Year : 2011 | Volume
: 56 | Issue : 1 | Page : 116--118
Study of risk factors for std and HIV infection among fish spawn traders: A unique mobile population
Sabyasachi Banerjee1, Dwijendra Nath Gangopadhyay1, Sujay Singh2, Sreeparna Ghosh Majumdar2,
1 Department of Dermatology, Calcutta National Medical College, Kolkata, India
2 Naihati Prolife, a Govt. registered NGO. Haridas Ghosh Road, P.O. Naihati, Dist. 24 Parganas (N) - 743 165, Kolkata, India
Haridas Ghosh Road, 24 pargana (N), Kolkata-743165
|How to cite this article:|
Banerjee S, Gangopadhyay DN, Singh S, Majumdar SG. Study of risk factors for std and HIV infection among fish spawn traders: A unique mobile population.Indian J Dermatol 2011;56:116-118
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Banerjee S, Gangopadhyay DN, Singh S, Majumdar SG. Study of risk factors for std and HIV infection among fish spawn traders: A unique mobile population. Indian J Dermatol [serial online] 2011 [cited 2022 Jan 24 ];56:116-118
Available from: https://www.e-ijd.org/text.asp?2011/56/1/116/77574
The incidence of HIV/AIDS in India is increasing drastically, and truck drivers are seen as critical sources of HIV transmission due to their high rates of unprotected sex with multiple partners.  Naihati, a suburban township in North 24 Parganas beside the river Ganges, 38 km north of Kolkata, is frequented by a unique mobile population, the fish spawn traders. Gangetic alluvial soil with suitable pH, a number of brackish water tanks, submersible lands, and plenty of rainfall enabled this area to grow as a vibrant market of fish spawn. There are more than 200 hatcheries at Naihati and its surrounding villages, which cater to the growing demand from various states of India. About 20000 people are involved in different aspects of this trade, 90% of them being migratory in nature. Their basic job is to buy fish spawn from market through auction, load tanks containing spawns on trucks, attend to these tanks throughout the journey by the way of oxygenating and changing water on roadside as and when necessary and sell them to distant markets for further pisciculture. These fish spawn traders and associated truckers arrive on their trucks at Naihati in the evening from 5 P.M. onwards. The market takes off at about 3 A.M. everyday and they leave for destination between 4 A.M. and 7 A.M. So, they are compelled to spend several hours together leisurely playing cards, gambling, indulging in addictions (alcohol and ganja), and most importantly, visiting red light areas in and around Naihati. During their long journey, they meet flying sex workers, mostly girls from slums by the sides of expressways, woman brick-field workers and agricultural workers, especially at night. They have sex in the bamboo bushes, open paddy or jute fields and inside roadside hotels and dhabas, where they halt for rest and food, if not on running trucks. We aimed to study knowledge, attitude, and practice of this hitherto unattended unique mobile population toward sexually transmitted diseases and HIV/AIDS and identify risk factors that make them vulnerable to HIV infection.
This paper was jointly conducted by the Department of Dermatology and Naihati Prolife, a local NGO who were already known to local people for their service. A detailed questionnaire was duly formulated and pretested. A list of dhabas where these people attend was made, five dhabas were randomly selected from the list and 40 fish spawn traders from each dhaba who took rest there were randomly chosen for one to one interaction with the interviewer.
A total of 200 fish spawn traders were interviewed. All of them were male. The monthly income of each trader depended on number of trips taken and was between Rs. 3000 and Rs. 4000 per month. Fifty-three percent of the respondents were married. The minimum age was 16 and maximum was 57. Most people (40.5%) belonged to age group 20-25 years.
About 38% of the subjects were illiterate, 6.5% could put their signature, 38% had primary education, 13.5% had secondary education, and only 4% ever went to college.
Two major habits of the study population are taking alcohol and ganja. About 63.5% of the respondents were addicted to alcohol while 27% to ganja. Some of them take both. Another 6.5% confessed to taking intravenous drugs too. We included those taking alcohol or ganja habitually at least thrice in a week for computation. Occasional drinkers were not included.
Prevalence of STD among the study population at the time of interview (self-reported) was 74.5% (n = 149). For their STD, 62.4% (n = 93) of respondents never sought any treatment except from faith healers (who dispense jaributi as well as various indigenous obscure medicine), 21.48% (n = 32) went to quacks for remedy, 6% (n = 9) visited private clinic, 4.03% (n = 6) took advice from medicine shop, 3.35% (n = 5) went to homoeopath, and only 2.68% (n = 4) visited any Government clinic.
The sexual behavioral pattern of the study population is a high-risk one, with frequent involvement in commercial sex. We found that 3% of the subjects had no sexual partner, 2% had sex only with spouse, 15% had 1-3 sex partners apart from spouse, 11% had 4-7 sex partners, 10.5% had 8-10 partners while a whopping 58.5% had more than 10 partners during last one year.
Among the respondents, 77% knew no risk factor for spread of STD, 17% knew one while 6% knew two or more risk factors for spread of STD. None of them heard the term HIV while 48% heard about AIDS. Only 6.5% knew that presence of STD increases the chance of acquiring AIDS. 36% thought that AIDS is fully curable.
Regarding routes of transmission of HIV/AIDS, 21% knew that AIDS can be acquired by sexual intercourse, 11.5% said that it spreads through blood, 8% knew of infected syringe and needle while 10.5% were aware of mother to child transmission.
Myths and misconceptions abound within the study population regarding routes of transmission of HIV/AIDS. Toilet (36%), unhygienic life style (32.5%), touch (21.5%), barber's shop (20%), bathing in dirty pond (18%), mosquito bite (16%), spicy food (6%), and addiction (5.5%) were mentioned as causes of AIDS during the study.
Glaring misconceptions related to sexual behavior also came up during the study. As high as 45.5% of respondents thought that there was no risk of disease if sex partner is an unmarried girl, 38% said that multiple sex partners increase sexual power, 25.5% of respondent held that it is good to have multiple sex partners since it reduces chance of being infertile. Moreover, 24% believed STD is cured by having sex with virgin girl. About 22.5% said that only two to three sexual partners does not cause STD while 19% said that only women become victim of AIDS if they have multiple sex partners.
Regarding awareness and practice pertaining to condom, 84% heard about it. 81.5% of respondents knew condom as birth control measure while only 10.5% knew it as STD/HIV preventing measure. 18% of people ever used condom. Only 8.5% used condom during commercial sex. None used condom in every act.
When categorically asked why they did not use condom, the respondents revealed several myths and misconceptions related to usage of condom prevalent in the community. Of those interviewed, 56% said that condom reduces pleasure of sex, while 41% said that it reduces sexual power. Another 28.5% said that condom causes urethral discharge since it itself is infected, 18.5% answered that condom causes cardiac problems, and 16% thought condom to be a cause of cancer.
The fish spawn traders are a mobile population, which share many characteristics of medium to long distance truckers who ply on our highways and, therefore, have similar sexual practice and vulnerabilities. The truckers are already known as a vulnerable group. , Long absence from home, availability of liquid money during journey, and readily available commercial sex partners at their resting places as well as while on the move are social reasons for their having multiple sex partners. Low literacy and substance abuse contribute to this risky behavior.
All of the respondents are of sexually active age group (16-57 years) and 95% of them confess to have history of promiscuity. High level of addiction also comes in the way of self-restrain. Poor level of literacy make them immune to Government campaign through mass media about prevention of STD/HIV. This fact is corroborated by high prevalence of STD and total non-familiarity with the term HIV among the respondents. More appalling is the treatment seeking behavior of the community for STD. Less than 10% consulted qualified doctors for treatment.
However, the figure of prevalence of STD (74.5%), being self-reported, sees to be higher than the actual prevalence. It reflects the perception of the respondents rather than the interviewer. The lay people tend to refer any symptom pertaining to sexual organs as well as psychosexual problems, e.g., erectile problems, loss of libido, and DHAT syndrome as STD. This must have inflated the figures that should ideally reflect the prevalence of reproductive-tract infection only. Conception regarding risk factors and modes of prevention of STD was seriously lacking. Regarding AIDS, though about half of respondents heard of it, knowledge of correct routes of transmission was far outweighed by misconception. These misconceptions are responsible for poor perception of risk, unnecessary panic, and formation of unhealthy attitude toward the disease. In spite of belonging to a high-risk group, only 11.5% thought that they were at risk of suffering from AIDS, none of them ever availed any HIV-related service, voluntary counseling or blood testing.
Use of condom as a method of preventing STD/HIV is very poor among the community with no consistent user in the group. However, this is commensurate with the prevailing myth and misconception and negative mindset of the community towards condom. Similar barriers came up in an African study among truck drivers a couple of years ago.  Consistent, determined counseling, and propaganda are necessary to change this negative attitude. Non-availability of quality condom in places accessed by them is also a serious issue. There was no condom outlet in and around the market area. Lack of awareness regarding hazards of STD/HIV, faulty attitude toward sexual health, and accompanying unsafe sex practice make this hard-to-reach community helpless prey to the menace of HIV infection. The same is true for similar mobile population of developing countries across the world. ,,
There is no vaccine to cure AIDS. Until a cure or vaccine for HIV infection is found, the only way to prevent the spread of the disease is by changing people's behavior through AIDS education programs. This is what "social vaccine" is all about. It involves spreading education on how to protect oneself, hundred percent condom use, and changing sexual behavior.  For prevention of HIV/AIDS among the unique high-risk mobile population under study, a targeted intervention program with components like STD treatment service at strategic points accessible to the target community, condom promotion and innovative behavioral change communication based on felt need of focus groups is recommended. The local NGO is arranging to take up this program among this group.
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