title: Male use of female sex work in India: a nationally representative behavioural survey.
abstract: Heterosexual transmission of HIV in India is driven by the male use of female sex workers (FSW), but few studies have examined the factors associated with using FSW. This nationally representative study examined the prevalence and correlates of FSW use among 31,040 men aged 15-49 years in India in 2006. Nationally, about 4% of men used FSW in the previous year, representing about 8.5 million FSW clients. Unmarried men were far more likely than married men to use FSW overall (PR = 8.0), but less likely than married men to use FSW among those reporting at least one non-regular partner (PR = 0.8). More than half of all FSW clients were married. FSW use was higher among men in the high-HIV states than in the low-HIV states (PR = 2.7), and half of all FSW clients lived in the high-HIV states. The risk of FSW use rose sharply with increasing number of non-regular partners in the past year. Given the large number of men using FSW, interventions for the much smaller number of FSW remains the most efficient strategy for curbing heterosexual HIV transmission in India.
authors.affiliation: Centre for Global Health Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Michelle F
authors.initials: MF
authors.lastname: Gaffey
authors.forename: Srinivasan
authors.initials: S
authors.lastname: Venkatesh
authors.forename: Neeraj
authors.initials: N
authors.lastname: Dhingra
authors.forename: Ajay
authors.initials: A
authors.lastname: Khera
authors.forename: Rajesh
authors.initials: R
authors.lastname: Kumar
authors.forename: Paul
authors.initials: P
authors.lastname: Arora
authors.forename: Nico
authors.initials: N
authors.lastname: Nagelkerke
authors.forename: Prabhat
authors.initials: P
authors.lastname: Jha
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006678:HIV / Q000502:physiology; D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D011477:Sex Work / Q000706:statistics & numerical data*; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012747:Sexual Partners / Q000145:classification / Q000523:psychology*; D012959:Socioeconomic Factors; D047568:Unsafe Sex / Q000706:statistics & numerical data; D055815:Young Adult