Sivaram Sudha, Johnson Sethulakshmi, Bentley Margaret E, Srikrishnan A K, Latkin Carl A, Go Vivian F, Solomon Suniti, Celentano David D
Infectious Diseases Program, Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
J Urban Health. 2007 Jul;84(4):563-76. doi: 10.1007/s11524-007-9196-0. Epub 2007 May 8.
Addressing male heterosexual risk is a high priority for HIV prevention efforts in India. Particularly in urban India, which draws men for employment opportunities, these efforts are gaining momentum with a focus on understanding possible risk facilitators such as alcohol use. However, little is known about venues where such efforts might be targeted. In this paper, we explore community-based alcohol outlets or "wine shops" in Chennai, India, as potential venues. We conducted ethnographic research with wine shop staff and clients to understand alcohol use and sexual behaviors. We then surveyed 118 wine shop patrons to quantify these risk behaviors and plan an appropriate intervention. Our results show that wine shops are a venue where social and sexual networks converge. Reports and observations of regular and heavy drinking were frequent. Over 50% of patrons surveyed reported three or more sexual partners in the past 3 months, and 71% of all patrons reported a history of exchanging sex for money. Condom use history was low overall but, in the adjusted analyses, was significantly higher (OR = 20.1) among those who reported that their most recent partner was a sex worker and lower (OR = 0.28) among those who reported they drank to feel disinhibited. The data suggest that wine shops may be an appropriate location to target men for HIV prevention interventions. We discuss how these findings helped design such an intervention in Chennai.
在印度，解决男性异性恋风险是艾滋病毒预防工作的重中之重。特别是在吸引男性就业的印度城市地区，这些工作正围绕了解诸如饮酒等可能的风险促成因素而蓬勃开展。然而，对于此类工作可能针对的场所却知之甚少。在本文中，我们探讨了印度金奈以社区为基础的酒类销售点或“葡萄酒商店”作为潜在场所的情况。我们对葡萄酒商店的工作人员和顾客进行了人种志研究，以了解饮酒情况和性行为。然后，我们对118名葡萄酒商店顾客进行了调查，以量化这些风险行为并规划适当的干预措施。我们的结果表明，葡萄酒商店是社交和性网络交汇的场所。经常和大量饮酒的报告及观察结果屡见不鲜。在接受调查的顾客中，超过50%的人报告在过去3个月中有三个或更多性伴侣，所有顾客中有71%的人报告有过以性换钱的经历。总体而言，避孕套使用史较低，但在调整分析中，报告其最近的伴侣为性工作者的人使用避孕套的比例显著更高（OR = 20.1），而报告饮酒是为了放松抑制的人使用避孕套的比例较低（OR = 0.28）。数据表明，葡萄酒商店可能是针对男性开展艾滋病毒预防干预措施的合适场所。我们讨论了这些发现如何有助于在金奈设计这样一种干预措施。
