Dandona Lalit, Dandona Rakhi, Kumar G Anil, Gutierrez Juan Pablo, McPherson Sam, Bertozzi Stefano M
Health Studies Area, Centre for Human Development, Administrative Staff College of India, Hyderabad, India.
BMC Public Health. 2006 Feb 15;6:31. doi: 10.1186/1471-2458-6-31.
HIV prevention in India has mostly focussed on heterosexual transmission. Data on homosexual transmission are not readily available from India. We therefore assessed the probability of acquiring and transmitting HIV for men who sell sex to men and compared this with women who sell sex in India.
Sexual behaviour characteristics of 6661 men who have sex with men and 6648 women who sell sex were obtained in the Indian state of Andhra Pradesh through confidential interviews. These, along with estimates of HIV rates among them and risk of HIV transmission per unprotected sex act from other sources, were used to calculate their annual probability of acquiring and transmitting HIV.
Of 6661 men who have sex with men in this sample, 1776 (26.7%) had sold sex to men. For every 1000 men who sell sex to men, annually 146 (95% confidence interval [CI] 116-179) would acquire HIV and HIV would be transmitted to 55 (95% CI 42-71) men who do not sell sex or women. These estimates were higher by 6.7 (95% CI 4.9-9.2) times for acquiring HIV and 2.5 (95% CI 2.0-3.2) times for transmitting HIV to sex partners outside their group, as compared with similar estimates for women who sell sex. In this sample, the average annual probability of acquiring HIV was higher among men who have sex with men but do not sell sex as compared with women who sell sex.
These data indicate that men who sell sex to men are at much higher risk of acquiring and transmitting HIV than women who sell sex. Therefore, men who sell sex to men and their clients warrant substantial attention for comprehensive HIV prevention in India.
印度的艾滋病病毒（HIV）预防工作主要集中在异性传播方面。印度关于同性传播的数据并不容易获取。因此，我们评估了男男性行为者感染和传播HIV的概率，并将其与印度的女性性工作者进行比较。
通过保密访谈，在印度安得拉邦获取了6661名男男性行为者和6648名女性性工作者的性行为特征。这些数据，连同他们当中的HIV感染率估计值以及来自其他来源的每次无保护性行为的HIV传播风险，被用于计算他们每年感染和传播HIV的概率。
在该样本的6661名男男性行为者中，有1776人（26.7%）与男性发生过性交易。每1000名与男性发生性交易的男性中，每年有146人（95%置信区间[CI] 116 - 179）会感染HIV，并且HIV会传播给55名（95% CI 42 - 71）未从事性交易的男性或女性。与女性性工作者的类似估计值相比，这些估计值在感染HIV方面高出6.7（95% CI 4.9 - 9.2）倍，在将HIV传播给其群体外性伴侣方面高出2.5（95% CI 2.0 - 3.2）倍。在该样本中，与女性性工作者相比，未从事性交易的男男性行为者的平均每年感染HIV的概率更高。
这些数据表明，男男性行为者感染和传播HIV的风险比女性性工作者高得多。因此，男男性行为者及其客户在印度全面的HIV预防工作中值得给予充分关注。
