title: 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.
abstract: OBJECTIVE
  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).
  
  
  METHODS
  A cross-sectional analysis using baseline data from a randomized controlled trial of an HIV prevention intervention for high-risk men in Mumbai, India.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division of Epidemiology, School of Public Health, University of California Berkeley, Berkeley, CA 94720-7360, USA. mpurnima@berkeley.edu
authors.forename: Purnima
authors.initials: P
authors.lastname: Madhivanan
authors.forename: Alexandra
authors.initials: A
authors.lastname: Hernandez
authors.forename: Alka
authors.initials: A
authors.lastname: Gogate
authors.forename: Ellen
authors.initials: E
authors.lastname: Stein
authors.forename: Steven
authors.initials: S
authors.lastname: Gregorich
authors.forename: Maninder
authors.initials: M
authors.lastname: Setia
authors.forename: Sameer
authors.initials: S
authors.lastname: Kumta
authors.forename: Maria
authors.initials: M
authors.lastname: Ekstrand
authors.forename: Meenakshi
authors.initials: M
authors.lastname: Mathur
authors.forename: Hema
authors.initials: H
authors.lastname: Jerajani
authors.forename: Christina P
authors.initials: CP
authors.lastname: Lindan
mesh_terms: D000428:Alcohol Drinking / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission*; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D012309:Risk-Taking; D011477:Sex Work; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission*