Alcohol and Sexual Risk Behavior among Migrant Female Sex Workers and Male Workers in Districts with High In-Migration from Four High HIV Prevalence States in India

Abstract

This paper examines the association between alcohol use and sexual risk in two critical migrant populations living within the same geographical areas—migrant men and female sex-workers (FSWs). Data are drawn from two independent surveys of migrant FSWs and male workers in 14 districts of four high HIV prevalent Indian states. In the paper we have examined the independent effects of degree of mobility and alcohol use prior to sex on HIV risk behaviors. Nearly two-thirds of FSWs and a similar proportion of male migrant workers, as well as nine out of ten clients of FSWs consume alcohol. More than half of the FSWs and their clients consumed alcohol prior to sex. The practice of alcohol use prior to sex among both FSWs and their clients has a significant association with inconsistent condom use during paid as well as unpaid sex, and these effects are independent of degree of mobility. The results suggest a need for developing an in-depth understanding of the role of alcohol in accentuating HIV risk particularly among migrant populations who move frequently from one place another.

The Relationship Between Alcohol Consumption and Human Immunodeficiency Virus Infection and Risk Behaviour: A Systematic Literature Review of High-Risk Groups, with a Focus on South Africa

“…In India, Verma et al (2010) found a significant association between alcohol use and having more than three partners per day, both paying and not paying. In these cases, condom use is minimal, and this problem is even more pronounced in migrant FSWs who travel greater distances .…”

“…Sex with a customer is often accompanied by alcohol consumption, as shown by studies in Afghanistan (Todd et al, 2010), China (Rogers et al, 2002;Wang et al, 2010), India (Bowen et al, 2010;Go et al, 2010;Samet et al, 2010;Verma et al, 2010), Kenya (Chersich et al, 2007), Mongolia (Witte et al, 2010), the Philippines (Chiao et al, 2006;Morisky et al, 2010), Scotland (Thomas et al, 1990), South Africa (Wechsberg et al, 2005;Wechsberg et al, 2009), Tanzania Fisher et al, 2010), the United States (Nemoto et al, 2003), and Vietnam (Nemoto et al, 2008). Alcohol is also consumed by male clients of FSWs in India (Madhivanan et al, 2005;Rodríguez et al, 2010;Samet et al, 2010;Schensul et al, 2010;Verma et al, 2010), Scotland (Morgan Thomas et al, 1990), Sri Lanka (Dissabandara et al, 2009), Thailand (Havanon et al, 1993), and Zimbabwe (Fritz et al, 2002).…”

“…Alcohol is also consumed by male clients of FSWs in India (Madhivanan et al, 2005;Rodríguez et al, 2010;Samet et al, 2010;Schensul et al, 2010;Verma et al, 2010), Scotland (Morgan Thomas et al, 1990), Sri Lanka (Dissabandara et al, 2009), Thailand (Havanon et al, 1993), and Zimbabwe (Fritz et al, 2002). In addition, FSWs often consume alcohol together with their clients, as observed in massage parlours and bars in Vietnam (Nemoto et al, 2008), the Philippines (Chiao et al, 2006), the United States (Nemoto et al, 2003), China (Wang et al, 2010), India (Rodríguez et al, 2010) and Tanzania ).…”

“…Xiao et al (2010) argue that migrants with a low level of education do not use condoms whether they bring into play alcohol or not. Verma et al (2010) illustrated greater alcohol consumption and higher rates of unprotected sex for migrants who were away from home for prolonged periods. This study, conducted in India, reported alcohol use prior to sex in general as significantly higher in highly mobile, male migrant workers (OR 1.5, CI 1.2-1.7).…”

Clients Bargaining for Having Unprotected Sex with Female Prostitutes

“…Causes or factors related to unprotected sex are drugs (4,5) and alcohol (6). Also, there is an argument that that some sex workers are willing to take the risk because clients are willing to pay more money to avoid the use of condoms (7).…”