Heterosexual behaviour and condom usage in an urban population of Delhi, India

Risk of Sexually-Transmitted Infections among Migrant Men: Findings from a Survey in Delhi

Male outmigration has been a traditional feature of rural to urban migration in India. Many of these out-migrants are married and have left their families behind. This raises the question of whether men actually abstain or seek other sexual partners. To address this question, this paper attempts to study migrants' sexual behavior and sexual health as well as their attitudes towards extramarital sex and preventive practices during sex outside marriage. Findings from the survey of 500 married male migrants suggest that migrants staying away from their families are 3.6 times more likely to indulge in extramarital sex than migrants staying with their families. The need for more information campaigns and providing recreational facilities for migrants living away from their families is suggested by the study.

HIV transmission potential among local and migrant factory workers in Kolkata, India

Migrant workers in India play a key role in the spread of HIV. Kolkata is a common destination for workers, who may acquire infection and transmit it to their wives and/or other sexual partners. We investigated sexual relations and condom use by factory workers. Migrant and local factory workers were randomly selected from five wards of Kolkata. Information was collected about demographic and socio-economic characteristics, sexual relationships, condom usage, and perceptions and intent to use condoms. Condom use was very low in both groups of workers, particularly among migrants. Many married workers visited female sex workers but never used condoms. Few intended to use condoms, and if they did, it did not always translate into actual usage. There is great potential for transmission of HIV/sexually transmitted infections by these workers. Carefully designed intervention and education programs in the context of low literacy and cultural norms are urgently needed.

Prevalence and determinants of HIV infection in South India: a heterogeneous, rural epidemic

OBJECTIVES

To assess the prevalence and determinants of HIV infection in the general population in Bagalkot district, a largely rural district in the southern Indian state of Karnataka.

METHODS

Approximately 6700 individuals aged 15-49 years were randomly sampled from 10 villages and six towns, from three of Bagalkot's six sub-districts. Each consenting respondent was administered a questionnaire, followed by blood collection and testing for HIV, syphilis, and herpes simplex virus type 2 (HSV-2) on a 25% sub-sample.

RESULTS

HIV prevalence was 2.9% overall, 2.4% in urban areas and 3.6% in rural areas [odds ratio (OR), 0.65; 95% confidence interval (CI), 0.45-0.95]. Significant differences in HIV prevalence were seen between the three sub-districts, with prevalences of 1.1, 3.0 and 6.4% (P < 0.05), and HIV prevalence in the 10 villages ranged from 0 to 8.2%. Reported multiple sexual partners, receiving money for sex and a history of medical injections were significantly associated with HIV infection, as were older age, being widowed, divorced, separated or deserted, lower education levels and being a woman of a lower caste. There was a strong association between HSV-2 and HIV infection (OR, 5.2; 95% CI, 2.3-11.5).

CONCLUSIONS

The rural nature of this epidemic has important implications for prevention and care programs. The striking differentials observed in HIV prevalence between sub-districts and even villages suggest that risk and vulnerability for HIV are highly heterogeneous. Further research is required to understand the individual and community-level factors behind these differentials, so that preventive interventions can be directed to where they are most needed.

AIDS related knowledge, attitudes, and professional preparation among social work students in India

Three-hundred and eighty-five social work students enrolled in 11 colleges in India were surveyed. Overall, the students demonstrated a moderate degree of knowledge about HIV/AIDS. However, they were generally unconcerned about the contagion. Three-fourths admitted to their lack of competence to deal with HIV+ patients. Regression analyses identified the positive effect of AIDS knowledge in combination with variables 'actual contact with AIDS patients' and 'sense of competence' on attitude toward PHWA. The paper discusses a curriculum strategy aimed at gender sensitive content and recommends behavior change as the best approach to reverse the tide of the contagion.

HIV/AIDS knowledge, beliefs, and behavior among women of childbearing age in India

This study investigated the relationships of health beliefs and HIV/AIDS knowledge with frequency of condom use among women of childbearing age in four major Indian cities. Surveys were completed by 210 women attending six primary health care centers. Among the sexually active women (N = 139), 68% noted rare or no use of condoms during intercourse. Perceived benefits (p < .05) and normative efficacy in requesting condom use (p = .01) were related to a greater frequency of condom use. About 54% of women knew that breast milk could transmit HIV, but fewer than a third were aware that an HIV-positive mother does not always infect her infant at delivery. Most participants endorsed HIV testing for women prior to pregnancy. Approximately three fourths of participants advocated abortion for HIV-seropositive pregnant women. Intervention efforts may benefit from dispelling misconceptions about AIDS (particularly regarding vertical transmission), emphasizing perceived benefits and women's efficacy in requesting condom use, increasing the availability of HIV testing, and highlighting choices for seropositive women of reproductive age as alternatives to abortion.

Determinants of HIV risk among Indian truck drivers

Although there are very high levels of HIV risk sexual behavior in India, there has been little research on the determinants of this behavior, the psychosocial correlates of condom use, or the potential for effective behavior change interventions. The present research used the information-motivation-behavioral skills model of HIV risk behavior to explore these issues in a sample of Indian truck drivers, a population that comprises an important vector of HIV transmission. This paper presents correlational data on the predictors of HIV risk and preventive behavior in a sample of truck drivers in Chennai, India. The data were collected via detailed individual structured interviews with 300 Indian truck drivers. Results indicated that Indian truck drivers had substantial deficits with respect to HIV prevention information, motivation, and behavioral skills. Consistent with the IMB model, these deficits were often found to be predictive of HIV risk and preventive behavior. The implications of these findings for future intervention are discussed.

Extent and speed of spread of HIV infection in India through the commercial sex networks: a perspective

India has the world's highest number of HIV/AIDS infections for any country outside Africa. Eighty-five per cent of HIV transmission in India occurs through heterosexual contact. One billion population, a large number of female sex workers, high prevalence of sexually transmitted infection (STIs) and low condom use make a potent combination for explosive growth of the epidemic. Taking available estimates of the number of female sex workers (FSWs), their work patterns, prevalence of HIV and STIs and condom use among them in 1999 as the base, and adopting reasonable infectivity rates, this paper attempts to present a model to estimate the spread of HIV infection in commercial sex networks until 2005. HIV infections in commercial sex networks are estimated to increase from the 1999 level of approximately 2.49 million to about 3.93 million by 2005 in a favourable scenario, and to 6.87 million in a worse scenario. Spread of HIV is influenced in the short term by condom use and prevalence of STIs, and these are the only factors that can be manipulated to limit the spread of the infection.

Ethnic minorities and their vulnerability to AIDS in a border state of India

To successfully stall the spread of HIV/AIDS among the ethnic minorities in India, it is imperative that we not only understand the complexity of issues in India with regard to HIV spread among ethnic groups but also comprehend that straightforward measures that might have worked in the context of other countries may not work in the Indian context. The authors present field work data and the results of interviews with 635 opinion leaders from eight 'tribal groups' from the north eastern border state of Manipur in India where a high rate of HIV infection is reported among the IDUs (intravenous drug users). The study found community support for AIDS, sex and drug education, along with an increasing perception of social vulnerability. Even though respondents perceive the threat of infection, few feel that they are personally susceptible. As HIV/AIDS prevention programmes compete with other socioeconomic conditions, the prevention blue print must be tailored to meet diverse demands in the study area and of the ethnic minorities in India.