Steward Wayne T, Satyanarayana Veena A, Heylen Elsa, Srikrishnan Aylur K, Vasudevan Canjeevaram K, Krishnan Gopal, Solomon Davidson, Ekstrand Maria L
a Center for AIDS Prevention Studies, Department of Medicine , University of California San Francisco , San Francisco , USA.
b Department of Clinical Psychology , National Institute of Mental Health and Neuro Sciences (NIMHANS) , Bengaluru , India.
AIDS Care. 2018 May;30(5):656-662. doi: 10.1080/09540121.2017.1394964. Epub 2017 Oct 30.
Male migrant workers (MMWs) in India are vulnerable to developing alcohol-related problems and engaging in unprotected sex, putting them at risk of HIV. Research has shown that alcohol-related expectancies mediate vulnerability to alcoholism. We examined which expectancies were associated with sexual risk and drinking. We surveyed 1085 heterosexual MMWs in two South Indian municipalities, assessing expectancies, sex under the influence, and unprotected sex with female sex workers (FSW) and casual female partners in the prior 30 days. Men more strongly endorsed positive than negative expectancies (t = 53.59, p < .01). In multivariate logistic regression, the expectancy of having more fun helped drive the combination of alcohol and unprotected sex with FSW partners (OR = 1.22, p < .05), whereas the expectancy of better sex helped drive a similar combination with casual partners (OR = 1.24, p < .01). Men concerned about alcohol-induced deficits were less likely to drink with FSW partners (OR = 0.81, p < .01), but more likely to have unprotected sex with them (OR = 1.78, p < .01). To reduce risk, MMWs would benefit from combination prevention approaches that use behavioral strategies to address drinking norms and awareness of risk, while using biomedical strategies to reduce viral transmission when risk does occur.
印度的男性农民工易出现与酒精相关的问题并进行无保护性行为，从而面临感染艾滋病毒的风险。研究表明，与酒精相关的预期会介导酗酒的易感性。我们研究了哪些预期与性风险和饮酒有关。我们在印度南部的两个城市对1085名异性恋男性农民工进行了调查，评估他们的预期、受酒精影响下的性行为以及在过去30天内与女性性工作者及临时女性伴侣发生无保护性行为的情况。男性对积极预期的认同程度高于消极预期（t = 53.59，p <.01）。在多因素逻辑回归分析中，追求更多乐趣的预期促使他们在饮酒时与女性性工作者发生无保护性行为（比值比[OR] = 1.22，p <.05），而对更好性体验的预期促使他们与临时伴侣发生类似行为（OR = 1.24，p <.01）。担心酒精导致身体机能下降的男性与女性性工作者一起饮酒的可能性较小（OR = 0.81，p <.01），但与她们发生无保护性行为的可能性更大（OR = 1.78，p <.01）。为降低风险，男性农民工将受益于综合预防方法，即采用行为策略来解决饮酒规范和风险意识问题，同时采用生物医学策略在风险发生时减少病毒传播。
