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Sexual Practices, HIV and Sexually Transmitted Infections Among Self-Identified Men who Have Sex with Men in Four High HIV Prevalence States of India.

Author (s): 
Brahmam, G N V, Kodavalla, V; Rajkumar, H
Publication details: 
USA, Lippincott Williams & Wilkins, 2008
Publication in: 
AIDS 2008, 22(suppl 5): S45–S57
Abstract:

Objective: To describe the sociodemographic characteristics, prevalence of high-risk sexual behaviours, HIV, sexually transmitted infections (STI), and perception of risk in self-identified men who have sex with men (MSM) in four south Indian states.

Methods: A cross-sectional probability-based survey of 4597 self-identified MSM in selected districts from four states in south India was undertaken. Self-defined sexual identity, sexual behaviour, and STI/HIV knowledge were assessed using a structured questionnaire. Blood and urine samples were tested for HIV and STI. Recruitment criteria differed slightly across states.

Results: When grouped by self-identity, the HIV prevalence was:hijra(transgender)
18.1%; bisexuals 15.9%;kothis(anal-receptive) 13.5%; double-deckers (both analinsertive/anal-receptive) 10.5%; and panthis(anal-insertive) 7.6%. Reported condom use with last paid male partner was over 80% in all states and categories. Consistent condom use was overall low among self-identified MSM, with less than 29% with noncommercial non-regular male partners and less than 49% with regular male partners. The percentage of self-identified MSM with regular female partners was 4–43%and with commercial female partners was 14–36% across states, and consistent condom use differed by self-identity. Syphilis prevalence was high among kothis andhijras(15.8 and 13.6%, respectively). Urethral gonorrhoea prevalence was less than 1% and chlamydia prevalence ranged from 0.4 to 4.0%.

Conclusion: HIV prevalence and risk behaviour within these self-identified MSM
communities in south India is high. Moreover, a significant proportion of them had female partners, both regular and commercial. The national programme’s focus on HIV prevention services for these high-risk MSM is justified.