title: Men who have sex with men and transgenders in Mumbai, India: an emerging risk group for STIs and HIV.
abstract: BACKGROUND
  Men who have sex with men and transgenders are an important risk group for sexually transmitted infections (STIs) and human immunodeficiency virus (HIV). They have risky sexual behaviors but low risk perception.
  
  
  OBJECTIVE
  To assess the sexual behavior, STIs, HIV and identify factors associated with HIV in men who have sex with men (MSM) and transgenders (TGs) in Mumbai.
  
  
  METHODS
  Participants were enrolled from two clinics in Mumbai. They completed an interviewer-administered questionnaire and were evaluated for STIs and HIV infection.
  
  
  RESULTS
  A total of 150 participants, 122 MSM and 28 TGs were evaluated; 17% of MSM and 68% of the TGs were HIV infected. HIV infection in MSM was associated with serological positivity for HSV2 IgG [adjusted odds ratio (aOR), 95% confidence interval (CI): 9.0 (2.2-36.9)], a positive Treponema pallidum hemagglutination assay (TPHA) [aOR (95% CI): 6.0 (1.5-24.0)], greater than five acts of receptive anal sex in the past six months [aOR (95% CI): 4.3 (1.2-15.0)] and per category increase in age (18-24 yrs, 25-29 yrs, > 30 yrs) [aOR (95% CI): 3.1 (1.3-7.1)] in multivariate analysis. Consistent condom use during receptive anal sex in the past six months was low (27%). Many MSM were married (22%) or had sex with females and may act as a 'bridge population'. HIV infection in TGs was associated with a positive TPHA [OR (95% CI): 9.8 (1.5-63.9)] and HSV 2 IgG [OR (95% CI): 6.7 (1.1-40.4)] in univariate analysis.
  
  
  CONCLUSIONS
  Prior STIs were strongly associated with HIV infection in MSM and TGs. These groups should be the focus of intensive intervention programs aimed at STI screening and treatment, reduction of risky sexual behavior and promotion of HIV counseling and testing.
authors.affiliation: McGill University, Montreal, Canada.
authors.forename: Maninder Singh
authors.initials: MS
authors.lastname: Setia
authors.forename: Christina
authors.initials: C
authors.lastname: Lindan
authors.forename: H R
authors.initials: HR
authors.lastname: Jerajani
authors.forename: Sameer
authors.initials: S
authors.lastname: Kumta
authors.forename: Maria
authors.initials: M
authors.lastname: Ekstrand
authors.forename: M
authors.initials: M
authors.lastname: Mathur
authors.forename: A
authors.initials: A
authors.lastname: Gogate
authors.forename: A R
authors.initials: AR
authors.lastname: Kavi
authors.forename: V
authors.initials: V
authors.lastname: Anand
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Klausner
mesh_terms: D000328:Adult; D000367:Age Factors; D001727:Bisexuality; D017280:Condoms / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000453:epidemiology / Q000209:etiology*; D018451:Homosexuality, Male / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007194:India; D008297:Male; D012309:Risk-Taking; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000209:etiology*; D014189:Transsexualism / Q000150:complications* / Q000523:psychology*