Barbers hold condoms during a training session.

In sleepy Indian suburbs, barbers have long been known as the repository of neighbourhood information. Whether it is juicy gossip on the village head's daughter eloping with a good-for-nothing or a lead on a house for rent, the scissors-wielding chatter-happy service provider always has help at hand.

Their quintessential 'word of mouth' variety of communication has now been identified as one of the most effective ways to hit home the point on HIV/AIDS in rural India, according to a new study.

Training community members such as barbers as peer educators could just be the way of spreading information on HIV/AIDS in these low-literacy, suburban communities. These communities are way behind in the fight against AIDS since HIV awareness programmmes seldom reach them. In a joint global collaboration project, researchers from NGOs Sahaya International and Rural Education and Development (READ, India) along with the University of California have recognized that rural communities are often neglected in such programmes that tend to focus on high-risk groups in urban parts of India, despite much evidence that HIV has spread to the general population.

Their findings1 suggest that education programmes aimed at rural populations face particular challenges. Basic health-care infrastructure tend to be minimal, and there is often low awareness and high stigma regarding HIV (and sexual issues in general), fuelled by low literacy, seasonal migration, gender inequality, spatial dispersion and cultural taboos.

In a year-long pilot project, sponsored by the Elton John AIDS Foundation, six non-governmental organizations (NGO) collaborated to build and test an HIV peer education model for communities in the rural district of Perambalur in Southern India. As part of the programme, 20 NGO outreach workers, 52 barbers and 102 women's self-help group leaders were trained to be peer educators. The researchers created cartoon-based materials including flipcharts, booklets and stickers to teach people about their susceptibility to HIV/AIDS and to suggest practical ways to reduce the risk of infection. They used street theatre to highlight issues related to HIV and stigma in the community.

The programme reached over 30,000 villagers. The outreach workers and peer educators distributed over 60,000 educational materials and nearly 70,000 condoms. Interestingly, at least 118 people were newly diagnosed as living with HIV and 129 people with HIV were referred to hospitals for medical support.

"In many remote rural communities, there are ordinary people with little or no academic credentials, but with proper training and appropriate material they can be empowered to cross their personal boundaries and become extraordinary peer educators," Van Rompay says.

Women trained as peer educators enjoyed a sense of pride and increased social recognition, which the researchers hope could help sustain the peer dialogue on HIV/AIDS, he says.

At their own end, the enlightened barbers have begun using disposable razors following rigorous training on the blood-borne transmission of HIV. Needless to say, they have more customers now and a more meaningful message to disseminate.