Self-Identity, Sexual Practices And Sexually Transmitted Infections Among High-Risk Men Who Have Sex With Men Attending Clinics In Urban India

Narayanan, Prakash; Das, Anjana; Prabhakar, Parimi; Gurung, Anup; Morineau, Guy; Rao, Gururaj; Gangakhedkar, Raman; Risbud, Arun

doi:10.4172/2155-6113.s1-011

Cited by 6 publications

(6 citation statements)

References 20 publications

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“…Qualitative studies indicate that kothis may be particularly vulnerable to multiple levels of stigmatization, discrimination, and violence in their families and communities [8, 9, 11, 24]. Kothis are more likely to participate in transactional sex and sex work for economic support, which contributes to higher risk of violence and greater vulnerability to HIV [9, 11, 24, 35–37]. Kothis’ feminine gender expression makes them recognizable [9, 11, 24], marking them as a visible target of stigmatization and discrimination [38].…”

Section: Introductionmentioning

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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Section: Introductionmentioning

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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“…The results also suggest that sexual identities that incorporate visible feminine qualities along with receptive anal sex practices may be subject to a convergence of social and biological risks for HIV (Chakrapani et al, 2008; Chakrapani, Newman, et al, 2011; Chakrapani et al, 2007; Logie et al, 2012; Narayanan et al, 2012). A similar convergence has been documented in South Africa by Sandfort and colleagues (2015), who have found that MSM who identify with more feminine gender characteristics are at increased risk for HIV.…”

Section: Discussionmentioning

confidence: 87%

Perspectives on Sexual Identity Formation, Identity Practices, and Identity Transitions Among Men Who Have Sex With Men in India

et al. 2016

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Men who have sex with men (MSM) remain at high risk for HIV infection. Culturally specific sexual identities, encompassing sexual roles, behavior, and appearance, may shape MSM's experiences of stigmatization and discrimination, and affect their vulnerability to HIV. This multi-site qualitative study (n = 363) encompassing 31 focus group discussions (FGDs) and 121 in-depth interviews (IDIs) across 15 sites in India investigated sexual identity formation, identity practices, and transitions and their implications for HIV prevention. IDIs and FGDs were transcribed, translated, and underwent thematic analysis. Our findings document heterogeneous sexual identity formation, with MSM who have more gender nonconforming behaviors or appearance reporting greater family- and community-level disapproval, harassment, violence, and exclusion. Concealing feminine aspects of sexual identities was important in daily life, especially for married MSM. Some participants negotiated their identity practices in accordance with socioeconomic and cultural pressures, including taking on identity characteristics to suit consumer demand in sex work and on extended periods of joining communities of hijras (sometimes called TG or transgender women). Participants also reported that some MSM transition toward more feminine and hijra or transgender women identities, motivated by intersecting desires for feminine gender expression and by social exclusion and economic marginalization. Future studies should collect information on gender nonconformity stigma, and any changes in sexual identity practices or plans for transitions to other identities over time, in relation to HIV risk behaviors and outcomes.

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“…Clearly, given the local cultural context in which marriage is near universal and age at marriage is low, a high percentage of women above age 15 would be married but lacking in agency to protect themselves in sexual relationships (75% of women ages 15-49 are currently married; IIPS & Macro International, 2007). On the part of MSM, on the other hand, introducing condoms in their marital relations is fraught with the danger of losing partner trust, risking disclosure of sexual identity or raising suspicion of HIV infection (Chakrapani et al, 2007;Go et al, 2004;Narayanan et al, 2012). In sum, stigma, homophobia and punitive country laws prevent many Indian MSM from being open about their sexual orientation within marriage, thereby exposing their spouses to risk of HIV and other STIs.…”

Section: Discussionmentioning

confidence: 91%

Sexual partner mixing and differentials in consistent condom use among men who have sex with men in Maharashtra, India

Deshpande

Bharat

2014

Global Public Health

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Sexual partner mixing among men who have sex with men (MSM), based on both gender and partnership status, is an understudied theme in India. Using data from Round 2 of the Integrated Bio-behavioral Survey, this paper reports on gender and partnership status-based sexual mixing and levels of consistent condom use (CCU) among MSM in Maharashtra. A total of 689 MSM were sampled using probability-based sampling. Bivariate and regression analyses were carried out on condom use and partnership mixing. Over half (52%) of all MSM reported having only male partners while about one-third (34.5%) reported having partners of both gender. Over 70% of MSM engaged in sex with a mix of casual, regular, commercial and non-commercial partners. MSM with only male partners reported lower CCU as compared to MSM with partners of both genders (47.3% and 62%, respectively, p = 0.11). CCU levels differed significantly by status of sex partner. Overall, MSM having 'men only' as partners and those with partners of mixed status have greater risk behaviour in terms of low CCU. HIV prevention interventions need to focus attention on men in 'exclusively male' sex partnerships as well as MSM with a mix of casual, regular and commercial partners.

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Self-Identity, Sexual Practices And Sexually Transmitted Infections Among High-Risk Men Who Have Sex With Men Attending Clinics In Urban India

Cited by 6 publications

References 20 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

Perspectives on Sexual Identity Formation, Identity Practices, and Identity Transitions Among Men Who Have Sex With Men in India

Sexual partner mixing and differentials in consistent condom use among men who have sex with men in Maharashtra, India

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