title: Social network and risk-taking behavior most associated with rapid HIV testing, circumcision, and preexposure prophylaxis acceptability among high-risk Indian men.
abstract: Indian truck drivers and their younger apprentice drivers are at increased risk of HIV infection. We determine network and risk practices associated with willingness to adopt HIV prevention interventions currently not being used in India: rapid HIV testing, circumcision, and preexposure prophylaxis (PrEP) in order to inform the National AIDS Control Program (NACP). Truck drivers and truck cleaners were systematically recruited to participate in a social network and risk survey in Hyderabad, Southern India. Three separate composite measures of acceptability of rapid HIV testing, circumcision, and PrEP acceptability were utilized to independently assess the relationship of these prevention interventions with risk-practices and social network characteristics. An 89% participation rate yielded 1602 truck drivers and truck cleaners with 54.2% younger than 30 years of age and 2.8% HIV infected. Twenty-five percent of respondents reported sex with female sex workers (FSW) and 5% with men (MSM). Rapid testing, circumcision, and PrEP acceptability were 97.4%, 9.1%, and 85.9%, respectively. Participants reporting prosocial network characteristics were more accepting of rapid testing (adjusted odds ratio [AORs] 3.07-6.71; p<0.05) and demonstrated variable PrEP acceptability (AORs 0.08-2.22; p<0.001). Sex with FSWs was associated with PrEP acceptability (AOR 4.27; p<0.001); sex with MSM was associated with circumcision acceptability only (AOR 2.66; p<0.01). Social network factors and risk-practices were associated with novel prevention acceptability, but not consistently across intervention type and with variable directionality. The NACP will need to consider that intervention uptake may likely be most successful when efforts are targeted to individuals with specific behavior and social network characteristics.
authors.affiliation: Department of Medicine, University of Chicago, Illinois 60637, USA. jschnei1@medicine.bsd.uchicago.edu
authors.forename: John
authors.initials: J
authors.lastname: Schneider
authors.forename: Rupali
authors.initials: R
authors.lastname: Kumar
authors.forename: Rakhi
authors.initials: R
authors.lastname: Dandona
authors.forename: Prem
authors.initials: P
authors.lastname: Kumar
authors.forename: Anil
authors.initials: A
authors.lastname: Kumar
authors.forename: Vemu
authors.initials: V
authors.lastname: Lakshmi
authors.forename: Edward
authors.initials: E
authors.lastname: Laumann
authors.forename: Kenneth
authors.initials: K
authors.lastname: Mayer
authors.forename: Lalit
authors.initials: L
authors.lastname: Dandona
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission; D000293:Adolescent; D000328:Adult; D000368:Aged; D001334:Automobile Driving / Q000706:statistics & numerical data*; D002944:Circumcision, Male / Q000706:statistics & numerical data*; D006679:HIV Seropositivity / Q000453:epidemiology* / Q000635:transmission; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D018986:Motor Vehicles; D010342:Patient Acceptance of Health Care; D015995:Prevalence; D012309:Risk-Taking; D011477:Sex Work; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012944:Social Support; D011795:Surveys and Questionnaires; D044465:White People; D055815:Young Adult