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

Deshpande, Sucheta; Bharat, Shalini

doi:10.1080/17441692.2014.972968

Cited by 8 publications

(8 citation statements)

References 39 publications

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“…We also found that living with a male partner was correlated with risk discordance for both MSM and TGW, which could result from a monogamous relationship in which the participants knew their partner's HIV status or the inconsistent condom use when these individuals engage in a trusted, intimate, stable relationship [23,24]. Past literature reported that MSM in exclusively male partnerships and MSM with a mix of casual, regular and commercial partners had lower consistency in condom use than MSM with partners of both genders [25], with the lowest consistency in condom use reported among MSM and their regular partner [23,26,27]. Condom use with regular partners has been observed to be a challenge, despite it being the main HIV protection method in Thailand [28].…”

Section: Discussionmentioning

confidence: 98%

Discordance between self‐perceived and actual risk of HIV infection among men who have sex with men and transgender women in Thailand: a cross‐sectional assessment

et al. 2019

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Introduction Low uptake of HIV testing and services, including pre‐exposure prophylaxis (PrEP), in Thai men who have sex with men (MSM) and transgender women (TGW) may be due to the inaccuracy in self‐risk assessment. This study investigated the discordance between self‐perceived HIV risk and actual risk. Methods Data were obtained between May 2015 and October 2016 from MSM and TGW enrolled in key population‐led Test and Treat study in six community health centres in Thailand. Eligible participants were at least 18 years old, Thai national, had sex with men, had unprotected sex with a man in the past six months or had at least three male sex partners in the past six months, and were not known to be HIV positive. Baseline demographic behavioural characteristics questionnaires, including self‐perceived HIV risk, were self‐administered. Participants received HIV/STI (syphilis/gonorrhoea/chlamydia) testing at baseline. Participants who self‐perceived to have low risk, but engaged in HIV‐susceptible practices were categorized as having risk discordance (RD). Regression was conducted to assess factors associated with RD among MSM and TGW separately. Results Of the 882 MSM and 406 TGW participants who perceived themselves as having low HIV risk, over 80% reported at least one of the following: tested HIV positive, engaged in condomless sex, tested positive for a sexually transmitted infection sexually transmitted infection (STI; or used amphetamine‐type stimulants. Logistic regression found that living with a male partner (p = 0.005), having never tested for HIV (p = 0.045), and living in Bangkok (p = 0.01) and Chiang Mai (p < 0.001) were associated with increased risk discordance among MSM. Living with a male partner (p = 0.002), being less than 17 years old at sexual debut (p = 0.001), and having a low knowledge score about HIV transmission (p < 0.001) were associated with increased risk discordance among TGW. However, for TGW, being a sex worker decreased the chance of risk discordance (p = 0.034). Conclusions Future HIV prevention messages need to fill in the gap between self‐perceived risk and actual risk in order to help HIV‐vulnerable populations understand their risk better and proactively seek HIV prevention services.

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Section: Discussionmentioning

confidence: 98%

Discordance between self‐perceived and actual risk of HIV infection among men who have sex with men and transgender women in Thailand: a cross‐sectional assessment

et al. 2019

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“…In Asian countries, condom use was found to be associated with substance use [ 17 – 20 ], cohabiting with a steady male or female partner [ 20 ], and trust between partners [ 21 ]. Other studies in Asia have reported the associations between condom use and sexual behaviors among MSM such as having multiple sex partners [ 20 ], sexual positions [ 20 ], types of sex partners [ 22 ], frequency of receptive anal sex with regular partners [ 18 ], number of casual partners [ 18 ], and early anal sex debut [ 20 ]. Several important perception and attitudinal factors have also been found to be associated with condom use among Asian MSM, including positive attitudes towards condom use [ 21 ], perceived condom acceptability by their partners [ 17 ], perceived ability to control condom use in their relationships [ 21 , 23 ], self-efficacy in insisting on condom use [ 24 ], and perceived efficacy of condom use for HIV prevention [ 23 ].…”

Section: Introductionmentioning

confidence: 99%

Factors Associated with Inconsistent Condom Use among Men Who Have Sex with Men in Cambodia

Tuot

Chhoun

et al. 2015

PLoS ONE

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BackgroundCompared to the general population, men who have sex with men (MSM) are at greater risk for HIV and less understood due to their more hidden and stigmatized nature. Moreover, the discrepancy in findings in the literature merits further investigations in MSM populations from different cultures and settings. We therefore conducted this study to explore factors associated with inconsistent condom use among high-risk MSM in Cambodia.MethodsThis cross-sectional study was conducted in 2014 among 367 MSM randomly selected from Battembang and Siem Reap using a two-stage cluster sampling method. A structured questionnaire was used for face-to-face interviews to collect information on characteristics of respondents, HIV testing history, self-perception of HIV risk, substance use, sexual behaviors, mental disorders, and HIV knowledge. Multivariable logistic regression analysis was performed to identify factors independently associated with inconsistent condom use.ResultsOn average, 62.3% of respondents reported that they always used condoms over the past three months. The rates varied with types of sexual partners; the proportion of respondents who reported always using condoms was 55.1%, 64.2%, 75.9%, 73.0%, 78.1%, and 70.3%, for sexual partners who were girlfriends, boyfriends, female sex workers, male sex workers, female clients, or male clients, respectively. After adjustment, inconsistent condom use was significantly associated with age of ≥25 (AOR = 1.77, 95% CI = 1.09–2.86), self-rated quality of life as good or very good (AOR = 4.37, 95% CI = 1.79–5.67), self-perception of higher HIV risk compared to the general population (AOR = 2.37, 95% CI = 1.35–4.17), illicit drug use in the past three months (AOR = 5.76, 95% CI = 1.65–10.09), and reported consistent lubricant use when selling anal sex to men in the past three months (AOR = 2.85, 95% CI = 1.07–8.12).ConclusionsWe found risky sexual behaviors to be considerably high among MSM in this study, especially among those who used illicit drugs or were older than 25. HIV education and social marketing should be expanded and specifically designed for MSM to better educate on the increased risk of HIV with unprotected anal sex and illicit drug use as risk factors, and the importance of the use of both condoms and lubricant during anal intercourse.

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“…At the beginning of the simulation, incidence for MSM is set to current epidemiological estimates from India [2]. The model also determines HIV transmissions from the primary (simulated) cohort of MSM to sexual partners outside the primary cohort, specifically from MSM to CGW and TGW [28].…”

Section: Hiv Transmission and Incidencementioning

confidence: 99%

The cost-effectiveness of a resilience-based psychosocial intervention for HIV prevention among MSM in India

Kazemian

Ding

Scott

et al. 2022

Aids

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Objective: MSM in India are at a high risk for HIV infection given psychosocial challenges, sexual orientation stress, and stigma. We examined the cost-effectiveness of a novel resilience-based psychosocial intervention for MSM in India. Design: We parameterized a validated microsimulation model (CEPAC) with India-specific data and results from a randomized trial and examined two strategies for MSM: status quo HIV care (SQ), and a trial-based psychosocial intervention (INT) focused on building resilience to stress, improving mental health, and reducing condomless anal sex (CAS). Methods: We projected lifetime clinical and economic outcomes for MSM without HIV initially. Intervention effectiveness, defined as reduction in self-reported CAS, was estimated at 38%; cost was $49.37/participant. We used a willingness-to-pay threshold of US$2100 (2019 Indian per capita GDP) per year of life saved (YLS) to define cost-effectiveness. We also assessed the 5-year budget impact of offering this intervention to 20% of Indian MSM. Results: Model projections showed the intervention would avert 2940 HIV infections among MSM over 10 years. Over a lifetime horizon, the intervention was cost-effective (ICER = $900/YLS). Results were most sensitive to intervention effectiveness and cost; the intervention remained cost-effective under plausible ranges of these parameters. Offering this intervention in the public sector would require an additional US$28 M over 5 years compared with SQ. Conclusion: A resilience-based psychosocial intervention integrated with HIV risk reduction counseling among MSM in India would reduce HIV infections and be cost-effective. Programs using this approach should be expanded as a part of comprehensive HIV prevention in India.

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

Cited by 8 publications

References 39 publications

Discordance between self‐perceived and actual risk of HIV infection among men who have sex with men and transgender women in Thailand: a cross‐sectional assessment

Discordance between self‐perceived and actual risk of HIV infection among men who have sex with men and transgender women in Thailand: a cross‐sectional assessment

Factors Associated with Inconsistent Condom Use among Men Who Have Sex with Men in Cambodia

The cost-effectiveness of a resilience-based psychosocial intervention for HIV prevention among MSM in India

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