title: An exploration of elevated HIV and STI risk among male sex workers from India.
abstract: BACKGROUND
  Men who have sex with men (MSM) who also report transactional sex (male sex workers or MSWs) are known to be at higher risk for HIV and sexually transmitted infections (STIs). The study aimed to profile socio-demographic characteristics and risk factors associated with high HIV prevalence among MSWs.
  
  
  METHODS
  A cross-sectional study was conducted in 2008-9 among 483 high-risk MSM who attended STI clinics at Mumbai and Hyderabad, two large cities in India.
  
  
  RESULTS
  About 70% of the MSM reported transactional sex. As compared to other MSM, MSWs had more male partners (8.9 versus 2.5, p < 0.001) and higher rates of receptive anal sex (96% versus 72%, p < 0.001). HIV prevalence among MSWs and other MSM was 43.6% and 18.1% respectively. HIV prevalence among MSWs was associated with the place of residence (MSWs from Hyderabad were 7.3 times more likely to be infected), positive syphilis serology (3.8 times) and duration of sex work (increased by 8% for every additional year).
  
  
  CONCLUSIONS
  The study showed that MSWs are at high risk for HIV acquisition/transmission, which highlights the need for intensified interventions for personalized risk-reduction counselling and STI screening. Newer biomedical interventions such as pre-exposure prophylaxis and treatment as prevention could also be considered.
authors.affiliation: FHI 360, India Country Office, New Delhi, India. p.narayanan@rediffmail.com.
authors.forename: Prakash
authors.initials: P
authors.lastname: Narayanan
authors.forename: Anjana
authors.initials: A
authors.lastname: Das
authors.forename: Guy
authors.initials: G
authors.lastname: Morineau
authors.forename: Parimi
authors.initials: P
authors.lastname: Prabhakar
authors.forename: Gururaj Rao
authors.initials: GR
authors.lastname: Deshpande
authors.forename: Raman
authors.initials: R
authors.lastname: Gangakhedkar
authors.forename: Arun
authors.initials: A
authors.lastname: Risbud
mesh_terms: D000328:Adult; D017280:Condoms / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000453:epidemiology / Q000209:etiology*; D018451:Homosexuality, Male / Q000706:statistics & numerical data; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D060386:Sex Workers / Q000706:statistics & numerical data*; D012725:Sexual Behavior / Q000706:statistics & numerical data; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000209:etiology*; D055815:Young Adult