title: Psychosocial risk factors for HIV sexual risk among Indian men who have sex with men.
abstract: Indian men who have sex with men (MSM) are at increased risk for HIV compared to the general Indian population. Psychosocial factors may be uniquely associated with HIV risk among Indian MSM and may moderate the beneficial impact of standard HIV prevention approaches. Psychiatric diagnostic interviews and psychosocial and sexual risk assessments were conducted among 150 MSM in Mumbai, India. Logistic regression was employed to examine the association of psychiatric disorders and psychosocial problems to recent sexual risk behavior. Twenty-five percent of participants reported engaging in unprotected anal sex (UAS) during their last sexual contact with a man. Men who were married to a woman were more likely to have engaged in UAS during their last sexual contact with a man (35% vs. 17%, p=0.018). In multivariable models, significant predictors of engaging in UAS were current major depression (adjusted odds ratio [AOR]=2.61; 95% confidence interval [CI] 1.07, 6.39) and number of stressful life events (AOR=0.91; 95% CI 0.83, 0.99). Alcohol dependence, anxiety, and self-esteem were not associated with engaging in UAS. Indian MSM with depression are at higher odds of engaging in UAS compared to MSM without depression. HIV prevention programs for Indian MSM may benefit from incorporating treatment or triage for mental health problems.
authors: a Department of Psychiatry , Harvard Medical School/Massachusetts General Hospital , Boston , MA , USA.
authors: Matthew J
authors: MJ
authors: Mimiaga
authors: Katie Brooks
authors: KB
authors: Biello
authors: Murugesan
authors: M
authors: Sivasubramanian
authors: Kenneth H
authors: KH
authors: Mayer
authors: Vivek Raj
authors: VR
authors: Anand
authors: Steven A
authors: SA
authors: Safren
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000523:psychology; D001008:Anxiety Disorders / Q000523:psychology; D003863:Depression / Q000523:psychology; D015658:HIV Infections / Q000453:epidemiology / Q000523:psychology*; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D007194:India / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012309:Risk-Taking; D012649:Self Concept; D047568:Unsafe Sex / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult