Male alcohol use and unprotected sex with non-regular partners: evidence from wine shops in Chennai, India.
BACKGROUND
In India, heterosexual transmission accounts for approximately 80% of the spread of HIV, the virus that causes AIDS. Male alcohol use and its putative association with sexual risk are explored to inform HIV prevention interventions.


METHODS
A survey of 1196 male patrons of wine shops or bars was conducted from August 2002-January 2003 as part of an ongoing HIV prevention trial in Chennai city in south India. In the analysis, we explored associations between covariates related to sexual behavior and alcohol use and our outcome of unprotected sexual intercourse with non-regular partners among men.


RESULTS
Nearly half (43%) of the respondents reported any unprotected sex with non-regular partners and 24% had four or more recent sexual partners. Over 85% reported using alcohol at least 10 days a month (17% reported drinking everyday). During a typical drinking day, 49% reported consuming five or more drinks. Alcohol use before sex was reported by 89% of respondents. Unprotected sex with non-regular partners was significantly higher among unmarried men (OR=3.25), those who reported irregular income (OR=1.38), who used alcohol before sex (OR=1.75) and who had higher numbers of sexual partners (OR=14.5).


CONCLUSIONS
Our findings suggest that future HIV prevention interventions in India might consider discussing responsible alcohol use and its possible role in sexual risk. These interventions should particularly consider involving unmarried men and weigh the role of structural factors such as access to income in developing prevention messages.
Sivaram
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Infectious Diseases Program, Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Room E6610, Baltimore, MD 21205, United States. ssivaram@jhsph.edu
Srikrishnan
A K
AK
Latkin
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C
Iriondo-Perez
J
J
Go
V F
VF
Solomon
S
S
Celentano
D D
DD
D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology*; D002391:Catchment Area, Health; D003132:Commerce / Q000706:statistics & numerical data*; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D012725:Sexual Behavior / Q000523:psychology*; D012747:Sexual Partners; D011795:Surveys and Questionnaires; D047568:Unsafe Sex / Q000706:statistics & numerical data*; D014920:Wine