Tuberculosis Research Center, Indian Council of Medical Research, Chennai, India.
AIDS Patient Care STDS. 2009 Nov;23(11):981-6. doi: 10.1089/apc.2009.0092.
India has the greatest number of HIV infections in Asia and the third highest total number of infected persons globally. Men who have sex with men (MSM) are considered by the Government of India's National AIDS Control Organization (NACO) a "core risk group" for HIV in need of HIV prevention efforts. However there is a dearth of information on the frequency of participation in HIV prevention interventions and subsequent HIV risk and other correlates among MSM in India. Recruited through peer outreach workers, word of mouth and snowball sampling techniques, 210 MSM in Chennai completed an interviewer-administered assessment, including questions about participating in any HIV prevention interventions in the past year, sexual risk taking, demographics, MSM identities, and other psychosocial variables. Bivariate and multivariable logistic regression procedures were used to examine behavioral and demographic correlates with HIV prevention intervention participation. More than a quarter (26%) of the sample reported participating in an HIV prevention intervention in the year prior to study participation. Participants who reported engaging in unprotected anal sex (UAS; odds ratio [OR] = 0.28; p = 0.01) in the 3 months prior to study enrollment were less likely to have participated in an HIV prevention program in the past year. MSM who were older (OR = 1.04; p = 0.05), kothis (feminine acting/appearing and predominantly receptive partners in anal sex) compared to panthis (masculine appearing, predominantly insertive partners; OR = 5.52, p = 0.0004), those with higher educational attainment (OR = 1.48, p = 0.01), being "out" about having sex with other men (OR = 4.03, p = 0.0001), and MSM who reported ever having been paid in exchange for sex (OR = 2.92, p = 0.001) were more likely to have reported participation in an HIV prevention intervention in the preceding year. In a multivariable model, MSM reporting UAS in the prior 3 months were less likely to have participated in an HIV prevention intervention (AOR = 0.34, p = 0.04). MSM who were older (AOR = 1.05, p = 0.05), those with higher educational attainment (AOR = 1.92, p = 0.0009), and MSM who were "out" about having sex with other men (AOR = 2.71, p = 0.04) were more likely to have reported participating in an HIV prevention program. Findings suggest that exposure to HIV prevention interventions may be protective against engaging in UAS for some MSM in India. Understanding predictors of participation in an HIV prevention intervention is helpful for identifying Indian MSM who might have had no exposure to HIV prevention information and skills building, hence allowing researchers and prevention workers to focus efforts on individuals at greatest need.
印度是亚洲艾滋病毒感染人数最多的国家，也是全球艾滋病毒感染人数第三多的国家。印度国家艾滋病控制组织（NACO）将男男性行为者（MSM）视为艾滋病毒的“核心风险群体”，需要进行艾滋病毒预防工作。然而，关于印度 MSM 参与艾滋病毒预防干预措施的频率以及随后的艾滋病毒风险和其他相关因素的信息很少。通过同伴外展工作者、口碑和滚雪球抽样技术招募的 210 名钦奈 MSM 完成了由访谈者进行的评估，包括在过去一年中是否参加过任何艾滋病毒预防干预措施、性行为风险、人口统计学、MSM 身份和其他社会心理变量等问题。采用双变量和多变量逻辑回归程序检查与 HIV 预防干预参与相关的行为和人口统计学因素。超过四分之一（26%）的样本报告在研究参与前的一年中参加了艾滋病毒预防干预措施。在研究入组前 3 个月报告发生无保护肛交（UAS；优势比[OR] = 0.28；p = 0.01）的参与者，过去一年参加艾滋病毒预防方案的可能性较小。年龄较大的 MSM（OR = 1.04；p = 0.05）、科蒂斯（在肛交中扮演女性化/女性化和主要接受者的角色；OR = 5.52，p = 0.0004）与潘蒂斯（男性化外观，主要插入者；OR = 5.52，p = 0.0004）、教育程度较高的 MSM（OR = 1.48，p = 0.01）、公开自己与其他男性发生性关系（OR = 4.03，p = 0.0001）和报告曾因性行为而获得报酬的 MSM（OR = 2.92，p = 0.001）更有可能报告在过去一年中参加了艾滋病毒预防干预措施。在多变量模型中，报告在过去 3 个月内发生 UAS 的 MSM 不太可能参加艾滋病毒预防干预措施（AOR = 0.34，p = 0.04）。年龄较大的 MSM（AOR = 1.05，p = 0.05）、教育程度较高的 MSM（AOR = 1.92，p = 0.0009）和公开自己与其他男性发生性关系的 MSM（AOR = 2.71，p = 0.04）更有可能报告参加了艾滋病毒预防方案。研究结果表明，对于一些印度 MSM，接触艾滋病毒预防干预措施可能有助于预防发生 UAS。了解参与艾滋病毒预防干预措施的预测因素有助于确定印度 MSM 是否没有接触过艾滋病毒预防信息和技能建设，从而使研究人员和预防工作者能够将精力集中在最需要的人身上。
