An exploration of elevated HIV and STI risk among male sex workers from India

Narayanan, Prakash; Das, Anjana; Morineau, Guy; Prabhakar, Parimi; Deshpande, Gururaj; Gangakhedkar, Raman; Risbud, Arun

doi:10.1186/1471-2458-13-1059

Cited by 32 publications

(33 citation statements)

References 22 publications

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“…Compared to MSM without commercial sex, the prevalence of HIV/STIs is usually higher among MSM sex workers [11, 16, 17]. Our findings also demonstrated this trend that MSM with commercial sex had higher HIV/STIs prevalence than those without commercial sex, as suggested in other study [18], though the prevalence of HIV, syphilis and HSV-2 was not significant different among MSM-selling, MSM-buying and NC-MSM.…”

Section: Discussionsupporting

confidence: 86%

Commercial sex and risk of HIV, syphilis, and herpes simplex virus-2 among men who have sex with men in six Chinese cities

Zheng

et al. 2016

BMC Infect Dis

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Background: Men who have sex with men (MSM) are at high risk of HIV and sexually transmitted infections (STIs) in China and globally. Engaging in commercial sex put them at even greater risk. This study estimated the prevalence of HIV/STIs among three subgroups of MSM: MSM who sold sex (MSM-selling), MSM who bought sex (MSM-buying), and non-commercial MSM (NC-MSM) and evaluated the relationship between commercial sex and HIV/STIs. Methods: We conducted a cross-sectional survey among MSM in six Chinese cities (Shenyang, Ji'nan, Changsha, Zhengzhou, Nanjing, and Kunming) from 2012 to 2013. Data on socio-demographics and sexual behaviors were collected. Serological tests were conducted to detect HIV, syphilis, and human simplex virus type 2 (HSV-2). Results: Of 3717 MSM, 6.8% were engaged in commercial sex. The overall prevalence of HIV, syphilis and HSV-2 infections was 11.1, 8.8 and 12.1%, respectively. MSM-selling had higher prevalence of HIV (13.4%), syphilis (12.1%) and HSV-2 (17.9%) than NC-MSM (10.9, 8.7 and 11.9% for HIV, syphilis and HSV-2, respectively), though the differences are not statistically significant. Among MSM-selling, HIV prevalence was significantly higher for those who found sex partners via Internet than those did not (19.4% vs. 8.1%, P = 0.04). Compared to NC-MSM, MSM-selling were more likely to use recreation drugs (59.3% vs. 26.3%), have unprotected anal intercourse (77.9% vs. 61.7%), and have ≥10 male sex partners (46.2% vs. 6.2%) in the past 6 months (each P < 0.05). Conclusions: All three subgroups of MSM in six large Chinese cities have high prevalence of HIV/STIs. Those who sell sex only have a particularly high risk of acquiring and transmitting disease, and therefore, they should be considered as a priority group in HIV/STIs surveillance and intervention programs.

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Section: Discussionsupporting

confidence: 86%

Commercial sex and risk of HIV, syphilis, and herpes simplex virus-2 among men who have sex with men in six Chinese cities

Zheng

et al. 2016

BMC Infect Dis

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“…Previous studies that have sought to characterize the MSW population in India have been limited in scope, and geographically concentrated in Mumbai and Hyderabad, two of the largest cities in India (Narayanan et al, 2013; Shinde et al, 2009). Shinde et al identified an HIV prevalence of 17.0% and a syphilis prevalence of 28% among MSW in Mumbai, 13.0% of which report never having used a condom (Shinde et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

“…Shinde et al identified an HIV prevalence of 17.0% and a syphilis prevalence of 28% among MSW in Mumbai, 13.0% of which report never having used a condom (Shinde et al, 2009). Using data from a study of MSM attending STI clinics in Mumbai and Hyderabad, Narayanan et al reported an HIV prevalence of 43.6% among MSM who engage in sex work (Narayanan et al, 2013). In Chennai – the biggest industrial and commercial center of South India – the prevalence of HIV and risk factors for HIV acquisition among the broader MSM community have been characterized (Chakrapani, Newman, & Shunmugam, 2008; Go et al, 2004; Mimiaga et al, 2011; Thomas et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

Transactional sex and the challenges to safer sexual behaviors: a study among male sex workers in Chennai, India

et al. 2016

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Male sex workers (MSW) are a significant but invisible population in India who are at risk for HIV/STI. Few studies from India have documented HIV risk factors and motivations for sex work in this population. Between 2013 and 2014, a community-based convenience sample of 100 MSW in Chennai (south India) completed a baseline risk assessment as part of a behavioral intervention. Participants were ≥18 years, and reported current sex work. We report medians and proportions, and Wilcoxon-Mann-Whitney and chi-square tests are used to examine differences between sex work and sexual behavior measures by income source. Participants were engaged in sex work for 5.0 years (IQR=2.3-10.0), and earned 3,000 (IQR=2000-8000) Rupees (<50 USD) per month from sex work. Sixty-four percent reported ever testing for HIV and 20.2% for any STI. The most common reasons for starting sex work were money (83.0) and pleasure (56.0%). Participants reported 8.0 (IQR=3.0-15.0) male clients and 7 (IQR=4.0-15.0) condomless anal sex acts with male clients in the past month. Compared to participants with an additional source of income, those whose only source of income was sex work reported more male clients in the past month (10.0 vs. 6.0, p=0.017), as well as more condomless anal sex acts with male clients (8.0 vs. 5.0, p=0.008). Nearly 70.0% were offered more money not to use a condom during sex with a client, and 74.2% reported accepting more money not to use a condom. Three-quarters reported having experienced difficulty using condoms with clients. MSW in India engage in high levels of sexual risk for HIV/STIs. Money appears to be a driving factor for engaging in sex work and condomless sex with clients. HIV prevention interventions with MSW should focus on facilitating skills that will support their ability to negotiate sexual safety in the context of monetary disincentives.

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“…The vast array of categories reflects the fluidity of sexuality that is untethered to gender expectations for Indian men (Asthana & Oostvogels 2001; Boyce 2007). All sub-groups of India MSM are known to engage in sex work; however studies have shown that paid sex is most commonly associated with the kothi identity (Narayanan et al, 2013; Newman et al, 2008; Thomas et al 2015). There is a high degree of heterogeneity among Indian MSW in terms of socio-demographic characteristics.…”

Section: Introductionmentioning

confidence: 99%

Development and Open Pilot Trial of an HIV-Prevention Intervention Integrating Mobile-Phone Technology for Male Sex Workers in Chennai, India

et al. 2015

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In India, men who have sex with men and engage in sex work (i.e., male sex workers; MSW) have a high risk of transmitting HIV. Globally, sex workers have become more spatially mobile due to advances in mobile phone technology. In 2012, in-depth qualitative feedback was garnered from 40 interviews with MSW and four focus groups with 35 key informants (KI) who had expert knowledge of the local MSW community to inform the design of an HIV prevention intervention among MSW in Chennai, India. All MSW were recruited during outreach by employees of a Chennai-based organization for MSM. The data were analyzed using a descriptive qualitative approach. MSW and KI discussed the need for intervention content that went beyond basic HIV psychoeducation. They emphasized the importance of addressing psychological distress, alcohol-related risk and sexual communication skills. Concerns were raised about confidentiality, privacy and scheduling. Participants endorsed a combination of in-person and mobile phone-delivered sessions as well as the integration of mobile phone messaging. These findings served as the basis for the development of a theoretically driven, manual-based intervention incorporating mobile phones. An open pilot assessed the feasibility and acceptability of the intervention with 8 MSW. Assessments and HIV testing were administered at baseline, three, and six months post-baseline. Exit interviews were conducted at the conclusion of the intervention. Retention for session attendance and assessment follow-up was 100%. There was a high level of acceptability for the format, structure and content. These data show initial promise, feasibility and acceptability of the intervention.

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An exploration of elevated HIV and STI risk among male sex workers from India

Cited by 32 publications

References 22 publications

Commercial sex and risk of HIV, syphilis, and herpes simplex virus-2 among men who have sex with men in six Chinese cities

Commercial sex and risk of HIV, syphilis, and herpes simplex virus-2 among men who have sex with men in six Chinese cities

Transactional sex and the challenges to safer sexual behaviors: a study among male sex workers in Chennai, India

Development and Open Pilot Trial of an HIV-Prevention Intervention Integrating Mobile-Phone Technology for Male Sex Workers in Chennai, India

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