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HIV Rates and Risk Behaviors Are Low in the General Population of Men in Southern India but High in Alcohol Venues: Results From 2 Probability Surveys

Go, Vivian F PhD*; Solomon, Suniti MD; Srikrishnan, Aylur K BA; Sivaram, Sudha DrPH*; Johnson, Sethulakshmi C MSW; Sripaipan, Teerada MPH*; Murugavel, Kailapuri G PhD; Latkin, Carl PhD; Mayer, Kenneth H MD§; Celentano, David D ScD*

JAIDS Journal of Acquired Immune Deficiency Syndromes: December 1st, 2007 - Volume 46 - Issue 4 - p 491-497
doi: 10.1097/QAI.0b013e3181594c75
Epidemiology and Social Science

Background: As the HIV epidemic continues to expand in India, empiric data are needed to determine the course of the epidemic for high-risk populations and the general population.

Methods: Two probability surveys were conducted in Chennai slums among a household sample of men and alcohol venue patrons (“wine shops”) to compare HIV and other sexually transmitted disease (STD) prevalence and to identify STD behavioral risk factors.

Results: The wine shop sample (n = 654) had higher rates of HIV and prevalent STDs (HIV, herpes simplex virus 2 [HSV-2], syphilis, gonorrhea, or chlamydia) compared with the household sample (n = 685) (3.4% vs. 1.2%, P = 0.007 and 21.6% vs. 11.8%, P < 0.0001, respectively). High-risk behaviors in the household sample was rare (<4%), but 69.6% of wine shop patrons had >2 partners, 58.4% had unprotected sex with a casual partner, and 54.1% had exchanged sex for money in the past 3 months. A multivariate model found that older age, ever being married, ever being tested for HIV, and having unprotected sex in the past 3 months were associated with STD prevalence in wine shop patrons.

Conclusions: Prevalent HIV and STDs, and sexual risk behaviors are relatively low among the general population of men. We found that men who frequent alcohol venues practice high-risk behaviors and have high rates of STDs, including HIV, and may play an important role in expanding the Indian epidemic.

From the *Infectious Diseases Program, Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD; †YRG Centre for AIDS Research and Education, Chennai, India; ‡Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD; and §Brown University AIDS Program, Providence, MA.

Received for publication May 17, 2007; accepted August 23, 2007.

Supported by the US National Institute of Mental Health (grant 1U10 MH61543).

Correspondence to: Vivian Go, PhD, Infectious Diseases Program, Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, 615 North Wolfe Street, Suite E-6610, Baltimore, MD 21205 (e-mail: vgo@jhsph.edu).

© 2007 Lippincott Williams & Wilkins, Inc.