Male-to-male sex among men who inject drugs in Delhi, India: Overlapping HIV risk behaviours

Armstrong, Gregory; Jorm, Anthony F; Samson, Luke; Joubert, Lynette; Singh, Shalini; Kermode, Michelle

doi:10.1016/j.drugpo.2014.08.007

Cited by 11 publications

(4 citation statements)

References 43 publications

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“…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]. Nevertheless, our findings support the expansion of substance use services to MSM.…”

Section: Discussionsupporting

confidence: 60%

“…Although relatively few MSM injected drugs, this population merits additional attention, especially in light of recent evidence from Delhi [65], which found that one-third of male PWID sampled engaged in MSM behavior and also had significant psychosocial vulnerabilities. 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.…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionsupporting

confidence: 60%

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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“…Among young MSM and TG, the statistically significant declining trend in HIV prevalence was consistent with self-reported improved condom use and thereby Nepal does not follow the worrying pattern in many other countries increase where we see a surge in non-use of condoms among MSM/TG and new infections. 32,37,38 This may be due to the massive political and legal movement in Nepal over the past decade, for MSM/TG rights 6 as well as a higher coverage of preventive interventions among MSM and TG compared to nearby countries with serious HIV epidemics in these key populations, e.g. Thailand.…”

Section: Discussionmentioning

confidence: 99%

HIV decline associated with changes in risk behaviours among young key populations in Nepal: analysis of population-based HIV prevalence surveys between 2001 and 2012

et al. 2016

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We assessed changes in HIV prevalence and risk behaviours among young key populations in Nepal. A total of 7505 participants (aged 16-24 years) from key populations who were at increased risk of HIV infection (2767 people who inject drugs (PWID); 852 men who have sex with men/transgender (MSM/TG); 2851 female sex workers (FSW) and 1035 male labour migrants) were recruited randomly over a 12-year period, 2001-2012. Local epidemic zones of Nepal (Kathmandu valley, Pokhara valley, Terai Highway and West to Far West hills) were analysed separately. We found a very strong and consistent decline in HIV prevalence over the past decade in different epidemic zones among PWID and MSM/TG in Kathmandu, the capital city, most likely due to a parallel increase in safe needle and syringe use and increased condom use. A decrease in HIV prevalence in 22 Terai highway districts, sharing an open border with India, was also consistent with increased condom use among FSW. Among male labour migrants, HIV prevalence was low throughout the period in the West to Far West hilly regions. Condom use by migrant workers involved with FSW abroad increased while their condom use with Nepalese FSW declined. Other risk determinants such as mean age at starting first injection, injection frequency, place of commercial sex solicitation, their mean age when leaving to work abroad did not change consistently across epidemic zones among the young key populations under study. In Nepal, the decline in HIV prevalence over the past decade was remarkably significant and consistent with an increase in condom use and safer use of clean needles and syringes. However, diverging trends in risk behaviours across local epidemic zones of Nepal suggest a varying degree of implementation of national HIV prevention policies. This calls for continued preventive efforts as well as surveillance to sustain the observed downward trend.

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“…These behaviours may exist on an aetiological continuum of self-destruction from sub-intentional to intentional. Studies have observed positive associations between STB and a range of health risk behaviours, for example, smoking (Miller et al, 2000), harmful alcohol (Bergen et al, 2012) and other drug use (Afifi et al, 2007), a high number of sexual partners and non-condom use (Armstrong et al, 2013(Armstrong et al, , 2015Sicard et al, 2017), sharing needles/ injecting equipment with others (Armstrong et al, 2013) and sedentary behaviour (Vancampfort et al, 2019). Associations have also been observed between STB and a range of behaviours that may carry social risks, for example, shoplifting (Afifi et al, 2007), problematic gambling (Maccallum and Blaszczynski, 2003), intimate partner violence (Rhodes et al, 2009) and dating violence and other assaults (Nahapetyan et al, 2014;Orpinas et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

High prevalence of health and social risk behaviours among men experiencing suicidal thoughts and behaviour: The imperative to undertake holistic assessments

Armstrong

Haregu

Caine

et al. 2020

Aust N Z J Psychiatry

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Objective: We aimed to examine whether suicidal thoughts and behaviour were independently associated with a wide range of health and social risk behaviours. Methods: We conducted cross-sectional analyses of data collected from 13,763 adult males who participated in The Australian Longitudinal Study on Male Health. We fit generalised linear models to estimate the relative risk of engaging in a range of health and social risk behaviours across several domains by suicidal thoughts and behaviour status. Results: Men with recent suicidal ideation (relative risk range, 1.10–5.25) and lifetime suicide attempts (relative risk range, 1.10–7.65) had a higher risk of engaging in a broad range of health and social risk behaviours. The associations between suicidal thoughts and behaviour and health and social risk behaviours were typically independent of socio-demographics and in many cases were also independent of depressive symptoms. Conclusion: Suicidal thoughts and behaviour overlaps with increased risk of engagement in a wide range of health and social risk behaviours, indicating the need for an alignment of broader public health interventions within clinical and community-based suicide prevention activities. The experience of suicidality may be an important catalyst for a broader psychosocial conversation and assessment of health and social risk behaviours, some of which may be modifiable. These behaviours may not carry an imminent risk of premature death, such as from suicide, but they carry profound health and social consequences if left unaddressed.

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Male-to-male sex among men who inject drugs in Delhi, India: Overlapping HIV risk behaviours

Cited by 11 publications

References 43 publications

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

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

HIV decline associated with changes in risk behaviours among young key populations in Nepal: analysis of population-based HIV prevalence surveys between 2001 and 2012

High prevalence of health and social risk behaviours among men experiencing suicidal thoughts and behaviour: The imperative to undertake holistic assessments

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