Alcohol use and HIV sexual risk among MSM in Chennai, India

Abstract

Summary Men who have sex with men (MSM) in India are a core risk group for HIV. Heavy alcohol consumption is associated with increased sexual risk-taking behaviours in many cultures, in particular among MSM. However, no studies to date have explored alcohol use and HIV risk among MSM in India. MSM in Chennai, India (n = 210) completed an interviewer-administered behavioural and psychosocial assessment. Bivariate and multivariable logistic regression procedures examined behavioural and demographic associations with weekly alcohol consumption. Twenty-eight percent of the sample (n = 58) reported using alcohol at least weekly to the point of being buzzed/intoxicated, which was associated with older age, being married to a woman, being panthi (masculine appearing, predominantly insertive partners) versus kothi (feminine acting/appearing and predominantly receptive partners), weekly tobacco use, unprotected anal sex and unprotected vaginal sex in the three months prior to study enrolment (all P < 0.05). In a multivariable model, unprotected vaginal sex in the previous three months and being married to a women were unique variables associated with weekly alcohol use (all P < 0.01). Further investigation of alcohol use within the context of sexual risk taking is warranted among Indian MSM. Panthis and MSM who are married to women may be particularly likely to benefit from interventions to decrease alcohol intake and concurrent unsafe sex.

Substance use among men who have sex with men: patterns, motivations, impacts and intervention development need

“…Condomless anal intercourse is particularly strongly correlated with alcohol use disorder (a clinical term determined by the Diagnostic and Statistical Manual of Mental Disorders) 42. This global-level association has been documented in many countries, including Australia,11 Cambodia,43 India,44 China,45 Canada46 and the USA 47. However, in many instances, interaction effects with illicit drugs or varied psychosocial factors that also influence sexual risk-taking can confound significant findings 37…”

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

“…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). Thomas et al identified not having previously engaged in an HIV prevention program, having symptoms of clinical depression and lower self-efficacy as predictors for MSM engaging in unprotected anal intercourse, a key risk factor for testing positive for HIV (Thomas et al, 2009).…”

Pervasive Heavy Alcohol Use and Correlates of Increasing Levels of Binge Drinking among Men Who Have Sex with Men, San Francisco, 2011

“…2,17 Binge drinking and other patterns of heavy alcohol use are independently associated with a variety of high-risk behaviors in MSM, including unprotected anal sex, multiple partners, and having HIV-serodiscordant partners, [18][19][20][21][22][23][24][25][26][27][28] a link also observed among Black, Native American, and older MSM. [29][30][31] Binge drinking and heavy alcohol consumption are major causes of incident HIV infections in MSM. Binge alcohol use was independently associated with a greater than threefold increase in odds for new HIV diagnoses among MSM who had a previously (past 12 months) negative HIV test in a case-control study.…”