Thomas Beena, Mimiaga Matthew J, Menon Sunil, Chandrasekaran V, Murugesan P, Swaminathan Soumya, Mayer Kenneth H, Safren Steven A
Tuberculosis Research Center, Indian Council of Medical Research, Chennai, India.
AIDS Educ Prev. 2009 Aug;21(4):372-83. doi: 10.1521/aeap.2009.21.4.372.
In India men who have sex with men (MSM) are stigmatized, understudied, and at high risk for HIV. Understanding the impact of psychosocial issues on HIV risk behavior and HIV infection can help shape culturally relevant HIV prevention interventions. Peer outreach workers recruited 210 MSM in Chennai who completed an interviewer-administered psychosocial assessment battery and underwent HIV testing and counseling. More than one fifth (46/210) reported unprotected anal intercourse in the past 3 months, 8% tested positive for HIV, and 26% had previously participated in an HIV prevention intervention. In a multivariable logistic-regression model controlling for age, MSM subpopulation (kothi, panthi, or double-decker), marital status, and religion, significant predictors of any unprotected anal intercourse were being less educated (adjusted odds ratio [AOR] = .54; p = .009), not having previously participated in an HIV prevention program (AOR = 3.75; p = .05), having clinically significant depression symptoms (AOR = 2.8; p = .02), and lower self-efficacy (AOR = .40; p < .0001). Significant predictors of testing positive for HIV infection were: being less educated (AOR = .53; .05) and not currently living with parent(s) (AOR = 3.71; p = .05). Given the prevalence of HIV among MSM, efforts to reach hidden subpopulations of MSM in India are still needed. Such programs for MSM in India may need to address culturally-relevant commonly cooccurring psychosocial problems to maximize chances of reducing risk for infection.
在印度，男男性行为者（MSM）受到污名化，研究不足，且面临着较高的艾滋病毒感染风险。了解心理社会问题对艾滋病毒风险行为和艾滋病毒感染的影响有助于制定与文化相关的艾滋病毒预防干预措施。同伴外展工作者在金奈招募了210名男男性行为者，他们完成了由访谈员进行的心理社会评估量表，并接受了艾滋病毒检测和咨询。超过五分之一（46/210）的人报告在过去3个月中有过无保护肛交行为，8%的人艾滋病毒检测呈阳性，26%的人此前曾参与过艾滋病毒预防干预措施。在一个控制了年龄、男男性行为者亚群体（kothi、panthi或双性恋者）、婚姻状况和宗教信仰的多变量逻辑回归模型中，无保护肛交行为的显著预测因素包括：受教育程度较低（调整后的优势比[AOR]=0.54；p=0.009）、此前未参与过艾滋病毒预防项目（AOR=3.75；p=0.05）、有临床显著的抑郁症状（AOR=2.8；p=0.02）以及自我效能感较低（AOR=0.40；p<0.0001）。艾滋病毒感染检测呈阳性的显著预测因素为：受教育程度较低（AOR=0..53；p=0.05）以及目前没有与父母同住（AOR=3.71；p=0.05）。鉴于男男性行为者中艾滋病毒的流行情况，仍需要努力接触印度隐藏的男男性行为者亚群体。印度针对男男性行为者的此类项目可能需要解决与文化相关的常见心理社会问题，以最大限度地降低感染风险。
