Characteristics of sex partners and sexual partnership correlates of inconsistent condom use among male injection drug users in India.

Previous studies have established the risky behaviors of IDUs in India, and that IDUs are sexually active; however, there is a need to better understand the nature of sexual partnerships of IDUs. A total of 783 (Delhi) and 766 (Imphal) male IDUs were recruited into the study through respondent-driven sampling. We examined characteristics of sex partners of male IDUs and individual and sexual partnership characteristics associated with unprotected sex in Delhi and Imphal. While 16.8% of sexual partnerships in Delhi were male-to-male, there were almost no male-to-male partnerships in Imphal. The majority of partners of male IDUs in Delhi (82.5%) and Imphal (92.3%) do not inject drugs, with the exception of male partners of male IDUs in Delhi. Commercial partners (females: 58.3%; males: 71.3%) were the most common type of sex partners of male IDUs in Delhi, while regular partners (65.2%) were the most common type of sex partners in Imphal. In Delhi, characteristics of sex partners significantly associated with unprotected sex were being male/transgender (AOR 2.2; 95% CI: 1.2-4.0), being a regular (AOR 5.1; 95% CI: 2.8-9.4) or non-regular partner (AOR 2.7; 95% CI: 1.7- 4.5), and sharing needles/syringes with the index IDU (AOR 2.8; 95% CI: 1.4-5.3). In Imphal, partner characteristics associated with unprotected sex were being a regular (AOR 10.1; 95% CI: 41-25.1) or non-regular partner (AOR 3.4; 95% CI: 1.5-7.6), and living outside of town or state (AOR 3.3; 95% CI: 1.2-9.6). Enhanced understanding of disassortative sexual mixing and context of unprotected sex within sexual partnerships may enhance sexual risk reduction interventions for IDUs.