awareness of Male Sex Workers Genre by MSW by Age Group

Awareness Male Sex Worker Subtypes (N=75)

Koti Panthi Dubli Hijra Gigolo Masseur Escort Londa Dancer
Age
(%) (%) (%) (%) (%) (%) (%) (%) (%)
75 75 75 69 10 43 8
TOTAL --- ---
100.0 100.0 100.0 92.0 13.3 57.3 10.7
2 2 2 2
< 18 --- --- --- --- ---
2.7 2.7 2.7 2.7
38 38 34 34 4 22 4
19-25 --- ---
50.7 50.7 45.3 45.3 5.3 29.3 5.3
25 25 25 24 5 16 4
26-32 --- ---
33.3 33.3 33.3 32.0 6.7 21.3 5.3
8 8 7 7 1 4
33-39 --- --- ---
10.7 10.7 9.3 9.3 1.3 5.3
2 2 2 2 1
40 & > --- --- --- ---
2.7 2.7 2.7 2.7 1.3

The data in table - 9 presented above describes the Male Sex Workers awareness of the various
types and sub-types of MSW that are reportedly existing in society in various proportions with
respect to their age.

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Comment

The overall analysis of MSW on awareness pertaining to MSW genre indicates that a majority
of the MSW in Vijayawada City is aware of predominantly main groups in the MSW
network in the city. While all respondents, 100 percent know about Koti, Panthi and Dubli. A
lesser number, 92 percent knew of Hijra and 57 hear about Masseurs. However, only 13 percent
knew about Gigolo and 11 percent heard reportedly heard of Dancer as a subtype of MSW in
Vijayawada City.

An analysis of the age-wise classification of data reveals that among those aware of Koti and
Panthi, an identical 51 percent are in the 19 to 25 years age group, followed by 33 percent in the
26 to 32 years age group. 11 percentage of respondents aware of Koti were between 33 and 39
years of age. A similar trend is observed in the case of those aware of Dubli, with 45 percent in
the 19 to 25 years age group, followed by 33 percent in the 26 to 32 years age group and 9
percent between 33 and 39 years of age. Among those aware of Hijra, 45 percent are in the 19 to
25 years age group, followed by 32 percent in the 26 to 32 years age group and 9 percent between
33 and 39 years of age.
Table – 10
Awareness of Male Sex Workers Genre by MSW by Education

Awareness Male Sex Worker Subtypes (N=75)

Koti Panthi Dubli Hijra Gigolo Masseur Escort Londa Dancer
Education
(%) (%) (%) (%) (%) (%) (%) (%) (%)
75 75 75 69 10 43 8
TOTAL --- ---
100.0 100.0 100.0 92.0 13.3 57.3 10.7
5 5 4 3
Illiterate --- --- --- --- ---
6.7 6.7 5.3 4.0
15 15 12 15 3 8 1
Primary --- ---
20.0 20.0 16.0 20.0 4.0 10.7 1.3
31 31 35 30 3 18 2
Middle --- ---
41.9 41.9 66.7 40.6 4.0 24.0 2.7
16 16 16 14 4 13 5
Hr. Sec. --- ---
21.3 21.3 21.3 18.7 5.3 17.3 6.7
7 7 7 6 4
Technical --- --- --- ---
9.3 9.3 9.3 8.0 5.3
1 1 1 1
Hr. Education --- --- --- --- ---
1.3 1.3 1.3 1.3

Table - 10 depicts the Male Sex Worker’s understanding of the various types and sub-types
prevalent with respect to their education. It may be deduced from the above data that majority of
the respondents aware of various types and sub-types within MSW are educated up to
middle school. The data indicates that majority of the respondents aware of Koti, Panthi, Dubli
and Hijra are educated up to middle school, 42 percent, 42 percent, 68 percent, 41 percent
respectively. Comparatively, a lesser number aware of the same subtypes are educated up to
higher secondary level, 18 to 21 percent of all respondents aware of such categories. It is also
observed that around 20 percent of respondents aware of these major groups are educated up to
20 percent. It may be observed from the data that educated respondents are more aware of the
major types and sub-types of MSW than uneducated respondents.

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Table – 11
Awareness of Male Sex Workers Genre by MSW by Marital status

Awareness Male Sex Worker Subtypes (N=75)

Koti Panthi Dubli Hijra Gigolo Masseur Escort Londa Dancer
Marital status
(%) (%) (%) (%) (%) (%) (%) (%) (%)
75 75 75 69 10 43 8
TOTAL --- ---
100.0 100.0 100.0 92.0 13.3 57.3 10.7
42 42 40 39 6 23 6
Unmarried --- ---
55.0 55.0 53.3 52.0 8.0 30.7 8.0
28 28 26 26 4 16 1
Married living with spouse --- ---
37.3 37.3 34.7 34.7 5.3 21.3 1.3
2 2 1 2 1
Married living without spouse --- --- --- ---
2.7 2.7 1.3 2.7 1.3
2 2 2 1 2 1
Separated/ Divorced --- --- ---
2.7 2.7 2.7 1.3 2.7 1.3
1 1 6 1 1
No Response --- --- --- ---
1.3 1.3 8.0 1.3 1.3

Table - 11 provides an analysis of awareness of MSW genre in relation to their marital status. The
statistics reveals that most unmarried respondents are aware of various types and sub-types
among MSW, as majority of respondents are unmarried. Overall,it may be seen that 52 to 55
percent of the respondents aware of the major sub-types – Koti, Panthi, Dubli and Hijra are
unmarried while around 35 to 37 percent aware of the same are married and living with spouse.

Table – 12
Awareness of Male Sex Workers Genre by MSW by Occupation

Awareness Male Sex Worker Subtypes (N=75)

Koti Panthi Dubli Hijra Gigolo Masseur Escort Londa Dancer
Occupation
(%) (%) (%) (%) (%) (%) (%) (%) (%)
75 75 75 69 10 43 8
TOTAL --- ---
100.0 100.0 100.0 92.0 13.3 57.3 10.7
14 14 14 14 1 7 3
Unemployed --- ---
18.7 18.7 18.7 18.7 1.3 9.3 4.0
34 34 36 32 4 20 2
Full-time --- ---
45.3 45.3 48.0 42.7 5.3 18.7 2.7
27 27 25 23 5 16 3
Part-time --- ---
36.0 36.0 33.3 30.7 6.7 21.3 4.0

According to the data presented in Table -12, awareness of MSW on various types and subtypes
of MSW genre based on their occupation is analysed. It may be observed that most MSW
employed in full-time employment are aware of the various groups followed by a large
number who are occupied in part-time occupations. This is followed by those who are
unemployed. Thus, on an average, 40 to 45 percent of MSW aware of Koti, Panthi, Dubli and
Hijra are employed in full-time jobs followed by 30 to 36 percent aware of the same having part-
time jobs. Around 19 percent of respondents equally knowing of the main subtypes are
unemployed.

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Table – 13
Awareness of Male Sex Workers Genre by MSW by Income

Awareness Male Sex Worker Subtypes (N=75)

Koti Panthi Dubli Hijra Gigolo Masseur Escort Londa Dancer
Average Income PM
(%) (%) (%) (%) (%) (%) (%) (%) (%)
75 75 75 69 10 43 8
TOTAL --- ---
100.0 100.0 100.0 92.0 13.3 57.3 10.7
Income (all sources)
30 30 27 28 3 16 5
< Rs.2500 --- ---
40.0 40.0 36.0 37.3 4.0 21.3 6.7
39 39 42 36 7 22 1
Rs.2501 – Rs.5000 --- ---
52.0 52.0 55.0 48.0 9.3 29.3 1.3
6 6 6 5 5 2
> Rs.5001 --- --- ---
8.0 8.0 8.0 6.7 6.7 2.7
Income (sex work)
61 61 62 55 9 36 7
< Rs.1500 --- ---
81.3 81.3 82.6 73.4 12.0 48.0 9.3
11 11 11 11 5
Rs.1501 – Rs.3000 --- --- --- ---
14.7 14.7 14.7 14.7 6.7
3 3 3 3 1 2 1
> Rs.3001 --- ---
4.0 4.0 4.0 4.0 1.3 2.7 1.3

Table - 13 presents the awareness of respondents on various types and subtypes of MSW in
Vijayawada City with regard to their monthly income. An overview of the data reveals that a
majority of MSW aware of their genre and subtypes earn a monthly income (from all
sources) of between Rs.2501 to Rs.5000 a month.

A closer look at the data reveals that around half the respondents aware of Koti, 52 percent
Panthi, 52 percent Dubli 55 percent Hijra, 48 percent and Masseur 29 percent earn between
Rs.2501 to Rs.5000 a month (from all sources). A lesser number of respondents aware of the
same major subtypes, Koti, 40 percent Panthi, 40 percent Dubli 36 percent Hijra, 37 percent and
Masseur 21 percent earn below Rs.2500 a month from all sources.

However, in relation to the income of the respondents from sex work, it is seen that a majority of
the respondents aware of the major subtypes reportedly earn less than Rs.1500 a month from sex
work (75 to 81 percent).

Type of Male Sex Workers as identified by MSW

The following analysis describes the manner in which Male Sex Workers define or identify
themselves. It also emphasises on their sexual orientation and gender.
From the data, it may be inferred that majority of the MSW in Vijayawada, 36 percent identify
themselves as Koti, while 32 percent consider that they are Dubli and according to 24
percent they are Panthi. Comparatively only 8 percent said they are Hijras. MSW do not
identify themselves as other categories here.

This indicates that in Vijayawada, one can find typically Koti, Pnthi or Dubli or Hijras and they
are clearly distinguished by their orientation – signs and symbols used by each of these groups to
identify and attract clientele, as well as clothing and other physical gestures as poise, walking
style and speech.

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Table – 14
Type of Male Sex Workers by MSW by Age Group

MSW Type Male Sex Worker Subtypes (N=75)

Koti Panthi Dubli Hijra Gigolo Masseur Escort Londa Dancer
Age
(%) (%) (%) (%) (%) (%) (%) (%) (%)
27 18 24 6
TOTAL --- --- --- --- ---
36.0 24.0 32.0 8.0
1 1
< 18 --- --- --- --- --- --- ---
1.3 1.3
10 14 11 3
19-25 --- --- --- --- ---
13.3 18.7 14.7 4.0
10 2 12 1
26-32 --- --- --- --- ---
13.3 2.7 16.0 1.3
6 1 1
33-39 --- --- --- --- --- ---
8.0 1.3 1.3
1 1
40 & > --- --- --- --- --- --- ---
1.3 1.3

From Table-14 given above, MSW identity and orientation with regard to age-wise categorisation
may be ascertained. It is observed that majority of MSW who indicate they are Koti, 13
percent Panthi, 19 percent and Hijra, 4 percent are in the 19 to 25 age group. This is
followed by many MSW, 13 percent Koti, Panthi, 3 percent and Hijra, 1 percent who are older,
aged between 26 and 32 years of age. However, among Dubli, majority, 16 percent are 26 to 32
years old followed by 15 percent who are younger in the 19 to 25 years age group. This shows
that while Kotis, Panthis and Hijras are younger, those who consider themselves as Dubli are
older.

Table – 15
Type of Male Sex Workers by MSW by Occupation

MSW Type Male Sex Worker Subtypes (N=75)

Koti Panthi Dubli Hijra Gigolo Masseur Escort Londa Dancer
Occupation
(%) (%) (%) (%) (%) (%) (%) (%) (%)
27 18 24 6
TOTAL --- --- --- --- ---
36.0 24.0 32.0 8.0
3 2 5 4
Unemployed --- --- --- --- ---
4.0 2.7 6.7 5.3
15 11 7 1
Full-time --- --- --- --- ---
20.0 14.7 9.3 1.3
9 5 12 1
Part-time --- --- --- --- ---
12.0 6.7 16.0 1.3

The occupational classification of MSW with respect to their identity is examined in Table-15. It
may be observed that majority of the MSW who consider themselves as Koti are employed in
full-time jobs, 20 percent followed by those in part-time jobs, 12 percent. Further 4 percent
of Koti are unemployed. A similar trend may be observed among those MSW considering
themselves as Panthi with 15 percent in full-time jobs, 7 percent in part-time jobs and 3 percent
unemployed. However, among Dubli, majority, 16 percent are employed in part-time jobs
followed by 9 percent in full-time employment and 7 percent are unemployed. Among Hijras, a

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majority 5 percent is unemployed and only one respondent each is employed either on part-time
or full-time basis.

Comment

It may thus be concluded that majority of the Male Sex Workers in Vijayawada are able to
distinguish only the major classical types and sub-types of sex workers and orientation. There
don’t seem to be specific regional classifications and an important feature is that there is little
distinction between one group and the other and unlike other places, MSW here more frequently
change roles and therefore distinction can become very difficult. Another important factor is that
the sex market in Vijayawada is pretty large and potential for earning through sex is therefore
proportionately higher. This increased demand also has lead to larger number of unemployed
youth into the sex industry.

Understanding Sex Industry Network (SIN) –

Place of soliciting/ pickup/ aggregating by Male Sex Workers.

The following analysis provides an understanding into the Sex Industry Network by pinpointing
the locations or places where Male Sex Workers solicit their clientele, pickup them for sexual
activities or indicates where such MSW aggregate to attract clients and engage in sex for
exchange of money, gifts, etc. It is important to identify such ‘hotspots’ as that would provide
vital clues in approaching this otherwise hidden community for long-term healthcare
interventions around HIV/ AIDS.

It is observed from the data that in Vijayawada City, the most popular places to solicit/
pickup clients and aggregate among MSW are the park, 89 percent, street, 85 percent, and
bus stand, 83 percent followed by telephone, 77 percent, and railway station, 55 percent.
Comparatively, the work areas for fewer MSW are the hotel, 37 percent or house, 36
percent. Besides, sex workers are also known to meet at brothels, chat rooms, through
pimps, internet, Massage Parlours and Godown.

Table – 16
Place of soliciting/ pickup/ aggregating by MSW by Age Group

Pickup
Male Sex Worker soliciting/ pickup/ aggregating points (N=75)
point
Railway Stn.
parlour (%)

Chat room
Telephone
Bus stand

Godown.
Massage

Internet
Brothel

House
Street

Hotel

Pimp
Park
(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)

Age

64 6 62 41 67 13 28 27 58 10 4 7 9
TOTAL
85.3 8.0 82.7 54.7 89.3 17.3 37.3 36.0 77.3 13.3 5.3 9.3 12.0
2 1 1 1 1 1
< 18 --- --- --- --- --- --- ---
2.7 1.3 1.3 1.3 1.3 1.3
31 2 31 21 34 10 17 14 28 7 1 4 5
19-25
41.3 2.7 41.3 28.0 45.3 13.3 22.7 18.7 37.3 9.3 1.3 5.3 6.7
22 1 23 13 24 2 5 5 21 1 2 1 2
26-32
29.3 1.3 30.7 17.3 32.0 2.7 6.7 6.7 28.0 1.3 2.7 1.3 2.7

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8 3 6 4 7 1 4 6 8 2 1 1 1
33-39
10.7 4.0 8.0 5.3 9.3 1.3 5.3 8.0 10.7 2.7 1.3 1.3 1.3
1 1 2 1 1 1 1 1 1
40 & > --- --- --- ---
1.3 1.3 2.7 1.3 1.3 1.3 1.3 1.3 1.3

Table - 16 describes the age-wise classification of places where MSW solicit and pickup their
clients or places where they aggregate to attract clients for sex work. From the data, it can be seen
that most MSW soliciting, picking and aggregating in public places are younger in the 19 to
25 years age group compared to a lesser number who are 26 to 32 years old. A further detailed
analysis reveals that among MSW who operate on the streets, 41 percent are younger in the 19-25
age group followed by 29 percent in the 26-32 years age group and 11 percent in the 33-39 age
range. Similarly, among those who solicit/ pickup clients in the park, many MSW, 45 percent are
in the young age group of 19-25 years compared to 32 percent aged between 26 and 32 years of
age. In railway stations, bus stands and massage parlours too, a similar pattern emerges.

Table – 17
Place of soliciting/ pickup/ aggregating by MSW by Occupation

Pickup point Male Sex Worker soliciting/ pickup/ aggregating points (N=75)
parlour (%)

Chat room
Telephone
Bus stand

Godown.
Massage

(%) y

Internet
Brothel

House
Street

Hotel

Pimp
Park
Stn.
(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)
Occupation

64 6 62 41 67 13 28 27 58 10 4 7 9
TOTAL
85.3 8.0 82.7 54.7 89.3 17.3 37.3 36.0 77.3 13.3 5.3 9.3 12.0
10 10 10 11 6 2 9 1 2 2
Unemployed --- --- ---
13.3 13.3 13.3 14.7 8.0 2.7 12.0 1.3 2.7 2.7
31 6 30 18 30 10 16 16 27 8 3 3
Full-time ---
41.3 8.0 40.0 24.0 40.0 13.3 21.3 21.3 36.0 10.7 4.0 4.0
23 22 13 26 3 6 9 22 2 3 2 4
Part-time ---
30.7 29.3 17.3 34.7 4.0 8.0 12.0 29.3 2.7 4.0 2.7 5.3

According to the data in Table - 17 the occupation-wise classification of place of soliciting/

picking up clients by MSW is analysed. It is observed that in the street, bus stand, park,
telephone, railway station, hotel and house, the number of MSW engaged in full-time jobs is
higher than those in part-time jobs or unemployed. It is important to note that many MSW
employed in industries, hotels, petty trade, vendors, drivers and massage parlours use the
premises to pick clients and even have sex with peers and others.

Modern expressway that is also a hotspot

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Table – 18
Place of soliciting/ pickup/ aggregating by MSW by Income

Pickup point Male Sex Worker soliciting/ pickup/ aggregating points (N=75)

Railway Stn.
parlour (%)

Chat room
Telephone
Bus stand

Godown.
Massage

Internet
Brothel

House
Street

Income

Hotel

Pimp
Park
(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)

(%)
(all sources)

64 6 62 41 67 13 28 27 58 10 4 7 9
TOTAL
85.3 8.0 82.7 54.7 89.3 17.3 37.3 36.0 77.3 13.3 5.3 9.3 12.0
25 1 25 16 24 5 10 6 21 3 2 2 2
< Rs.2500
33.3 1.3 33.3 21.3 32.0 6.7 13.3 8.0 28.0 4.0 2.7 2.7 2.7
Rs.2501 – 33 4 31 21 35 7 16 18 31 7 2 2 4
Rs.5000 44.0 5.3 41.3 28.0 46.7 9.3 21.3 24.0 41.3 9.3 2.7 2.7 5.3
6 1 6 4 6 1 2 3 6 3 3
> Rs.5001 --- ---
8.0 1.3 8.0 5.3 8.0 1.3 2.7 4.0 8.0 4.0 4.0

The income-wise classification of pickup points for sex work is presented in Table 18. From the
above table, it is evident that larger number of MSW soliciting clients in park, 47 percent street,
44 percent bus stand 41 percent, telephone, 41 percent and railway station 28 percent earn more –
between Rs.2501 and Rs.5000 a month from all sources.

Comment

This indicates that in Vijayawada city, the sex industry is very unorganised but the numbers of
sex workers are large and therefore it has become common in many public places such as parks,
railway stations, bus stands, theatres, parks, public toilets and other public places.

One of the fastest growing metropolises in India reporting increased MSW activity

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11.0 SEXUALITY, SEXUAL PRACTICES AND VULNERABILITY

11.1 Sexual encounters, partners, commercial sex

Sexual practices, behaviour and client profile of MSW

The tables presented below describe the sexual practices in terms of encounters with clients,
sexual behaviour including condom use and seek to capture client profile as seen by Male Sex
Workers. A bird’s eye view of the sexual practices among MSW reveals that MSW had paid sex
consistently over the last 6 months. More specifically, a large number, 95 percent reported
engaging in sex in exchange for money, gifts, etc., during the last time they had sex. This
relates to increased sex activity on commercial basis. Data also points out that a large number in
Vijayawada City, 73 percent reportedly used condoms consistently over the last 6 months
when they had paid sex. Further, 63 percent reported using a condom during the last time
they had sex in exchange for money, gifts, etc. Finally, a question posed on who their sexual
partner was on their last paid sexual encounter revealed a rough profile of the clients of MSW.
While it is assumed that only 19 percent clients are of high class – defined thus as being either
equal to or economically better than MSW themselves. To this group belong mostly peers,
students, teachers, office goers, blue collared workers, petty businessmen and the like. On the
other hand, 77 percent reported that their clients are low class – meaning those hailing from lower
socio-economic strata – mainly rickshaw pullers, boatmen, unorganised workers, construction
labour, unemployed youth, slum populations and so on.

This reinforces the fact that not all men who have sex with men (MSM) do so only for physical or
psychological stimulation. Observations from the field validate the fact that many MSW started
as MSM but in due course, on pressing economic grounds they engage in sex on commercial
basis for sheer survival. Hence is visible both survival sex and recreational sex in most cities
though it is very difficult to differentiate the two. MSW have also reiterated that there is a huge
potential for male sex partners among both men and women and demand for young boys cannot
be underestimated. The mixed clientele of MSW makes it an ardent task in identifying specific
client groups. Overall, however, it is seen that two distinct levels operate. One male sex work
circuit caters to the economically richer segment in society and operate in houses, brothels, hotels
and massage parlours while the other sex circuit is carried on at the street level and public places,
demanding the sexual needs of people in the lower socio-economic milieu such as those in slums
and poor housing colonies operating in parks, railway stations, bus stands, public toilets, and
roadside shanties.

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Table – 19
Sexual practices, behaviour and client profile of MSW by Age group

Sexual history Sexual practices, behaviour and client profile (N=75)

Sex for Clientele
Condom Condom
money/
use use High Low
Age group gifts
(6 months) (Last time) class class
(Last time)
(%) (%) (%) (%)
(%)
71 55 47 14 58
TOTAL
94.7 73.3 62.7 18.7 77.3
2 1 1 2
< 18 ---
2.7 1.3 1.3 2.7
37 27 24 5 32
19-25
48.3 36.0 32.0 6.7 42.7
23 19 15 7 16
26-32
30.7 25.3 20.0 9.3 21.3
7 6 6 1 7
33-39
9.3 8.0 8.0 1.3 9.3
2 2 1 1 1
40 & >
2.7 2.7 1.3 1.3 1.3

An analysis of the data in Table - 19 provides insight into the sexual practices and behaviour of
MSW with respect to their age. It is evident from the data that majority of the MSW, 48 percent
who had sex in exchange for money during the last sexual encounter were 19-25 years of age
followed by 31 percent who were older between 26 and 32 years old. A sizeable number of 9
percent were also in the age range of 33 to 39 years of age. This indicates that though MSW are
generally younger, many middle-aged MSW too are engaged in paid sex activities. Condom use
consistently in the last 6 months has been reported by majority of MSW, 36 percent in the same
19-25 age group followed by 25 percent in the older 26-32 age group. The trend is similar
pertaining to condom use during last sexual encounter where 32 percent in 19-25 age range
reported condom use and 20 percent between 26 and 32 years said they used condoms during
their last sexual encounter. It is interesting to note that more clients of MSW, 77 percent are
reported to belong to lower class and are younger, in the 19-25 age group 43 percent.
Table – 20
Sexual practices, behaviour and client profile of MSW by Education

Sexual history Sexual practices, behaviour and client profile (N=75)

Sex for Clientele
Condom Condom
money/
use use High Low
Education gifts
(6 months) (Last time) class class
(Last time)
(%) (%) (%) (%)
(%)
71 55 47 14 58
TOTAL
94.7 73.3 62.7 18.7 77.3
5 5 1 2 3
Illiterate
6.7 6.7 1.3 2.7 4.0
14 7 6 1 13
Primary
18.7 9.3 8.0 1.3 17.3
30 24 22 5 26
Middle
40.0 32.0 29.3 6.7 34.7

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14 13 12 2 12
Hr. Sec.
18.7 17.3 16.0 2.7 16.0
7 6 5 3 4
Technical
9.3 8.0 6.7 4.0 5.3
1 1
Hr. Education --- --- ---
1.3 1.3

Table 20 describes the sexual practices, behaviour and client profile of MSW by education status.
It is important to note from the above table that though involvement in sex for exchange of
money, gifts, etc., is high by educated MSW, that may be a result of rising unemployment and
resulting ‘survival sex’, higher education also indicates consistent condom use, 32 percent by
those educated up to middle school (majority of respondents in the study) and a high 17 percent
by those who studied up to higher secondary. Similarly, larger number of educated MSW, 29
percent educated up to middle school and 16 percent up to higher secondary reported condom use
during last sexual encounter compared to only 9 percent who studied up to primary level and 7
percent illiterate MSW. The educational profile of clients indicates that they are similar to that of
the MSW and sex workers prefer clients of equal educational and economic status or better that
ensures more earning through sex work. Though safe sex practices adoption among those
engaging in recreational sex has not been directly recorded, indications are that even among such
male sex workers, condom use is high and depends on education status of sex worker as well as
client.

This therefore indicates that education is an important factor in determining safe sex practices
among male sex workers. Uneducated MSW are neither aware of safe sexual practices nor have
the appropriate perception of risk. This also points to the fact that educated MSW are in a better
position to read and understand HIV/ AIDS related prevention messages and one-to-one rapport
with educated clients and NGO/ community workers that reflects on better adoption of safe sex
practices.
Table – 21
Sexual practices, behaviour and client profile of MSW by Marital status

Sexual history Sexual practices, behaviour and client profile (N=75)

Sex for Clientele
Condom Condom
money/
use use High Low
Marital status gifts
(6 months) (Last time) class class
(Last time)
(%) (%) (%) (%)
(%)
71 55 47 14 58
TOTAL
94.7 73.3 62.7 18.7 77.3
38 30 27 8 31
Unmarried
50.7 40.0 36.0 10.7 41.3
28 23 18 5 23
Married living with spouse
37.3 30.7 24.0 6.7 30.7
2 1 1 1 1
Married living without spouse
2.7 1.3 1.3 1.3 1.3
3 1 1 3
Separated/ Divorced ---
4.0 1.3 1.3 4.0

According to the data presented in Table – 21, the sexual behaviour and practices of MSW are
highlighted based on their marital status. The data reveals that 51 percent of MSW who
engaged in sex in exchange for money, gifts, etc. are unmarried while 44 percent were ever-

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married. Condom use data indicates that 40 percent of unmarried respondents reportedly used
condoms consistently during the last 6 months and a similar number, 36 percent reported condom
use during their last sexual encounter. Data on client profile reveals that among so-called low-
class clients, majority are unmarried, 41 percent though a good number, 31 percent are also ever-
married. Marital status does not appear to be an important variable in accepting or adopting safe
sex practices though it is viewed as important in the case of bisexual MSW.

Table – 22
Sexual practices, behaviour and client profile of MSW by Occupation

Sexual history Sexual practices, behaviour and client profile (N=75)

Sex for Clientele
Condom Condom
money/
use use High Low
Occupation gifts
(6 months) (Last time) class class
(Last time)
(%) (%) (%) (%)
(%)
71 55 47 14 58
TOTAL
94.7 73.3 62.7 18.7 77.3
14 9 8 4 10
Unemployed
18.7 12.0 10.7 5.3 13.3
32 25 19 4 29
Full-time
42.7 33.3 25.3 5.3 38.6
25 21 20 6 19
Part-time
33.3 28.0 26.7 8.0 25.3

The occupation-wise classification of sexual practices of clients may be observed in Table - 22

given above. It may be observed that as majority MSW are employed in full-time jobs, larger
number among such MSW, 43 percent said they had sex in exchange for money, gifts, etc.,
followed by 33 percent who are in part-time jobs who said they had such paid sex. Condom use,
consistent use over 6 months is reportedly high by full-time employed MSW, 33 percent
compared to part-time employed MSW 28 percent. However, with regard to condom use during
the last time, more part-time employed MSW 27 percent reported condom use compared to 25
percent employed in full-time jobs. Among clients of MSW, larger numbers of low class clients
are employed in full-time jobs or are unemployed however, more number of high-class clients are
in part-time jobs.
Table – 23
Sexual practices, behaviour and client profile of MSW by Income

Sexual history Sexual practices, behaviour and client profile (N=75)

Sex for Clientele
Condom Condom
money/
use use High Low
Average Income PM gifts
(6 months) (Last time) class class
(Last time)
(%) (%) (%) (%)
(%)
71 55 47 14 58
TOTAL
94.7 73.3 62.7 18.7 77.3
Income (all sources)
30 21 21 4 26
< Rs.2500
40.0 28.0 28.0 5.3 34.7
Rs.2501 – Rs.5000 35 30 21 7 29

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46.7 40.0 28.0 9.3 38.6

2 4 5 3 3
> Rs.5001
2.7 5.3 6.7 4.0 4.0
Income (sex work)
58 45 40 10 48
< Rs.1500
77.3 60.0 53.3 13.3 63.0
10 9 5 3 8
Rs.1501 – Rs.3000
13.3 12.0 6.7 4.0 10.7
3 1 2 1 2
> Rs.3001
4.0 1.3 2.7 1.3 2.7

According to the data presented in Table – 23, the sexual practices, behaviour and client
profile of MSW by income is analysed. The data reveals that majority of MSW, 47 percent
who had sex in exchange for money during last time earn between Rs.2501 and Rs.5000/-
per month. Comparatively a lesser number, 40 percent earn below Rs.2500/- a month.
It is also important to note that larger number of MSW, 77 percent who engaged in paid sex
during last sexual encounter earn up to Rs.1500/- from sex work. A high 13 percent who earned
between Rs.2501 and Rs.5000/- per month had sex in exchange for money, gifts etc. A similar
pattern is observed with regard to condom use. Income levels of clients match those of MSW and
therefore they may be said to be of the same economic class.
It is noteworthy that those MSW who earn higher incomes adopt safer sex practices as they can
afford them. With respect to condoms, discussions revealed that MSW are not satisfied with
cheap or freely distributed condoms that tear or break on use. MSW prefer to use well lubricated
condoms especially during anal sex. Condom use during oral sex is not popular as risk perception
of spread of infection through the mouth is reportedly unheard of among MSW though a few
insist that their clients use condoms during oral sex too. MSW know about and prefer flavoured
condoms for oral sex but are concerned about the cost of use. (A pack of 3’s of good lubricated/
flavoured condoms costs at least Rs.15/- that cannot be afforded by all MSW). Many reportedly
carry condoms at all times (powdered/ jelly filled) and are known to negotiate condom use with
clients. However, it has been noticed that intimacy of relationships (especially recreational sex)
may lead to increased instances of unprotected sex.

The placid Krishna River shrouds hectic MSW activity on its banks

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11.2 Type of sex, condom use and risk

Sexual practices

The tables given below provide an analysis of the type of sex popular among MSW in
Vijayawada City. An overview of the type of sex indicates that a large number of MSW, 87
percent engage in oral sex followed by 78 percent in anal sex and 67 percent ‘thigh’ sex
where clients use the thighs of MSW to have sex. Further, 16 percent reported having vaginal sex
(presumably bisexuals) and only 5 percent engage in other sex acts (‘rolling sex’ where two
sexual partners roll on the cot or ground while having sex, ‘body sex’, also involving licking the
whole body of the sexual partner and ‘group sex’ where more than three to four sex partners
fondle and have sex together). Other sexual practices include ‘Rimming’ or licking the anus of
sex partners that is also reportedly popular among MSW.

Table – 24
Type of sex by MSW by Age Group

Type of sex Type of Sex (N=75)

Oral Anal Vaginal Thigh Others
Age
(%) (%) (%) (%) (%)
65 59 12 50 4
TOTAL
86.7 78.7 16.0 66.7 5.3
2 2 1
< 18 --- ---
2.7 2.7 1.3
32 30 10 26
19-25 ---
42.7 40.0 13.3 34.7
22 20 1 18 3
26-32
29.3 18.7 1.3 24.0 4.0
7 6 5 1
33-39 ---
9.3 8.0 6.7 1.3
2 1 1
40 & > --- ---
2.7 1.3 1.3

The age-wise distribution of type of sex by MSW is depicted in Table –24. It is observed that a
majority of those involved in oral sex, 43 percent are in the 19-25 age group followed by 29
percent who are 26 to 32 years old. A similar pattern is visible in the case of MSW engaging
in anal sex with 40 percent in the 19-25 age group and around half that number, 19 percent
having anal sex are older (26-32 years of age) and 35 percent involved in thigh sex also are in the
younger age group compared to 24 percent in the older age range. In the case of vaginal sex too,
more number of MSW, 13 percent belonged to the younger age group of 19 to 25 years.

This indicates that oral and anal sex is very popular among MSW. This has also to be seen in the
light of the identity that they perceive. As observed earlier, many MSW view themselves as Koti
(playing a passive role and receiving sex) and this may explain for higher preference for anal sex.

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Table – 25
Type of sex by MSW by Marital Status

Type of sex Type of Sex (N=75)

Oral Anal Vaginal Thigh Others
Marital status
(%) (%) (%) (%) (%)
65 59 12 50 4
TOTAL
86.7 78.7 16.0 66.7 5.3
36 34 8 25 1
Unmarried
48.0 45.3 10.7 33.3 1.3
24 21 4 23 3
Married living with spouse
32.0 28.0 5.3 30.7 4.0
Married living without 2 2
--- --- ---
spouse 2.7 2.7
3 3 2
Separated/ Divorced --- ---
4.0 4.0 2.7

Table -25 given above describes the type of sex activity preferred by MSW in relation to their
marital status. Expectedly, larger number of unmarried MSW, 45 to 48 percent reportedly
engage in anal and oral sex compared to ever-married respondents, 35 and 39 percent
respectively. Further, it is observed that MSW who also have sex with their female sex partners,
and engage in anal and or oral sex. This is important from the prevention point of view as
unprotected anal sex with male partner may lead to chances of infection on subsequent
unprotected sex with spouse.

Comment

The type of sex that is popular among male sex workers is definitely anal sex though a large
number also engage in oral sex, especially the transgender community. Moreover, the younger
age group are known to enjoy variations in different kinds of sex though there is a preference for
anal sex. As mentioned earlier, anal sex activity may be attributed to more number of MSW
identifying themselves as Koti. Bisexual partners are known to engage in both anal and vaginal
sex and the need to educate them on having protected sex always is key to prevention of HIV
among this risk group. Owing to the fact that majority of MSW are unmarried, it is important they
are informed about risks in anal sex as many are of marriageable age and many are mere
‘hustlers’ who may go back into mainstream sex life after a brief spell of commercial sex activity.
It has also been observed that MSW do not consider having sex with other males (predominantly
anal sex) as posing risk of HIV infection reflected in poor condom use. Therefore prevention
efforts need to be directed at making MSW realise appropriate perception of risk.

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11.3 Violence, criminalisation

Violence and criminal assault

The following tables depict the extent of sex-related violence that MSW faced from their clients
and others as a result of engaging in sex work. It is important to note that around half the
number of MSWs interviewed, 57 percent experienced acts of violence committed against
them and a lesser number, 20 percent faced criminal assault – booked by police and law
enforcing authorities on false charges of being public nuisance, petty theft cases and the like and
harassed in custody.

Table – 26
Violence and criminal assault against MSW by Age group

Forced sex, violence and

Violence, etc.
criminal assault (N=75)
Forced sex Criminal
Age group & violence assault
(percent) (percent)
43 15
TOTAL
57.3 20.0
2
< 18 ---
2.7
24 8
19-25
32.0 10.7
11 5
26-32
14.7 6.7
6 2
33-39
8.0 2.7
40 & > --- ---

The age-wise distribution of forced sex and violence as well as criminal assault is described in
Table – 26. From the above table, it may be observed that a majority of the younger MSW, 32
percent in the age group of 19 to 25 years were forced to have sex with their clients and acts
of violence were perpetrated against them. Comparatively, 15 percent in the 26 to 32 age group
said they faced such sex-related violence. Moreover, 8 percent of older respondents in the 33-39
age group also reported such violence. This indicates that age is not a factor and sex related
violence occurs among all MSW for which they have no recourse as they are unorganised and
most instances go unreported. Many described about being burnt over the body with cigarette
buts, thrashed and beaten on their backs and sex organs, made to indulge in painful sex acts,
gagged and forced to have sex. Many MSW however view such acts as rare instances by a few
clients whom they consider facing a psychological problem. It is also seen that clients who pay
more indulge in such harsh treatment while having sex.

With regard to criminal assault too, a similar pattern is visible with majority of younger MSW 11
percent in the 19-25 years age group reporting such experiences more often than 7 percent
of those in the 26 to 32 years age group. Around 3 percent of older MSW in the 33-39 age group
also faced criminal charges filed against them.

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Table – 27
Violence and criminal assault against MSW by Income

Forced sex, violence and

Violence, etc.
criminal assault (N=75)
Forced sex Criminal
Income
& violence assault
(all sources)
(percent) (percent)
43 15
TOTAL
57.3 20.0
20 7
< Rs.2500
18.7 9.3
21 7
Rs.2501 – Rs.5000
28.0 9.3
2 1
> Rs.5001
2.7 1.3

According to the data given in Table - 27 above, violence and criminal assault against MSW with
respect to their average monthly income from all sources is analysed. It may be noticed from the
above data that incidence of forced sex and sexual violence is higher among more number of
the MSW, earning between Rs.2501 and Rs.5000 a month, 28 percent compared to that of
MSWs earning lower income of up to Rs.2500/- a month, 19 percent. However, in the case of
criminal assault by police and goondas an equal 9 percent of MSW earn lower monthly incomes
(up to Rs.2500 a month) as well as between Rs.2501 to Rs.5000.

Comment

Discussions indicated that MSW earning more are considered to be hailing from better socio-
economic backgrounds and hence clients as well as others fear from harming them. However,
poorer MSW have to face the brunt of physical violence and assault. With regard to criminal
cases, MSW opine that first-timers always face problems from police. Many are forced to have
sex with policemen and their henchmen. However, in due course when they become
acquaintances, police only harass them and demand money. They then go after younger or new
entrants into the sex trade. Many hijras maintain good rapport with police personnel and though
they are caught initially in a raid, on the way to the police station or even in the police jeep, they
have sex or demand money and release the sex workers.

Another view of the massive Krishna Bridge

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12.0 HIV/ AIDS PREVENTION, TREATMENT, CARE AND SUPPORT SERVICES

12.1 Awareness, sources and sexual behaviour

The tables given below provide information on the extent of awareness of MSW on HIV/ AIDS,
source of awareness and resultant sexual behaviour. Indications are that there is good awareness
with large number of respondents stating they are aware about HIV/AIDS.
.
Figure – 11
Sources of Awareness on HIV/AIDS of MSW

Sources of awarene ss on HIV/A IDS

77.3
80 73.3
66.7
70
57.3 54.7
60 50.7
50
40 32
30
14.7
20
10
0
0
Sources of awareness
Television Radio Newspaper
Poster Pamphlet Doctor
NGO/ CBO Friends Other sources

The main sources of awareness of HIV/ AIDS messages is depicted in Figure-11 given above.
From the same, it may be observed that Posters are an important media, 77 percent followed
by Television, 73 percent and Pamphlets, 67 percent. Other significant media include
Newspaper, 57 percent followed by friends, peers or colleagues, 55 percent and NGO/ CBO,
51 percent. Other important sources of awareness include Radio, 32 percent. Around 15 percent
MSW also mentioned doctors as sources of awareness on HIV/ AIDS. Hence, in disseminating
prevention messages, it is important to focus on the popular mass and electronic as well as print
media such as Television, Radio, Newspapers, Posters and Pamphlets. Besides one-to-one
communication by NGO/CBO workers, doctors and peers are also seen as important channels to
provide vital information to the hidden male sex worker community.

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Table – 28
Awareness on HIV/AIDS and sexual behaviour of MSW

Awareness on HIV/AIDS and

behaviour of MSW (N = 75)
Responses
Sexual behaviour
(Percent)
59
Last time had sex for money/ gifts, etc. (MSW)
78.7
44
Last time used condoms while having sex
58.7

Awareness of MSW on HIV/AIDS and resultant sexual behaviour is analysed in Table -28 given
above. From the table, it may be observed that among MSW who are aware of HIV/ AIDS, a
high 79 percent reportedly had sex in exchange for money, gifts, etc. during the last time and
among MSW aware of HIV/ AIDS, 59 percent reported using condoms during the last time they
had sex. This indicates that though awareness on HIV/ AIDS is high and engaging in sex in
exchange for money is prevalent (indicating high level of multi-partner sexual activity) such
knowledge is not translated into changed behaviour as unprotected sex is high. This points at the
need to strengthen Behaviour Change Communication measures among the target audience –
MSW in order to enhance knowledge and awareness and result in adoption of safe sex methods to
prevent HIV infection. As seen earlier, MSW do not also perceive risk of infection as a result of
anal or oral sex. (Many simply have the misconception that HIV infection can be spread only
through vaginal sex with female commercial sex workers).

12.2 Availability and access to services

Awareness, Availability and Access to services by MSW

The following tables provide an understanding of the awareness on HIV/ AIDS related services
provided by NGOs/ CBOs by the Male Sex Workers in Vijayawada city, availability of such
services and accessibility of such services by MSW. The overall scenario on service awareness,
availability and access reveals that only few MSW in the city are aware of such services, 32
percent and fewer numbers are aware of the range of services offered such as condoms,
medicines, clinical facilities (testing and treatment), counselling and referral services and are
neither aware where such services are offered and by whom (NGO/ CBO/ Government/ private/
traditional systems). However, all MSW who are aware of available services access the same.
Yet overall access to services is a poor 32 percent among all MSW.

Table – 29
Awareness, Availability and Access to services by MSW by Age Group

Service access Awareness, Availability and Access to services (N=75)

Range of services
Age Aware NGO Condom Clinic Drugs Jelly Access
(%) (%) (%) (%) (%) (%) (%)
24 18 1 24
TOTAL --- --- ---
32.0 24.0 1.3 32.0

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< 18 --- --- --- --- --- --- ---

11 8 1 10
19-25 --- --- ---
14.7 10.7 1.3 13.3
11 9 12
26-32 --- --- --- ---
14.7 12.0 16.0
1 1
33-39 --- --- --- --- ---
1.3 1.3
1 1 1
40 & > --- --- --- ---
1.3 1.3 1.3

Table -29 provides an insight into the awareness, availability and access to health and related
services for MSW with respect to their age. It may be seen that an equal percent of MSW
aware of such services, 15 percent are in the 19-25 age group as well as those in the 26-32 age
group, 15 percent. A majority aware of services said they knew only of NGO/ CBO providing
such services. The range of services is not known to many respondents and only one respondent
mentioned of condoms, as services available to MSW in the city. Accessibility to services is very
low with those who are aware of such services accessing such services.

Table – 30
Awareness, Availability and Access to services by MSW by Education

Service access Awareness, Availability and Access to services (N=75)

Range of services
Education Aware NGO Condom Clinic Drugs Jelly Access
(%) (%) (%) (%) (%) (%) (%)
24 18 1 24
TOTAL --- --- ---
32.0 24.0 1.3 32.0
2 2
Illiterate --- --- --- --- ---
2.7 2.7
2 5
Primary --- --- --- --- ---
2.7 6.7
14 8 1 13
Middle school --- --- ---
18.7 10.7 1.3 17.3
3 5 4
Higher Secondary --- --- --- ---
4.0 6.7 5.3
3 3 1
Technical --- --- --- ---
4.0 4.0 1.3
Higher Education --- --- --- --- --- --- ---

From the above Table – 30, the education-wise distribution of service awareness, availability and
access may be ascertained. It is evident from the above data that more educated MSW, 19
percent educated up to middle school level and 4 percent with higher secondary education
are aware of treatment services and also access such services. Though the numbers indicate
that service access is poor despite good awareness, among those who have accessed such
services, it is observed that they are more educated and therefore education and increased
awareness is an important variable in improving service access.

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Table – 31
Awareness, Availability and Access to services by MSW by Marital status

Service access Awareness, Availability and Access to services (N=75)

Range of services
Marital status Aware NGO Condom Clinic Drugs Jelly Access
(%) (%) (%) (%) (%) (%) (%)
24 18 1 24
TOTAL --- --- ---
32.0 24.0 1.3 32.0
9 8 1 11
Unmarried --- --- ---
12.0 10.7 1.3 14.7
14 10 13
Married, living with spouse --- --- --- ---
18.7 13.3 17.3
Married, living without spouse --- --- --- --- --- --- ---
1
Separated/ Divorced --- --- --- --- --- ---
1.3

The data in Table -31 presented above describes the awareness, availability and access to services
with respect to marital status of the MSW in Vijayawada City. It may be seen that though more
number of respondents are unmarried, so are more MSW married and living with spouse are
aware of such services, 19 percent than 12 percent unmarried respondents and many know only
of NGOs offering such services. Access to services is seen to be better among married MSW
living with spouse compared to unmarried respondents.

The famous Mogalrajpuram caves also attracts hustlers

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12.3 Barriers in accessing services and suggestions

Only few respondents were able to directly mention various barriers faced in accessing services in
the quantitative study. However, from the discussions and qualitative phase, inputs reveal that
there are several barriers that male sex workers need to overcome to access services even if
awareness levels are high. The key issue is availability of such services. Not all range of
services are offered that are needed by MSW. The only services that MSW seem to know include
condoms, clinics, drugs and provision of jelly for pain in sex organs. However, they opine that
services not available readily are counselling, diagnosis and testing and provision of free
medicines for all sex-related diseases (including STI and HIV infection). Moreover, such
services are not easily accessible, as they are located in inconvenient locations where
respondents have to cover long distances for access. Respondents have complained of ill-
equipped centres with poor infrastructure and non-availability of personnel.

Male sex workers would prefer services that are within reach for cheap and easy reach –
availability of cheap public transport is also important to access such services. The next issue
is regarding timing of service centres. Many services are available only between 10:00 a.m. and
6:00 p.m. in clinics, hospitals or NGO outreach centres. These timings are inconvenient for
majority of the MSW who are employed full-time or even may be engaged in sex work during
these hours. MSW preferred clinics that are open late in the evenings or even early in the day that
they could access. Another important concern is the non-availability of qualified medical
personnel as doctors or para-medical staff. Where there are few personnel, their attitude puts the
MSW away and hence MSW shy away from accessing these centres.

Other important barriers in accessing services include cost of treatment and medicines that are
provided by private and supported medical centres and where free treatment is available, quality
of services is reportedly very poor. Hence MSW prefer that medical, psychological and referral
services be affordable, easily available at all places and at convenient times and of good quality.
Many MSWs also preferred that condoms be distributed free of cost and there is a need for a ‘safe
space’ for MSW to share their experiences with others and also cater to their recreational needs.
Other factors for poor access besides lack of knowledge and information mentioned include
stigma and discrimination in accessing such services located in populous surroundings or fear of
identification by known persons.

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12.4 Problems faced by Male Sex Workers

Figure – 12
Problems faced by MSW

Problems faced by MSW

100 88
70.7 68 72
80
60
60
40 29.3
20 21.3 24
20 16
1.3
0
Problems faced

Jealousy Robbing clients Police harassment

Blackmailing Cheating/ free sex Switching loyalty
Hiding from family Fear of disclosure No consent to open
Exposure Other problems

According to Figure-12 portrayed above, the problems faced by MSW in Vijayawada City is
examined. The data indicates that Male Sex Workers face a host of problems. The most pressing
problems that surface are jealousy between sex workers themselves, 88 percent that points out
to intra-community (among Kotis, Dublis, Masseurs for clients and money) and inter-
community (between hijras and others for control of areas/ leadership) conflicts prevalent
among male sex workers. Most of the other problems identified are on an individual basis such
as harassment and forced sex by police, 68 percent cheating by customers or not paying
agreed sum after sex, 72 percent and robbing of clients from friends/ other MSW. Here, it is
important to note that older MSW see younger MSW as their rivals as clients prefer younger
(stronger) male sex workers. This also indicates that younger sex workers are paid better than
older ones and hence this develops into conflict between sex workers. Other reasons for concern
among MSW include hiding their behaviour from family members, 60 percent as many carry
on the sex work without knowledge of the family with sisters of marriageable age and younger
siblings whom they have to support economically. Many are worried about being ostracised
when discovered that they are sex workers. Another 16 percent opined that it is difficult to hide
their behaviour and are under constant threat of being exposed in society by friends/ peers or
even clients in public. While 21 percent feared that they might disclose their sex-related
behaviour to their families, 24 percent said they were afraid that others would reveal their
involvement in sex activity without their consent. Around 1 percent MSW said they faced
other problems as being betrayed by own community, threats from relatives and fear of goondas
or rowdies.

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13.0 OVERALL RECOMMENDATIONS

13.1 Defining MSW – issues of identity and differentiation from MSM for programmatic
interventions

As far as awareness of MSW genre among MSW themselves, many are aware of the predominant
types/ sub-types across cities though there is considerable confusion on how each MSW perceives
or defines a type/ sub-type. Overall, there is a need to target all MSW irrespective of their types/
sub-types

Similarly, many community based organisations/ NGOs work among specific groups (most
commonly among Kotis only). They may be targeted to get to the Koti community and similarly
other groups may be clustered for better outreach among this hidden population.

13.2 Extensive outreach – Being hidden community, need for enhancement of community-based
MSW-peer-based approach to identify new/ hidden groups and networks and extend
services

As a majority of the MSW are young persons, they need to be targeted more intensively through
various programmes. Focus on school programme, drop-out youth and on unemployed to be
stressed.

Clients of MSW in all ages must be the target of all grassroots interventions and clients may be
segregated based on socio-economic criteria. (As it has been observed that in some cities, clients
are older while in others, clients are younger, hence age is not a critical factor).

13.3 Inclusion – combating issues of social stigma and discrimination within their groups/ sub-
groups as well as by the general population through better awareness/ appropriate media
advocacy

There is an immediate need for advocacy among both police as well as law enforcing authorities
(such as railway ticket inspectors) and the media.

It has been proved in the study that almost all sex workers contacted have sex in exchange for
money that shows that ‘survival sex’ is predominant though ‘recreational sex’ may be carried out
simultaneously. Thus interventions need to target MSW irrespective of their sexual behaviour
based on their needs.

The places most frequented by that also serve as the place of actual sex activity in most cities
presents a similar picture. Streets, parks, bus stands and railway stations are seen as major
hotspots for reaching out to MSW. This is followed by houses (of clients), public toilets, brothels
and massage parlours (mainly in Kolkata). Hence a lot of outreach activity can be planned around
these areas and should be carried our consistently – over long-term period in order to have better
impact.

13.4 Service Information – providing all MSW with adequate information on available resources
and services for HIV/ AIDS prevention, treatment, care and support

The television, radio and newspapers are popular media to reach out to MSW as many reportedly
access these. However, one-to-one peer group communication, friends and health care givers are
also ways that are effective communication channels among MSW. With regard to sources of
information on HIV/ AIDS, the TV, NGO and friends are the most important sources followed by
posters, newspapers and pamphlets. Thus, an appropriate media mix can target MSW in an
effective way.

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13.5 Improve service access – through intertwining public-private institutional and individual health
care givers thereby ensuring expended range of services and easy access with accent on quality
and affordability

Though occupational status does not emerge to be significant, unemployed youth and those
engaged in sex on part-time basis need more information on safe sex practices and increase in their
appropriate perception of risk.

MSW with lower incomes are particularly vulnerable to risk of infection as they may be unable to
afford safe sex practices and hence they need to be targeted more intensely.

Unemployment and underemployment are main problems that MSW face and many are skilled
and would like to engage in some economic activity – as turners/ fitters/ electricians or similar
small industries but are denied jobs when it is known they are sex workers too. Avenues for
training and providing initial inputs for entrepreneurial ventures may be worked out.

13.6 Further empirical research – focus on mapping MSW, sexual behaviour, condom
programming, communication, treatment access, training needs assessment of MSW (peers/
programme staff)

In the absence of estimates of Male Sex Workers in different parts of the country, a
comprehensive mapping of MSW through NGOs, CBOs and involving MSW themselves.

14.0 SPECIFIC PROGRAMMATIC RECOMMENDATIONS

14.1 Strengthening NGO/ CBO programming exclusively for MSW

Establishing exclusive MSW-centred NGO/CBO networks is seen as important as very few such
entities exist. Many programme activities are an extension of MSM projects where MSW are
segregated and service access by MSW themselves is low

Overall, it has been observed that the range of services offered across all cities is poor, inadequate
and not need-based. Thus, whole range of following services may be offered:

a) More number of HIV testing/ diagnosis facilities and motivating MSW for testing to ensure
protection against infection
b) Better condom programming with an accent on lubricated ones for anal sex/ flavoured
condoms for oral sex
c) Clinics with staggered timings – open late in the evenings and or early mornings when MSW
can access them without disturbing other routine tasks
d) Provision of free drugs and medicines for STI/ HIV
e) Quality care and specialised services such as counselling, referrals and linkages with an array
of service providers – private/ government/ NGO/ others

14.1.1 Adequate infrastructure, funding, scaling up and technical support and materials

NGO/ CBO need to be adequately equipped with infrastructural facilities as well as with qualified,
experienced and trained human resources for better service delivery. Timely disbursement of
funds and completion of planned project cycle would enable maximum impact as well as feed
inputs for further refined interventions. Scaling up of efforts is a dire need if the widening chasm
between supply and demand for MSW-oriented services is to be bridged. Materials also need to be
provided wherever possible – such as IEC materials, condoms, drugs and medicines and other
relevant articles.

Technical support is to be provided to new organisations in programme management on financial,

managerial and other technical aspects as skill building, behavioural training and so on.

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14.1.2 Psychosocial services

Forced sex and harassment as well as criminal assault are reportedly common among MSW across
cities and this may be rectified through community organisation among MSW so they are able to
fight for the protection of their rights. This warrants better networking within MSW as well as
extending professional counselling and referral services to all MSW. Such services need to focus
on enhancing personality development and self-esteem of young males in the sex industry.

Problems faced by MSW indicate that there is considerable inter-community and intra-community
rivalry between MSW as there is a lot of confusion on clear cut definitions and that several types
and sub-types of MSW are targeting the same clients. Preference for younger clients indicates that
they need to be targeted more extensively and fear of exposure and stigma need to be dealt with
appropriately through effectively community-based approaches involving peers, care givers,
media, family of MSW and key influencers.

14.1.3 Networking and linkages

There is an unmet need of merging multi-sector institutions extending services that include
government, private and individual care givers as well as at various levels – at local level (rural/
urban slums), block/ mandal, district, and state (city) level. MSW need to be not only informed of
these groups but also be able to access services without trouble.

14.2 Information services

14.2.1 IEC and communication strategy

With regard to awareness about various services offered, the same differs from city to city
depending on numerous factors such as:

a) extent of dissemination of information by various sources

b) media mix
c) logistics of distributing and obtaining information
d) reach (in terms of geographical area) by CBOs/ NGOs
e) public opinion and community perspective to MSW (stigma)

What is critical though, is the need to increase information about existing services available and
offered in each city. This maybe done through developing a database on all services, service
providers and places where they can be accessed including cost and other important information
which MSW can use and thereby improve service access.

Next, among those who are aware, it is observed that access is low, due to various factors such as
timing, non-availability of doctors, costly drugs and medicines, inconvenient location and hence
poor reach. Therefore a need for Service Centres catering exclusively for MSW that are friendly,
cheap, easily accessible at all times and that provide quality services.

14.2.2 Need for Information on specific sexual practices, associated risks and prevention – anal –
understood and developed by MSW themselves

It is very important that information is provided on specific sexual practices among MSW – which
is currently absent. MSW rely on general information available for other high risk groups that are
inappropriate and do not address key issues such as anal sex, etc.

More importantly, materials targeted at MSW have to be designed, developed, pre-tested and
accepted by MSW themselves thereby catering to their specific needs and being user-friendly, (use
of pictures) with increased retention level and facilitate behaviour change.

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As educational status of MSW is rather poor, they need to be targeted with more information on
HIV/ AIDS and importance of protected sex that is appropriate, easily understandable and
practical and motivated for accepting safe sex behaviours.

14.2.3 Capacity building of peer groups/ networks

The present study witnessed the magical effect of capacity building in managing the quantitative
and qualitative survey efficiently and effectively, producing the desired results. Thus, technical
support should be in the form of ‘hand holding’ where grassroots level MSW organisations are
equipped in project management thereby ensuring ‘ownership’ of the intervention thereby
ensuring sustainability.

14.3 STI and condom promotion services

14.3.1 Ensure availability, accessibility of condoms (lubricated) and motivate for consistent use (stock
and carry easily)

Probably poor condom use may also be due to preference for anal sex among MSW in which they
do not perceive risk of infection even in multi-partner sex. Hence the need for better condom
programming including provision of lubricated condoms/ gel for male sex workers.

14.3.2 Enhance dissemination on need for condom use through media/ social marketing

It is also observed that even though MSW may have information and awareness on importance of
use of condoms and on the need for protected sex, the same is not translated into behaviour change
indicated by poor condom use. This calls for an effective communication strategy for MSW.

Smoking, alcohol and tobacco consumption being predominant habits of MSW, places such as
paan and bidi shops, wine shops and bars and local street-side shops are places frequented by
MSW where they can be reached and where IEC dissemination can also be done effectively.

14.3.3 Partner treatment (both male and female partners)

Unmarried youth need to be targeted vigorously. Among married MSW too, stress needs to be laid
on protected sex and partner treatment in the case of STI/ HIV.

Photo courtesy: Srinivas Kurungati

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15.0 CONCLUSION

In the light of the above study, it is suggested that city-wise Action Plans be prepared pinpointing
areas of action – beginning with identification of Sex Industry Networks, planning outreach
activities through community-based networks of MSW, outlaying and extending diagnostic and
treatment as well as specialised services such as counselling and referrals that are currently very
scattered and insufficient across each city and networking care givers, service providers and local
community efforts in improving conditions of MSW. Going a step further, there is an unmet need
of identifying and prioritising current priorities of the MSW community and working around
those priorities.

Such needs pertain to Basic needs – provision of food, and shelter (safe space) for MSW where
they can meet, enlist support and learn from the experience of others (economic self-reliance and
preventive health)

Education – basic skills and vocational training besides treatment literacy, knowledge and
awareness on care and support.

Provision of Medical services – diagnostic and treatment services – as seen from the study, many
MSW are unaware of VCTC and HIV testing facilities – neither do they access such services.
Where available, MSW complain of non-availability or non-affordability of drugs and medicines,
poor quality of services, inconvenient location or reach and poor logistics.

Economic Needs – financial support in the wake of unemployment or underpaid employment,

vocational training and guidance and support through provision of infrastructure to begin
entrepreneurial activities, training and guidance in sustaining economic ventures.

Social Acceptance – MSW face untold suffering upon disclosure of their status in public as a
result of increasing stigma and discrimination against sex work that is considered taboo and with
even more strictures placed on same-sex activities. There is an immediate need to sensitize the
general public through various programmes on the prevalence of male sex work activity and
preventive measures that need to be adopted to stem HIV infection through this mode.

Psychological – Male Sex Workers reportedly face increasing psychological pressure that is
projected by their sense of low self-esteem, powerlessness and dejection in society. However,
professional counselling services are scattered and few NGO/ CBO provide services to a handful
of MSW. Many MSW are unaware of the availability of such services across each city and have
no clue as to how to access such services.

Targeted Interventions on Male Sex Workers need to be drawn through a well-defined multi-
pronged strategy with specific components such as:
i. MSW-centred communications strategy
ii. Condom programming
iii. Prevention programmes at MSW and general population
iv. Care and support initiatives focused at MSW and
v. Advocacy among media/ law enforcers on issues facing MSW

Barriers and obstacles faced by MSW too need to be identified and broken down.

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ANNEXURE – 1 (KOLKATA)

Table – 1
Age of Male Sex Workers (MSW)
Age of MSW (N = 75)
Age in Age at first Age first sex Average age
Age completed sex with money/ of client
Range years (Percent) gifts (%) (Percent)
(Percent)
5 61 41 3
< 18
6.7 81.3 54.6 4.0
35 14 30 23
19-25
46.7 18.7 40.0 30.7
22 --- 25
26-32 ---
29.3 33.3
11 --- 19
33-39 ---
14.7 25.3
2 --- 5
40 & > ---
2.7 6.7

Table – 2
Education status of Male Sex Workers (MSW)
Education status of MSW (N = 75)
Responses
Education
(Percent)
5
Illiterate
6.7
19
Primary
25.3
23
Middle school
30.7
16
Higher Secondary
21.3
6
Technical
8.0
5
Higher Education
6.7
1
No Response
1.3

Table – 3
Marital status of Male Sex Workers (MSW)
Marital status of MSW (N = 75)
Responses
Marital status
(Percent)
53
Unmarried
70.7
9
Married, living with spouse
12.0
7
Married, living without spouse
9.3
5
Separated/ Divorced
6.7
1
No Response
1.3

Table – 4
Nature of occupation of Male Sex Workers (MSW)

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Nature of occupation of MSW (N = 75)

Responses
Nature of occupation
(Percent)
25
Unemployed
33.3
47
Full-time employed
62.7
3
Part-time employed
4.0

Table – 5
Average monthly income of Male Sex Workers (MSW) (all sources)
Average monthly income of MSW
from all sources (N = 75)
Responses
Average Monthly Income
(Percent)
48
< Rs.2500
64.0
25
Rs.2501 – Rs.5000
33.3
2
> Rs.5001
2.7

Table – 6
Average monthly income of Male Sex Workers (MSW) (Sex work)

Average monthly income of MSW

from sex work (N = 75)
Responses
Average Monthly Income
(Percent)
41
< Rs.1500
54.7
28
Rs.1501 – Rs.3000
37.3
6
> Rs.3001
8.0

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Table – 7
Media habits of Male Sex Workers (MSW)
Media habits of MSW (N = 75)
(multiple responses)
Responses
Nature of Mass Media
(Percent)
71
Television
94.7
49
Radio
65.3
53
Newspaper
76.7
16
Magazines
21.3
17
Cinema
22.7

Table – 8
Other habits of Male Sex Workers (MSW)
Other habits of MSW (N = 75)
(multiple responses)
Responses
Other common habits (Percent)
51
Smoking
68.0
33
Alcoholism
44.0
14
Drugs
18.7
30
Consuming tobacco
40.0
19
Other habits
25.3

Table – 9
Sources of Awareness on HIV/AIDS of MSW
Sources of Awareness on HIV/AIDS of MSW (N =
75) (multiple response)
Responses
Sources of awareness
(Percent)
66
Television
88.0
44
Radio
58.7
40
Newspaper
53.3
41
Poster
54.7
32
Pamphlet
42.7
34
Doctor
45.3
50
NGO/ CBO
66.7
52
Friends
69.3
32
Other sources
42.7

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Table – 10
Problems faced by MSW
Problems encountered by MSW (N = 75) (multiple response)
Responses
Sources of awareness
(Percent)
51
Jealousy
68.0
41
Robbing clients from peers
54.7
43
Police harassment/ sex
57.3
24
Blackmailing by clients, others
32.0
43
Cheating, being underpaid after sex
57.3
28
Switching of loyalty by clients
37.3
38
Hiding behaviour from family, friends
50.7
32
Fear of disclosure by self to others
42.7
24
Unwanted disclosure by others without consent
32.0
37
Constant fear of being exposed in society
49.3
39
Other problems
52.0

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ANNEXURE – 2 (AHMEDABAD)

Table –11
Age of Male Sex Workers (MSW)

Age of MSW (N = 75)

Age in Age at first Age first sex Average age
Age completed sex with money/ of client
Range years (Percent) gifts (%) (Percent)
(Percent)
1 70 33 34
< 18
1.3 93.3 44.0 45.3
31 5 37 32
19-25
41.3 6.7 49.3 42.7
20 5 8
26-32 ---
18.7 6.7 10.7
13 --- 1
33-39 ---
17.3 1.3
10 --- ---
40 & > ---
13.3

Table – 12
Education status of Male Sex Workers (MSW)

Education status of MSW (N = 75)

Responses
Education
(Percent)
10
Illiterate
13.3
22
Primary
29.3
27
Middle school
36.0
10
Higher Secondary
13.3
Technical ---
2
Higher Education
2.7
4
No Response
5.3

Table – 13
Marital status of Male Sex Workers (MSW)

Marital status of MSW (N = 75)

Responses
Marital status
(Percent)
45
Unmarried
60.0
26
Married, living with spouse
34.7
1
Married, living without spouse
1.3
3
Separated/ Divorced
4.0

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Table –14

Nature of occupation of Male Sex Workers (MSW)

Nature of occupation of MSW (N = 75)
Responses
Nature of occupation
(Percent)
5
Unemployed
6.7
10
Full-time employed
13.3
60
Part-time employed
80.0

Table – 15

Average monthly income of MSW

from all sources (N = 75)
Responses
Average Monthly Income
(Percent)
70
< Rs.2500
93.3
2
Rs.2501 – Rs.5000
2.7
3
> Rs.5001
4.0

Table – 16
Average monthly income of Male Sex Workers (MSW) (Sex work)

Average monthly income of MSW

from sex work (N = 75)
Responses
Average Monthly Income
(Percent)
41
< Rs.1500
54.7
26
Rs.1501 – Rs.3000
34.7
8
> Rs.3001
10.7

Table – 17
Media habits of Male Sex Workers (MSW)

Media habits of MSW (N = 75)

(multiple responses)
Responses
Nature of Mass Media
(Percent)
69
Television
92.0
46
Radio
61.3
57
Newspaper
82.0
13
Magazines
17.3

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7
Cinema
9.3

Table – 18
Other habits of Male Sex Workers (MSW)

Other habits of MSW (N = 75)

(multiple responses)
Responses
Other common habits (Percent)
20
Smoking
26.6
10
Alcoholism
13.3
1
Drugs
1.3
33
Consuming tobacco
44.0

Other habits ---

Table – 19
Sources of Awareness on HIV/AIDS of MSW

Sources of Awareness on HIV/AIDS of MSW (N =

75) (multiple response)
Responses
Sources of awareness
(Percent)
54
Television
72.0
34
Radio
45.3
39
Newspaper
52.0
50
Poster
66.7
42
Pamphlet
56.0
40
Doctor
53.3
74
NGO/ CBO
98.7
66
Friends
88.0
1
Other sources
1.3

Table – 20
Problems faced by MSW

Problems encountered by MSW (N = 75) (multiple response)

Responses
Sources of awareness
(Percent)
64
Jealousy
85.3
56
Robbing clients from peers
74.7

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40
Police harassment/ sex
53.3
38
Blackmailing by clients, others
50.7
49
Cheating, being underpaid after sex
65.4
44
Switching of loyalty by clients
58.6
42
Hiding behaviour from family, friends
56.0
31
Fear of disclosure by self to others
41.3
36
Unwanted disclosure by others without consent
48.0
40
Constant fear of being exposed in society
53.3
3
Other problems
4.0

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ANNEXURE – 3 (VIJAYAWADA)

Table – 21
Age of Male Sex Workers (MSW)
Age in Age at first Age first sex Average age
Age completed sex with money/ of client
Range years (Percent) gifts (%) (Percent)
(Percent)
2 59 20 1
< 18
2.7 78.7 26.7 1.3
38 15 52 41
19-25
50.7 20.0 69.3 54.7
25 1 3 27
26-32
33.3 1.3 4.0 36.0
8 6
33-39 --- ---
10.7 8.0
2
40 & > --- --- ---
2.7

Table – 22
Education status of Male Sex Workers (MSW)
Responses
Education
(Percent)
5
Illiterate
6.7
15
Primary
20.0
31
Middle school
41.3
16
Higher Secondary
21.3
7
Technical
9.3
1
Higher Education
1.3

Table – 23
Marital status of Male Sex Workers (MSW)
Responses
Marital status
(Percent)
42
Unmarried
56.0
28
Married, living with spouse
37.3
2
Married, living without spouse
2.7
3
Separated/ Divorced
4.0
Table – 24
Nature of occupation of Male Sex Workers (MSW)

Responses
Nature of occupation
(Percent)
14
Unemployed
18.7
34
Full-time employed
45.3

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27
Part-time employed
36.0

Table – 25
Average monthly income of Male Sex Workers (MSW) (all sources)
Average monthly income of MSW
from all sources (N = 75)
30
< Rs.2500
40.0
39
Rs.2501 – Rs.5000
52.0
6
> Rs.5001
8.0

Table – 26
Average monthly income of Male Sex Workers (MSW) (Sex work)
Average monthly income of MSW
from sex work (N = 75)
61
< Rs.1500
81.3
11
Rs.1501 – Rs.3000
14.7
3
> Rs.3001
4.0

Table – 27
Media habits of Male Sex Workers (MSW)
Media habits of MSW (N = 75)
(multiple responses)
Responses
Nature of Mass Media
(Percent)
63
Television
84.0
25
Radio
33.3
22
Newspaper
29.3
5
Magazines
6.7

Table – 28
Other habits of Male Sex Workers (MSW)
Responses
Other common habits (Percent)
35
Smoking
46.7
55
Alcoholism
73.3
10
Drugs
13.3
27
Consuming tobacco
36.0
1
Other habits
1.3

Table – 29
Sources of Awareness on HIV/AIDS of MSW
Responses
Sources of awareness
(Percent)

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55
Television
73.3
24
Radio
32.0
43
Newspaper
57.3
58
Poster
77.3
50
Pamphlet
66.7
11
Doctor
14.7
38
NGO/ CBO
50.7
41
Friends
54.7

Table – 30
Problems faced by MSW
Problems encountered by MSW (N = 75) (multiple response)
Responses
Sources of awareness
(Percent)
66
Jealousy
88.0
53
Robbing clients from peers
70.7
51
Police harassment/ sex
68
22
Blackmailing by clients, others
29.3
54
Cheating, being underpaid after sex
72.0
15
Switching of loyalty by clients
20.0
45
Hiding behaviour from family, friends
60.0
16
Fear of disclosure by self to others
21.3
12
Unwanted disclosure by others without consent
16.0
18
Constant fear of being exposed in society
24.0
1
Other problems
1.3

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