HIV Status Disclosure and Condom Use Among HIV-Positive Men Who Have Sex With Men and<i>Hijras</i>(Male-to-Female Transgender People) in India: Implications for Prevention

Chakrapani, Venkatesan; Shunmugam, Murali; Newman, Peter A.; Kershaw, Trace; Dubrow, Robert

doi:10.1080/15381501.2013.859113

Cited by 22 publications

(18 citation statements)

References 31 publications

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“…(9, 10) For example, a study conducted in India revealed that only about one-quarter of Indian MSM disclosed their HIV status to their male partners. (11) Lack of HIV serostatus disclosure among MSM in LMICs may be due to fear of discrimination and violence(12), lack of social and psychological support(13, 14), and low HIV testing rate. (15) For example, due to feared discrimination and social isolation, and feared relationship broken-up, people in LMICs are less likely to disclose their serostatus to partners.…”

Section: Introductionmentioning

confidence: 99%

Receiving HIV Serostatus Disclosure from Partners Before Sex: Results from an Online Survey of Chinese Men Who Have Sex with Men

et al. 2018

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HIV serostatus disclosure before sex can facilitate serosorting, condom use and potentially decrease the risk of HIV acquisition. However, few studies have evaluated HIV serostatus disclosure from partners before sex. We examined the rate and correlates of receiving HIV serostatus disclosure from regular and casual male partners before sex among an online sample of men who have sex with men (MSM) in China. An online cross-sectional study was conducted among MSM in eight Chinese cities in July 2016. Participants completed questions covering sociodemographic information, sexual behaviors, HIV testing (including HIV self-testing) history, self-reported HIV status, and post-test violence. In addition, participants were asked whether they received HIV serostatus disclosure from their most recent partners before sex. Overall, 2105 men completed the survey. Among them, 85.9% were never married, and 35.4% had high school or less education. A minority (20.6%, 346/1678; 17.8%, 287/1608) of men received HIV serostatus disclosure from their most recent regular and casual male partners, respectively. Multivariate analysis indicated that participants who ever self-tested for HIV were more likely to have received HIV status disclosure from regular [adjusted OR (aOR) = 1.92, 95% CI 1.50-2.44] and casual (aOR = 2.34, 95% CI 1.80-3.04) male partners compared to never self-tested participants. Compared to participants who had not received HIV status disclosure from regular partners, participants who received disclosure from regular male partners had higher likelihood in experiencing post-test violence (aOR = 5.18, 95% CI 1.53-17.58). Similar results were also found for receiving HIV serostatus disclosure from casual partners. This study showed that HIV serostatus disclosure from partners was uncommon among Chinese MSM. Interventions and further implementation research to facilitate safe disclosure are urgently needed for MSM.

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Section: Introductionmentioning

confidence: 99%

Receiving HIV Serostatus Disclosure from Partners Before Sex: Results from an Online Survey of Chinese Men Who Have Sex with Men

et al. 2018

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“…An invisible and often ignored population due to stigma and societal expectations, male sex workers (MSW) who have sex with men are at elevated risk for HIV and other STIs compared to the broader MSM population. Contextual factors related to sex work, including stigma, increased financial incentives for riskier behaviors, and lack of access to prevention services make it likely that the prevalence of HIV and STIs among MSW exceeds that of the broader MSM population in India (Biello, Colby, Closson, & Mimiaga, 2014; Chakrapani, Shunmugam, Newman, Kershaw, & Dubrow, 2015; Closson et al, 2015; Oldenburg, Biello, et al, 2014; Oldenburg et al, 2015; Shinde, Setia, Row-Kavi, Anand, & Jerajani, 2009). Few studies have sought to estimate the prevalence of HIV among MSW specifically, with some estimates as high as 33.0% among a population of MSW living in Maharashtra (Shinde et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

Transactional sex and the challenges to safer sexual behaviors: a study among male sex workers in Chennai, India

et al. 2016

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Male sex workers (MSW) are a significant but invisible population in India who are at risk for HIV/STI. Few studies from India have documented HIV risk factors and motivations for sex work in this population. Between 2013 and 2014, a community-based convenience sample of 100 MSW in Chennai (south India) completed a baseline risk assessment as part of a behavioral intervention. Participants were ≥18 years, and reported current sex work. We report medians and proportions, and Wilcoxon-Mann-Whitney and chi-square tests are used to examine differences between sex work and sexual behavior measures by income source. Participants were engaged in sex work for 5.0 years (IQR=2.3-10.0), and earned 3,000 (IQR=2000-8000) Rupees (<50 USD) per month from sex work. Sixty-four percent reported ever testing for HIV and 20.2% for any STI. The most common reasons for starting sex work were money (83.0) and pleasure (56.0%). Participants reported 8.0 (IQR=3.0-15.0) male clients and 7 (IQR=4.0-15.0) condomless anal sex acts with male clients in the past month. Compared to participants with an additional source of income, those whose only source of income was sex work reported more male clients in the past month (10.0 vs. 6.0, p=0.017), as well as more condomless anal sex acts with male clients (8.0 vs. 5.0, p=0.008). Nearly 70.0% were offered more money not to use a condom during sex with a client, and 74.2% reported accepting more money not to use a condom. Three-quarters reported having experienced difficulty using condoms with clients. MSW in India engage in high levels of sexual risk for HIV/STIs. Money appears to be a driving factor for engaging in sex work and condomless sex with clients. HIV prevention interventions with MSW should focus on facilitating skills that will support their ability to negotiate sexual safety in the context of monetary disincentives.

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“…Furthermore, Indian TGW engage in condomless sex with male regular partners to show love, trust, and intimacy (Chakrapani et al 2007), and also because of fear of being rejected (Chakrapani et al 2015). This context may be unique to the moderate victimization profile and is consistent with research on the difficulty of negotiating safer sex between TGW and their partners (Kosenko 2011b).…”

Section: Discussionmentioning

confidence: 59%

“…It might have been anticipated that TGW in the high victimization profile would have a heightened likelihood of all five sexual risk outcomes, but this was not supported in our findings. The high victimization profile had the highest prevalence of TGW living with HIV and previous research finds that people living with HIV, who are aware of their HIV status, are more willing to adapt safer sex behaviors (Chakrapani et al 2015). Moreover, these findings may be indicative of desensitization theories.…”

Section: Discussionmentioning

confidence: 76%

Victimization and Human Immunodeficiency Virus-Related Risk Among Transgender Women in India: A Latent Profile Analysis

Willie

Chakrapani

Hughto

et al. 2017

Violence and Gender

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Globally, transgender women (TGW) experience multiple forms of victimization such as violence and discrimination that can place them at risk for poor sexual health. To date, research overlooks the heterogeneity in experiences of victimization among TGW. Furthermore, few studies have examined the association between victimization and sexual risk among TGW in India, despite the high burden of HIV and victimization in this community. Latent profile analysis was performed to identify patterns of victimization in a convenience sample of 299 TGW recruited from nongovernmental organizations across four states in India. Analysis of covariance was performed to examine differences in sexual risk (i.e., alcohol use before sex; inconsistent condom use with a male regular partner, a male causal partner, and a male paying partner; and having multiple sexual partners) between latent profiles. Five distinct profiles of Indian TGW were identified based on the type and severity of victimization: (1) Low victimization, (2) High verbal police victimization, (3) High verbal and physical police victimization, (4) Moderate victimization, and (5) High victimization. While controlling for age, education, income, HIV status, and marital status, results revealed that TGW in the moderate victimization and high victimization profiles had higher sexual risk than TGW in the low victimization and high verbal police victimization profiles. In addition, TGW in high verbal and physical police victimization profile had higher sexual risk than TGW in low victimization profile. These findings underscore the importance of tailoring sexual risk reduction interventions to the specific needs of TGW based on patterns of victimization.

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HIV Status Disclosure and Condom Use Among HIV-Positive Men Who Have Sex With Men andHijras(Male-to-Female Transgender People) in India: Implications for Prevention

Cited by 22 publications

References 31 publications

Receiving HIV Serostatus Disclosure from Partners Before Sex: Results from an Online Survey of Chinese Men Who Have Sex with Men

Receiving HIV Serostatus Disclosure from Partners Before Sex: Results from an Online Survey of Chinese Men Who Have Sex with Men

Transactional sex and the challenges to safer sexual behaviors: a study among male sex workers in Chennai, India

Victimization and Human Immunodeficiency Virus-Related Risk Among Transgender Women in India: A Latent Profile Analysis

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