Alcohol Use by Men Is a Risk Factor for the Acquisition of Sexually Transmitted Infections and Human Immunodeficiency Virus From Female Sex Workers in Mumbai, India

Division of Epidemiology, School of Public Health, University of California Berkeley, Berkeley, CA 94720-7360, USA.
Sex Transm Dis (Impact Factor: 2.84). 12/2005; 32(11):685-90. DOI: 10.1097/01.olq.0000175405.36124.3b
Source: PubMed

ABSTRACT We investigated whether men who were under the influence of alcohol when visiting female sex workers (FSW) were at greater risk for sexually transmitted infections (STI) and human immunodeficiency virus (HIV).
A cross-sectional analysis using baseline data from a randomized controlled trial of an HIV prevention intervention for high-risk men in Mumbai, India.
The overall HIV prevalence among 1741 men sampled was 14%; 64% had either a confirmed STI or HIV; 92% reported sex with an FSW, of whom 66% reported having sex while under the influence of alcohol (SUI). SUI was associated with unprotected sex (odds ratio [OR]: 3.1; 95% confidence interval [CI], 2.3-4.1), anal sex (OR: 1.5; 1.1-2.0), and more than10 FSW partners (OR: 2.2; 1.8-2.7). SUI was independently associated with having either an STI or HIV (OR: 1.5; 1.2-1.9).
Men who drink alcohol when visiting FSWs engage in riskier behavior and are more likely to have HIV and STIs. Prevention programs in India need to raise awareness of this relationship.

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Available from: Maria Ekstrand, Sep 28, 2015
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    • "Alcohol use and its association with HIV-related sexual risk is well documented by studies in other countries [4–7], including studies on MSM [8–11]. Studies in India have found alcohol use to be associated with HIV-related sexual risk across a range of male populations—married men [12], male migrant workers [13], men from low income communities [14], male clients of female sex workers (FSWs) [15], and male patrons of wine shops [16]. However, little information is available on alcohol use among Indian MSM and its association with HIV-related sexual risk. "
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    ABSTRACT: This paper examines the association between alcohol use and HIV-related sexual risk behaviors among men who have sex with men (MSM). A cross-sectional bio-behavioral survey was conducted among 3,880 MSM, recruited using time-location cluster sampling from cruising sites in three Indian states. Nearly three-fifths of the participants reported alcohol use. Among frequent users (40 % of the sample), defined as those who consumed alcohol daily or at least once a week, 66 % were aged 25 years and above, 53 % self-identified as kothi (feminine/receptive), and 63 % consistently used condoms with male paying partners. Multivariate logistic regression demonstrated that frequent users were more likely to be aged 25 years and above, less likely to self-identify as kothi, and less likely to consistently use condoms with male paying (AOR = 0.7; 95 % CI 0.5-0.9) and male regular (AOR = 0.7; 95 % CI 0.6-0.9) partners. HIV prevention interventions for MSM need to provide tailored information on alcohol use-related sexual risk, especially for MSM in sex work and MSM with male regular partners.
    AIDS and Behavior 01/2014; 18(7). DOI:10.1007/s10461-014-0699-x · 3.49 Impact Factor
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    • "Alcohol's contribution to the global HIV epidemic by encouraging high risk behaviour, especially among high risk groups, has long been acknowledged (Brown & Van Hook, 2006; Madhivanan et al., 2005; Raj, Cheng, Levison, Meli, & Samet, 2006). In this regard, research worldwide indicates that alcohol use predicts increased HIV related-risk behaviour for female sex workers (FSWs) via increased risk of unprotected sex with their clients (Chersich et al., 2007; Plant, Plant, & Thomas, 1990; Plant, 1990; Yang et al., 2005). "
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    ABSTRACT: Researching female sex workers (FSWs) in Indonesia, where commercial sex tends to be hidden or undercover, is challenging but possible. This is even more challenging when it involves investigation of sensitive behaviors, such as their alcohol use, a known disinhibitor to risk behavior. The adoption of effective strategies is needed to increase response rates and improve data quality. This article describes procedures used to research FSWs' alcohol use during commercial sex in the Eastern part of Indonesia. Challenges, lessons learned, and recommendations for best practices are discussed.
    Substance Use &amp Misuse 07/2013; 48(14). DOI:10.3109/10826084.2013.808221 · 1.23 Impact Factor
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    • "While this helped the enrollment process, sex workers who are in contact with peer educators are likely to be sex worker collective members and to have access to the services offered by the HIV programme. Alcohol consumption may be an important vulnerability factor [13] [14] [15]. However, although specifically asked about the women's and their clients' alcohol consumption and its effect on condom use, in many sex work settings women were reluctant to admit that they drink alcohol beverages, possibly due to the strong stigma against alcohol consumption in India, especially among women. "
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    ABSTRACT: HIV prevalence in India remains high among female sex workers. This paper presents the main findings of a qualitative study of the modes of operation of female sex work in Belgaum district, Karnataka, India, incorporating fifty interviews with sex workers. Thirteen sex work settings (distinguished by sex workers' main places of solicitation and sex) are identified. In addition to previously documented brothel, lodge, street, dhaba (highway restaurant), and highway-based sex workers, under-researched or newly emerging sex worker categories are identified, including phone-based sex workers, parlour girls, and agricultural workers. Women working in brothels, lodges, dhabas, and on highways describe factors that put them at high HIV risk. Of these, dhaba and highway-based sex workers are poorly covered by existing interventions. The paper examines the HIV-related vulnerability factors specific to each sex work setting. The modes of operation and HIV-vulnerabilities of sex work settings identified in this paper have important implications for the local programme.
    AIDS research and treatment 12/2012; 2012:371482. DOI:10.1155/2012/371482
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