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Researching stigmatised communities: lessons from a study of MSM in India
  1. Vijay Kumar Silan1,
  2. Shashi Kant2
  1. 1Department of Community Medicine, BPS Govt. Medical College for Women, Sonepat, Haryana, India
  2. 2Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
  1. Correspondence to Vijay Kumar Silan, Department of Community Medicine, BPS Govt. Medical College for Women, Khanpur Kalan, Sonepat, Haryana, India; vijay.silan{at}gmail.com

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Research with men who have sex with men (MSM) involves many challenges, largely related to the stigma experienced by this community. We describe here our approach in India, which we hope may be useful to future researchers.

Initial rapport building with stakeholders helped us gain an initial understanding of how to formulate our research and obtain undocumented information about the MSM. For example, we familiarised ourselves with code words for sexual practices and sexual partners such as Khomad (oral sex), Baatal Dhuraana (anal sex), Giriya (insertive partner), Kothii (receptive partner), Khanjra (commercial sex) with the help of peer educators and outreach workers. This enabled participants to be more comfortable talking to interviewers.

Interestingly, most chose to remain anonymous by writing a female name on the consent form, and we deferred to this decision. Such ethical issues in MSM research must be seen in the broader context of stigmatisation. We experienced this when nobody came forward to participate in the study on the first day of data collection. In response, we organised a discussion with stakeholders and conducted mock interviews of the peer educators and outreach workers in presence of MSMs on the next day. This was effective, as nearly ten of these men came forward to participate on the next day.

A key factor in recruitment is the special relationship known as guru–chelaa (teacher–student) prevalent among MSM in which the chelaa considers his guru as an authority above their family members. We, therefore, first sought to recruit the guru. Once we interviewed the guru, the chelaas generally consented to participate.

The sharing of challenges and solutions in the conduct of research is important for the next generation of researchers to succeed—this is not sufficiently recognised or achieved in a medical literature that focuses so largely on the publication of results.

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Footnotes

  • Contributors VKS prepared the first draft of the letter. SK reviewed the letter.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval Ethics Committee of Instititute, All India Institute of Medical Sciences, New Delhi.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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