High HIV prevalence among Indian Men who have sex with men

[Guest guest]

Men who have sex with men in India have high HIV prevalence and

multiple risk factors for HIV

HIV prevalence is significantly higher among men who have sex with

men in India than among men reporting only sex with women, according

to a study published in the March 1st edition of the Journal of

Acquired Immune Deficiency Syndromes. The study also revealed that

the majority of men reporting sex with men were married, and that HIV-

positive men who reported having sex with men were also likely to

report multiple risk factors for HIV, including drug use, multiple

sex partners and exchanging sex for money.

India has the second-highest number of HIV-positive people in the

world, and evidence suggests that heterosexual sex is the main mode

of transmission. The prevalence of HIV amongst men who have sex with

men in India is not known, and, unlike the situation in many other

countries, men who have sex with men in India often do not conform to

a homosexual identity.

Investigators therefore wished to determine the prevalence of HIV and

other sexually transmitted infections among men reporting oral or

anal sex with another man in the Chennai slums.

The study was a cross-sectional population-based one, and recruited a

random sample of 774 men in 2001. Participants provided details of

their sexual and drug use behaviour to trained counsellors and

provided a blood sample for HIV and syphilis testing and a urine

sample for chlamydia and gonorrhoea testing.

A total of 46 men (5.9%) reported ever having sex with another man,

and 6.5% of these men were HIV-positive compared to only 0.9% of men

who did not report sex with another man.

Men who had sex with men were also more likely to report a history of

sexually transmitted infections (odds ratio 2.66, 95% CI: 1.18 –

6.02), or to report having discharge from the penis (OR = 3.96, 95%

CI: 1.87 – 8.38), than men who did not report sex with men.

The investigators also found that men reporting sex with other men

were also significantly more likely to engage in other HIV risk

behaviours, including the use of illicit drugs (OR = 4.94, 95% CI:

2.61 – 9.34), more than four life-time sexual partners (OR = 3.22,

95% CI: 1.78 – 5.83), and exchanging money for sex (OR = 5.50, 95%

CI: 3.12 – 9.96).

" Overall, [men who have sex with men] are more likely than non-[men

who have sex with men] to be infected with HIV and more likely to

have a history of STs, " comment the investigators. However, they

add that HIV-positive men who have sex with men are also more likely

to report other risk activities that could result in HIV infection.

Although the investigators did not gather information on sexual

identity, they noted that 57% of men reporting sex with another man

were married, " reflecting the fluidity of sexual behaviour in India. "

The investigators conclude, " Our study suggests that unsafe sex among

men who have sex with men is one of several high HIV risk behaviours

that this subgroup of individuals engages in. Rather than targeting

this group in the context of sexuality, HIV interventions might

address a range of HIV risk behaviours, including a number of unsafe

sexual practices, including sex with men. "

Reference

Go VF et al. High prevalence and risk behaviours in men who have sex

with men in Chennai, India. JAIDS 35: 314 – 319, 2004.

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