The first step of this project was conducting formative research in 2003, with young men in low-income communities in Mumbai (formerly known as Bombay), India, on the links between gender and masculinity, sexuality, and health risk. Formative research involved qualitative methods of data gathering employing key informant and in-depth interviews, mapping exercises and focus group discussions (FGDs). Trained peer leaders from three low-income communities conducted a total of 51 interviews with young men in the age group of 16-24 years and four FGDs with community leaders and young women from the same communities.

Then, intervention activities for young men were developed/adapted, including a curriculum for group education. In the second half of 2004, peer leaders were trained to implement the activities, and a group of over 100 young men participated in group education sessions over a 6-month period. Pre and post-test surveys were conducted, as well as qualitative interviews and observations, by an independent study team to determine the feasibility and acceptability, as well as the impact of the intervention. Changes in attitudes towards gender norms – using the Gender-Equitable Men (GEM) Scale developed by Horizons and Instituto Promundo (see Box) – as well as changes in violence and HIV risk behaviours were measured. A gender-equitable man was defined for this project as one that: 1) supports relationships based on respect, equality and intimacy rather than sexual conquest; 2) is an involved father, both financially and in terms of care-giving; 3) takes responsibility for reproductive health and disease prevention; and 4) opposes intimate partner violence.

Real men and women

The concept of an asli nari or an "ideal woman" was also explored. She was shy and did not respond to men's sexual advances. These women were considered "marriageable". In contrast, girls who did not match these ideals "deserved" (and often were subject to) sexual harassment.

Yari-dosti – Tapping alternative voices

Based on the results from the formative study, the team developed an intervention called Yari-dosti, which means friendship or bonding among men. The intervention was adapted from Program H, a group-based project working with young men that was developed and tested by Instituto Promundo and partners in Brazil.¹ Both Program H and the Yari-dosti project seek to tap into "alternative" voices of young men that promote more gender-equitable norms and behaviours. During a weeklong workshop, followed by two months of community consultations, the team adapted 20 group educational exercises for the Indian context. Among the main themes covered in the exercises were STI/HIV risk and prevention, partner, family and community violence, gender and sexuality, and the reproductive system.

These exercises were then piloted and tested with a group of young men from low-income communities in Mumbai. Selected peer leaders underwent an intensive two-week training programme to strengthen their knowledge and facilitation skills. Peer leaders then recruited young men from the community to participate in the intervention. The 126 participants thus recruited were divided into four groups of 30-35 participants each. The pilot started with an intensive week of group educational activities, facilitated by peer leaders and gender specialists and was followed by two to three-hour sessions every week, led by peer leaders only, for a duration of six months.

Results from the intervention

Process data indicate that almost all of the young men recruited for the project consistently participated in activities. Also, most were greatly interested in the topic areas addressed, as it was their first opportunity to discuss these issues with other men. Participants were initially most interested in factual/biological information (e.g., on the human body, sex, HIV), but over time they found sessions on gender-related attitudes, sexual violence, and power dynamics between men and women very engaging. The peer leaders observed that the process of change began with denial of existing norms and their links to risk, to gradual acceptance that these norms existed, and that change would be worthwhile, and then to exploring ways to challenge these norms and behaviours.

Based on the experiences generated during the pilot intervention, a large evaluation of the group education intervention – with over 1000 young men – has begun in the city of Mumbai and the states of Goa and Uttar Pradesh. In addition, a community-based "lifestyle" social marketing campaign, consisting of activities such as street theatre and poster distribution, is under development. The campaign will act to reinforce the gender equitable and HIV prevention messages from the group education sessions. With the tag line Soch sahi mard vahi ("A real man has the right attitude"), the campaign is being designed and executed by young men from the community.