Correlates of HIV Testing Uptake among Kothi-Identified Men who have Sex with Men in Public Sex Environments in Chennai, India

Woodford, Michael R.; Newman, Peter A.; Chakrapani, Venkatesan; Shunmugam, Murali; Kakinami, Lisa

doi:10.1007/s10461-011-9974-2

Cited by 13 publications

(11 citation statements)

References 25 publications

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“…At the personal level, lack of knowledge about HIV/AIDS was related to fear of death. Consistent with other research, (8,12) this study found that those with higher HIV knowledge are more likely to have been tested for HIV. Similarly, concerns about partner's reaction to one's HIV positive status identified in this study was consistent with a South African research (11) that found HIV testing to be delayed due to fear of potential conflict with partner.…”

Section: Barriers To Hiv Testingsupporting

confidence: 91%

Factors influencing HIV testing uptake among priority populations in a resettlement colony of a North Indian city

Choudhary¹,

Chakrapani²,

Kaur³

et al. 2020

Indian J Community Health

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Background: The recent adoption of HIV ‘test and treat’ strategy by India’s National AIDS Control Organization (NACO) necessitates an urgent need to improve HIV testing among priority populations at risk for HIV. Aim & Objectives: To identify barriers to and facilitators of HIV testing among priority populations such as pregnant women, tuberculosis patients, sexual partners of people living with HIV (PLHIV) and key populations; and to examine the role of new HIV testing modalities (e.g., non-invasive HIV testing) in improving HIV testing. Settings and Design: A cross sectional survey was conducted among priority populations in a resettlement colony of Chandigarh, North India. Materials and methods: A total of 160 participants were recruited using non-probability-based sampling. Statistical analysis used: Chi-square test was used to assess differences between priority populations who had been tested or not tested for HIV. Multivariable logistic regression was conducted to identify significant predictors of HIV testing status. Results: Participants with higher HIV knowledge (Adjusted Odds Ratio [aOR] =1.7, 95% CI 1.2 to 2.5) and family support (aOR=8.2, 95% CI 1.9 to 35.3) had higher odds of getting tested for HIV. Major barriers identified were fear of anticipated discrimination and previous bad experiences in government HIV testing centres, and key facilitators were empathetic attitude of the staff and government initiatives (e.g., free-of-cost tests, reimbursements of travel costs). For periodic testing, priority populations preferred non-invasive (non-blood-based) HIV tests. Conclusions: Interventions to promote HIV testing among priority populations need to reduce HIV-related stigma, and offer non-invasive HIV testing in public hospitals.

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Section: Barriers To Hiv Testingsupporting

confidence: 91%

Factors influencing HIV testing uptake among priority populations in a resettlement colony of a North Indian city

Choudhary¹,

Chakrapani²,

Kaur³

et al. 2020

Indian J Community Health

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“…That is, preferences for intermittent dosing, long-acting injectables, and concerns about from where and from whom to access PrEP, may be best understood in the sociocultural context of widespread stigma associated with HIV and MSM in India, and the enduring centrality, and often proximity, of family, including the prevalence of heterosexual marriage among MSM. Our previous research with MSM in India similarly identified stigma as a significant barrier to HIV testing 32 and extensive fears about HIV status disclosure. 11 Unfortunately the 2013 Indian Supreme Court decision recriminalizing samesex behaviors in India, reversing a Delhi High Court order that had decriminalized 'homosexual acts' since 2009, is likely to exacerbate these challenges to PrEP implementation, and to HIV prevention for MSM more broadly.…”

Section: Discussionmentioning

confidence: 88%

Acceptability of HIV Pre-Exposure Prophylaxis (PrEP) and Implementation Challenges Among Men Who Have Sex with Men in India: A Qualitative Investigation

Chakrapani

Newman

Shunmugam

et al. 2015

AIDS Patient Care and STDs

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119

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This qualitative study explored the acceptability of HIV pre-exposure prophylaxis (PrEP) among MSM in India, and identified facilitators and barriers to future PrEP uptake. In 2014, we conducted 10 focus groups (n=61) among a purposive sample of diverse MSM recruited through community-based organizations in Chennai and Mumbai, and 10 key informant interviews with community leaders and health care providers. Participants' mean age was 26.1 years (SD 4.8); 62% completed secondary education, and 42% engaged in sex work. No focus group participants had heard of PrEP, but once explained, most reported they would likely use it. PrEP was alternately perceived as a 'back-up plan', a condom substitute, or a burden with concurrent condom use. Facilitators were potential for covert use, sex without condoms, and anxiety-less sex. Potential barriers emerged around stigma associated with PrEP use, fear of disclosures to one's family, wife, or male steady partner, and being labeled as HIV-positive or promiscuous by peers. Preferences emerged for intermittent rather than daily PrEP use, injectable PrEP, and free or subsidized access through community organizations or government hospitals. Key informants expressed additional concerns about risk compensation, non-adherence, and impact on ART availability for treatment. Demonstration projects are needed in India to support PrEP implementation tailored for at-risk MSM. Educational interventions for MSM should address concerns about PrEP effectiveness, side effects, and mitigate risk compensation. Community engagement may facilitate broad acceptability and challenge stigma around PrEP use. Importantly, provision of free or subsidized PrEP is necessary to making implementation feasible among low socioeconomic status MSM in India.

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“…This explains why in most of the studies in India majority of the participants were Kothis [ 20 , 22 , 26 ]. They were also more likely to show up in investigations regarding willingness to get tested for HIV [ 27 ] or participation in vaccine trials [ 28 ] despite facing stronger barriers for accessing preventive and curative services [ 29 , 30 ]. In our study also the proportion of Panthis among participating MSM was as less as 8.62% only.…”

Section: Discussionmentioning

confidence: 99%

Burden and Correlates of HIV among Men Who Have Sex with Men in West Bengal, India: Analysis of Sentinel Surveillance Data

et al. 2015

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BackgroundLittle is known about the socio-behavioral risk factors for HIV acquisition among hard-to-reach men who have sex with men (MSM) population in India, particularly from the densely populated eastern part. Thus to measure the burden and correlates of HIV among MSM in West Bengal state of eastern India, a cross-sectional analysis of the national HIV Sentinel Surveillance (HSS) data was conducted.MethodsIn 2011, between July and September, involving all sentinel sites of the state, 1237 consenting MSM were anonymously interviewed and tested for HIV following national guidelines. Using a short, structured questionnaire, information was collected on socio-behavioral factors along with sexual practices and was analyzed to determine burden of HIV and the role of its socio-behavioral correlates on HIV acquisition.ResultsAmong participants, mean age was 23.4 years, 44.55% were “Kothis” (usually receptive partner) and 25.1% admitted receiving money for sex with man. HIV sero-positivity was 5.09%. Using logistic regression method, for both bivariate and multivariate (with saturated model) analyses, transport-workers [adjusted odds ratio (AOR)=8.95, 95% confidence interval (95%CI): 1.09-73.71), large business-owners/self-employed (AOR=8.46, 95%CI: 1.25-57.49), small business-owners/cultivators (AOR=7.90, 95%CI: 1.67-37.38), those who visited the sentinel site for official purposes (AOR=7.60, 95%CI: 1.21-47.83) and paying money for having sex with men (AOR=3.03, 95%CI: 1.10-8.33) were strongly associated with higher HIV sero-positivity with than their counterparts. Using the parsimonious model for multivariate analysis, Kothis (AOR=4.64, 95%CI: 1.03-20.89), paying (AOR=2.96, 95%CI: 1.15-7.58) or receiving (AOR=2.06, 95%CI: 1.06-3.99) money for having sex with a man were associated with higher risk of HIV.ConclusionsFocused intervention targeting the high risk MSM subgroups including Kothis, transport-workers, business-owners/self-employed and those who exchanged money for having sex with men, seemed to be the need of the hour for preventing the spread of HIV infection within and from this understudied population.

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Correlates of HIV Testing Uptake among Kothi-Identified Men who have Sex with Men in Public Sex Environments in Chennai, India

Cited by 13 publications

References 25 publications

Factors influencing HIV testing uptake among priority populations in a resettlement colony of a North Indian city

Factors influencing HIV testing uptake among priority populations in a resettlement colony of a North Indian city

Acceptability of HIV Pre-Exposure Prophylaxis (PrEP) and Implementation Challenges Among Men Who Have Sex with Men in India: A Qualitative Investigation

Burden and Correlates of HIV among Men Who Have Sex with Men in West Bengal, India: Analysis of Sentinel Surveillance Data

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