Sexual practices, HIV and sexually transmitted infections among self-identified men who have sex with men in four high HIV prevalence states of India
Brahmam, G.N.V.; Kodavalla, V.; Rajkumar, H.; Rachakulla, H.K.; Kallam, S.; Myakala, S.P.; Paranjape, R.S.; Gupte, M.D.; Ramakrishnan, L.; Kohli, A.; Ramesh, B.M.; Deshpande, A.; Amey, S.; Salagare, A.; Risbud, A.; Kishorekumar, B.; Bhagyashri; More, D.; Pardeshi, D.; Mehetre, G.; Navale, J.; Dale, J.; Mainkar, M.; Pore, M.; Panchal, N.; Gupta, R.; Gangakhedkar, R.; Kale, S.; Sachin, P.; Aralkar, S.; Vetal, S.; Kazi, S.; Gaikwad, S.; Jadhav, S.; Deshpande, S.; Zankar, S.; Khatavkar, T.; Joshi, T
Aids 22(Suppl 5): S45-S57
2008
ISSN/ISBN: 1473-5571 PMID: 19098479 DOI: 10.1097/01.aids.0000343763.54831.15Document Number: 204331
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. 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. When grouped by self-identity, the HIV prevalence was: hijra (transgender) 18.1%; bisexuals 15.9%; kothis (anal-receptive) 13.5%; double-deckers (both anal-insertive/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 non-commercial 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 and hijras (15.8 and 13.6%, respectively). Urethral gonorrhoea prevalence was less than 1% and chlamydia prevalence ranged from 0.4 to 4.0%. 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.