Patterns of condom use by men who have sex with men before and after the Avahan intervention in Andhra Pradesh state of India

Abstract

BackgroundTwo rounds of integrated biological and behavioural assessment (IBBA) surveys were done among men who have sex with men (MSM) in Andhra Pradesh during 2006 and 2009. Avahan, the India AIDS initiative, funded by the Bill and Melinda Gates Foundation implemented HIV prevention interventions among MSM starting around the time of the first round of IBBA.MethodsData on socio-demographic, sex behaviour characteristics and HIV status of MSM from the two IBBA rounds were used. Changes in the rates of consistent condom use over the past one month by MSM with various types of partners between the two rounds were assessed. Multivariate analysis was performed to assess associations between various factors and inconsistent condom use for sex with regular partners as well as HIV in MSM.ResultsA significant increase in consistent condom use by MSM was noted from 2006 to 2009 for paid male partners (19.5% to 93.8%), occasional male partners (13.2% to 86.2%), and paid female partners (25.9% to 94.2%). Consistent condom use with regular sex partners also increased but remained lower with regular male partner (75.8%) and very low with regular female partners (15.7%). MSM who used condoms inconsistently with their regular male partner were also more likely to use condoms inconsistently with their regular female partner. Multivariate analysis showed MSM who used condoms inconsistently with regular male partner had higher odds of HIV (odds ratio 1.8; 95% CI 1.2-2.7). MSM who received condoms from Avahan had the lowest odds (odds ratio 0.3; 95% CI 0.1-0.5) of inconsistent condom use with regular male partners.ConclusionsCondom use by MSM increased markedly after implementation of Avahan, though a causal association cannot be assessed with the available data. The relatively lower condom use with regular partners of MSM suggests that additional programme effort is needed to address this aspect specifically.

High HIV prevalence and incidence among MSM across 12 cities in India

“…Correlates of prevalent HIV are also consistent with reports from India[18-20,23,26-28]. Being married remained consistently associated with a higher likelihood of being HIV-infected even in smaller cities.…”

Changes in condom use among males who have sex with males (MSM): Measuring the effect of HIV prevention programme in Dhaka city

“…These findings are consistent with other studies conducted in various countries globally. For example, similar findings were observed among MSM in Andhra Pradesh, Maharashtra and Tamil Nadu in India where HIV prevention programme had a positive impact on increasing condom use [45][46][47] as was the case in Anhui and Sichuan Provinces in China [48,49] and in Senegal [50].…”

Condom use social norms and self-efficacy with different kinds of male partners among Chinese men who have sex with men: results from an online survey

“…This finding is inconsistent with a study conducted in India [ 22 ] but supported by other studies conducted in China, which showed that condomless sex among MSM was more likely to occur when regular partners were involved [ 42 – 44 ]. The potential reasons for this include that MSM have a higher awareness of self-protection when having sex with casual partners [ 45 ], and using a condom with regular partners would be considered as an insult to the partner [ 39 ]. Even like this, previous studies indicated that a large proportion of Chinese MSM persistently engaged in condomless sex with casual partners [ 46 , 47 ].…”