title: The emerging HIV epidemic among men who have sex with men in Tamil Nadu, India: geographic diffusion and bisexual concurrency.
abstract: In India, men who have sex with men (MSM) remain hidden because anal intercourse was criminalized and marriage socially required. We characterize HIV/STI prevalence among MSM in Tamil Nadu. Eligible participants were recruited using respondent-driven sampling in eight cities (n = 721). Median age was 28, 34% were married and 40% self-identified as homosexual. Median number of male partners in the prior year was 15; 45% reported any unprotected anal intercourse (UAI). HIV, herpes simplex virus-2 (HSV-2), chronic hepatitis B virus (HBV) and syphilis prevalence were 9, 26, 2 and 8%, respectively; among married men, all were higher: 14, 32, 3 and 11% (p < 0.01 for HIV and HSV-2). Less education, HSV-2, more male partners, UAI and not having a main male partner were associated with HIV prevalence. The high STI and UAI prevalence may lead to a burgeoning HIV epidemic among MSM, reinforcing the need for focused preventive measures incorporating complex circumstances.
authors.affiliation: YR Gaitonde Centre for AIDS Research and Education (YRGCARE), VHS Adyar, Taramani, Chennai, India. sunil@yrgcare.org
authors.forename: Sunil Suhas
authors.initials: SS
authors.lastname: Solomon
authors.forename: Aylur K
authors.initials: AK
authors.lastname: Srikrishnan
authors.forename: Frangiscos
authors.initials: F
authors.lastname: Sifakis
authors.forename: Shruti H
authors.initials: SH
authors.lastname: Mehta
authors.forename: Canjeevaram K
authors.initials: CK
authors.lastname: Vasudevan
authors.forename: Pachamuthu
authors.initials: P
authors.lastname: Balakrishnan
authors.forename: Kenneth H
authors.initials: KH
authors.lastname: Mayer
authors.forename: Suniti
authors.initials: S
authors.lastname: Solomon
authors.forename: David D
authors.initials: DD
authors.lastname: Celentano
mesh_terms: D000328:Adult; D001727:Bisexuality; D058872:Epidemics; D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D007194:India / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D015995:Prevalence; D018570:Risk Assessment; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000453:epidemiology* / Q000635:transmission; D012923:Social Class; D011795:Surveys and Questionnaires; D047568:Unsafe Sex; D055815:Young Adult
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