Association Between Alcohol Use and HIV-Related Sexual Risk Behaviors Among Men Who Have Sex with Men (MSM): Findings from a Multi-Site Bio-Behavioral Survey in India

Yadav, Dipendra Kumar; Chakrapani, Venkatesan; Goswami, Prabuddhagopal; Ramanathan, Shreena; Ramakrishnan, Lakshmi; George, Bitra; Sen, Shrabanti; Subramanian, Thilakavathi; Harikumar, R.; Paranjape, Ramesh

doi:10.1007/s10461-014-0699-x

Cited by 37 publications

(29 citation statements)

References 41 publications

(53 reference statements)

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“…Our results, wherein 45% of our sample had an AUD vs. 12% in the general population (WHO Country Profiles, 2014), would seem to support findings from a number of recent international studies that suggest a high burden of alcohol use among gender/sexual minority groups (Lu et al, 2013; Li and McDaid, 2014; Yadav et al, 2014; Kalichman et al, 2007b). However, our sample was distinctly high-risk due to the inclusion criteria, and therefore most likely any comparisons to the general population are more exaggerated than if the sample had not focused on high-risk MSM/TW.…”

Section: Discussionsupporting

confidence: 88%

Impact of alcohol use on sexual behavior among men who have sex with men and transgender women in Lima, Peru

Herrera

Konda

León

et al. 2016

Drug and Alcohol Dependence

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Background Alcohol use disorders (AUDs) may enhance the likelihood of risky sexual behaviors and the acquisition of sexually transmitted infections (STIs). Associations between AUDs with condomless anal intercourse (CAI) and STI/HIV prevalence were assessed among men who have sex with men (MSM) and transgender women (TW) in Lima, Peru. Methods MSM and TW were eligible to participate based on a set of inclusion criteria which characterized them as high-risk. Participants completed a bio-behavioral survey. An AUDIT score ≥8 determined AUD presence. Recent STI diagnosis included rectal gonorrhea/chlamydia, syphilis, and/or new HIV infection within 6 months. Prevalence ratios (PR) were calculated using Poisson regression. Results Among 312 MSM and 89 TW, 45% (181/401) had an AUD. Among those with an AUD, 164 (91%) were hazardous/harmful drinkers, and 17 (9%) had alcohol dependence. Higher CAI was reported by participants with an AUD vs. without, (82% vs. 72% albeit not significant). Reporting anal sex in two or more risky venues was associated with screening AUD positive vs. not (24% vs. 15%, p=0.001). There was no difference in recent STI/HIV prevalence by AUD status (32% overall). In multivariable analysis, screening AUD positive was not associated with CAI or recent STI/HIV infection. Conclusions In our sample AUDs were not associated with CAI or new HIV infection/recent STI. However higher prevalence of CAI, alcohol use at last sex, and anal sex in risky venues among those with AUDs suggests that interventions to reduce the harms of alcohol should be aimed toward specific contexts.

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Section: Discussionsupporting

confidence: 88%

Impact of alcohol use on sexual behavior among men who have sex with men and transgender women in Lima, Peru

Herrera

Konda

León

et al. 2016

Drug and Alcohol Dependence

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“…While our qualitative results did not yield insight into injection drug use, perhaps due to the relatively low overall prevalence of injection among MSM, they support pervasive alcohol use and its role in managing psychological stress associated with being MSM. Other studies among MSM have also highlighted the diverse uses of alcohol and its role in high-risk sexual behavior [14, 18, 20, 21, 66]. Since substance use is both a cause and consequence of poor psychosocial health, including depression, these associations are difficult to disentangle [17, 65].…”

Section: Discussionmentioning

confidence: 99%

Diverse Rates of Depression Among Men Who Have Sex with Men (MSM) Across India: Insights from a Multi-site Mixed Method Study

et al. 2015

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Poor psychosocial health contributes to HIV risk behavior and reduced engagement in treatment and care. This study investigates depression and its correlates among 11,992 MSM recruited via respondent driven sampling in 12 cities across India using the Patient Health Questionnaire-9 and supplemented by analysis of qualitative research from 15 sites with 363 MSM. Overall prevalence of depression was 11 %, with substantial variation across sites and subgroups of MSM, and high prevalence of suicidal thoughts among depressed MSM. In multivariable analyses identification as a kothi (feminine sexual identity) [adjusted odds ratio (aOR) = 1.91], disclosure of being MSM to non-family (aOR = 1.7) and family (aOR = 2.4), disclosure of HIV-status (aOR = 5.6), and substance use were associated with significantly higher odds of depression. Qualitative results emphasized dire social consequences of disclosing MSM- and HIV- status, especially to family, including suicidality. Combination prevention interventions should include mental health services that address disclosure, suicidality, and substance use.

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“…In 2004 India introduced free provision of ART through government run ART centers and at the present time, the existing centers are able to serve approximately 35% of those needing treatment (30). One of the primary factors fueling the HIV epidemic in India is alcohol consumption (31). For the past 20 years, alcohol marketing, sales and consumption have climbed rapidly and drinking preferences have shifted to alcohol with higher ethanol content per standard drink, primarily from Indian-produced whiskey (32–34).…”

Section: Introductionmentioning

confidence: 99%

Identifying the Intersection of Alcohol, Adherence and Sex in HIV Positive Men on ART Treatment in India Using an Adapted Timeline Followback Procedure

Schensul

et al. 2017

AIDS Behav

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Objective(s) People Living with HIV (PLHIV) on anti-retroviral treatment (ART) who drink are less adherent and more likely to engage in unprotected sex. Using an adapted Timeline Follow-Back (A-TLFB) procedure, this paper examines the day by day interface of alcohol, medication adherence and sex to provide a fine grained understanding of how multiple behavioral risks coincide in time and space, explores concordance/discordance of measures with survey data and identifies potential recall bias. Methods Data are drawn from a survey of behavior, knowledge and attitudes, and a 30 day TLFB assessment of multiple risk behaviors adapted for the Indian PLHIV context, administered to 940 alcohol-consuming, HIV positive men on ART at the baseline evaluation stage of a multilevel, multi-centric intervention study Results On days participants drank they were significantly more likely to be medication non-adherent and to have unprotected sex. In the first day after their alcohol consuming day, the pattern of nonadherence persisted. Binge and regular drinking days were associated with nonadherence but only binge drinking co-occurred with unprotected sex. Asking about specific “drinking days” improved recall for drinking days and number of drinks consumed. Recall declined for drinking days and nonadherence from the first week to subsequent weeks but varied randomly for sex risk. There was high concordance and low discordance between adapted TLFB drinking and nonadherence but these results were reversed for unprotected sex. Conclusions Moving beyond simple drinking-adherence correlational analysis, the adapted TLFB offers improved recall probes and provides researchers and interventionists with the opportunity to identify types of risky days and tailor behavioral modification to reduce alcohol consumption, nonadherence and risky sex on those days.

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Association Between Alcohol Use and HIV-Related Sexual Risk Behaviors Among Men Who Have Sex with Men (MSM): Findings from a Multi-Site Bio-Behavioral Survey in India

Cited by 37 publications

References 41 publications

Impact of alcohol use on sexual behavior among men who have sex with men and transgender women in Lima, Peru

Impact of alcohol use on sexual behavior among men who have sex with men and transgender women in Lima, Peru

Diverse Rates of Depression Among Men Who Have Sex with Men (MSM) Across India: Insights from a Multi-site Mixed Method Study

Identifying the Intersection of Alcohol, Adherence and Sex in HIV Positive Men on ART Treatment in India Using an Adapted Timeline Followback Procedure

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