HIV Prevention Interventions in Chennai: Are MSM Being Reached?

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HIV Prevention Interventions in Chennai, India: Are Men Who Have Sex with Men

Being Reached?

Beena , J. Mimiaga, H. Mayer, Carey V. , Sunil

Menon, V. Chandrasekaran, P. Murugesan, Soumya Swaminathan, A. Safren.

AIDS Patient Care and STDs. November 2009, 23(11): 981-986.

doi:10.1089/apc.2009.0092.

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Published in Volume: 23 Issue 11: November 20, 2009

Online Ahead of Print: October 12, 2009

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Abstract

India has the greatest number of HIV infections in Asia and the third highest

total number of infected persons globally. Men who have sex with men (MSM) are

considered by the Government of India's National AIDS Control Organization

(NACO) a " core risk group " for HIV in need of HIV prevention efforts. However

there is a dearth of information on the frequency of participation in HIV

prevention interventions and subsequent HIV risk and other correlates among MSM

in India.

Recruited through peer outreach workers, word of mouth and snowball sampling

techniques, 210 MSM in Chennai completed an interviewer-administered assessment,

including questions about participating in any HIV prevention interventions in

the past year, sexual risk taking, demographics, MSM identities, and other

psychosocial variables.

Bivariate and multivariable logistic regression procedures were used to examine

behavioral and demographic correlates with HIV prevention intervention

participation. More than a quarter (26%) of the sample reported participating in

an HIV prevention intervention in the year prior to study participation.

Participants who reported engaging in unprotected anal sex (UAS; odds ratio [OR]

= 0.28; p = 0.01) in the 3 months prior to study enrollment were less likely to

have participated in an HIV prevention program in the past year. MSM who were

older (OR = 1.04; p = 0.05), kothis (feminine acting/appearing and predominantly

receptive partners in anal sex) compared to panthis (masculine appearing,

predominantly insertive partners; OR = 5.52, p = 0.0004), those with higher

educational attainment (OR = 1.48, p = 0.01), being " out " about having sex with

other men (OR = 4.03, p = 0.0001), and MSM who reported ever having been paid in

exchange for sex (OR = 2.92, p = 0.001) were more likely to have reported

participation in an HIV prevention intervention in the preceding year.

In a multivariable model, MSM reporting UAS in the prior 3 months were less

likely to have participated in an HIV prevention intervention (AOR = 0.34, p =

0.04). MSM who were older (AOR = 1.05, p = 0.05), those with higher educational

attainment (AOR = 1.92, p = 0.0009), and MSM who were " out " about having sex

with other men (AOR = 2.71, p = 0.04) were more likely to have reported

participating in an HIV prevention program.

Findings suggest that exposure to HIV prevention interventions may be protective

against engaging in UAS for some MSM in India.

Understanding predictors of participation in an HIV prevention intervention is

helpful for identifying Indian MSM who might have had no exposure to HIV

prevention information and skills building, hence allowing researchers and

prevention workers to focus efforts on individuals at greatest need.