HIV risk behaviours among contracted and non-contracted male migrant workers in India: potential role of labour contractors and contractual systems in HIV prevention.
OBJECTIVE
To assess the HIV risk behaviours of male migrant contracted and non-contracted labourers in India and to understand the role of contract labour systems for use in HIV prevention efforts.


METHODS
Cross-sectional surveys (N = 11 219) were conducted with male migrant workers, aged 18-49 years from 21 districts in four high HIV prevalence states of India. Analyses involved data from the subsample of contracted labour (n = 3880; 35% of total sample) to assess the prevalence of HIV risk behaviours and sexually transmitted infection (STI) symptoms and further comparisons with non-contracted labourers.


RESULTS
Contracted male labourers are largely young; 70% were between the ages of 18 and 29 years. Over half (55%) were married, and a third (34%) resided away from their wives because of migrant work. More than one in six contract labourers (17%) reported having sex with a sex worker, and two-fifths of these reported an inconsistent use of condoms. One in 10 reported sex with both sex workers and non-spousal unpaid female partners in the past year in the places they had migrated to, and 31% reported sex with either a sex worker or non-spousal unpaid female partner in their places of origin over the past 2 years. After adjustment for sociodemographic characteristics, the contracted labourers were significantly more likely to report alcohol use and HIV risk behaviours than non-contracted labourers.


CONCLUSIONS
The existence of a wide network of labour contractors and a structured infrastructure of the contract system provides opportunities for effective and sustained worksite HIV prevention programmes among contracted male migrant workers in India.
Saggurti
Niranjan
N
HIV and AIDS Programme, Population Council, New Delhi, India. nsaggurti@popcouncil.org
Verma
Ravi K
RK
Jain
Anrudh
A
RamaRao
Saumya
S
Kumar
K Anil
KA
Subbiah
Anjaneyalu
A
Modugu
Hamini Reddy
HR
Halli
Shiva
S
Bharat
Shalini
S
D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology; D017280:Condoms / Q000706:statistics & numerical data; D003284:Contract Services / Q000706:statistics & numerical data*; D004812:Epidemiologic Methods; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012309:Risk-Taking; D011477:Sex Work / Q000706:statistics & numerical data; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014171:Transients and Migrants / Q000523:psychology* / Q000706:statistics & numerical data; D047568:Unsafe Sex / Q000706:statistics & numerical data; D055815:Young Adult