title: The effect of mobility on sexual risk behaviour and HIV infection: a cross-sectional study of men who have sex with men in southern India.
abstract: OBJECTIVE
  Mobility is an important factor contributing to the spread of HIV among key population at risk for HIV; however, research linking this relationship among men who have sex men (MSM) is scarce in India. This study examines the association between mobility and sexual risk behaviour and HIV infection among MSM in southern India.
  
  
  METHODS
  Data are drawn from a cross-sectional biobehavioural survey of 1608 self-identified MSM from four districts of Andhra Pradesh in India, recruited through a probability-based sampling in 2009-2010. Logistic regression models were used to estimate odds ratios and 95% CIs for sexual risk behaviours (unprotected sex with any male partner) and HIV infection based on the mobility status (travelled and had sex in the past year) after adjusting for sociodemographics and risk behaviours.
  
  
  RESULTS
  Of the 1608 MSM, one-fourth (26%) were mobile. Of these, three-fourths had travelled across districts but within the state (56%), and one-fifth (20%) across states. As compared to non-mobile MSM, a higher proportion of MSM who were mobile across districts (adjusted (OR=1.42, 95% CI 1.04 to 1.95) or states (adjusted OR=3.20, 95% CI 1.65 to 6.17) reported having unprotected sex with any male sexual partner. Further, mobility across districts (adjusted OR=1.43, 95% CI 1.01 to 2.03) or states (adjusted OR=2.45, 95% CI 1.46 to 4.10) was significantly associated with HIV infection.
  
  
  CONCLUSIONS
  Mobile MSM have a higher likelihood of contracting HIV. Interventions extending the ways to reach out to MSM with greater mobility may augment ongoing efforts to reduce the spread of HIV/AIDS in India.
authors.affiliation: Population Council, Golf Links, New Delhi, India.
authors.forename: Sowmya
authors.initials: S
authors.lastname: Ramesh
authors.affiliation: Population Council, Golf Links, New Delhi, India.
authors.forename: Purnima
authors.initials: P
authors.lastname: Mehrotra
authors.affiliation: Population Council, Golf Links, New Delhi, India.
authors.forename: Bidhubhusan
authors.initials: B
authors.lastname: Mahapatra
authors.affiliation: Population Council, Golf Links, New Delhi, India.
authors.forename: Deepika
authors.initials: D
authors.lastname: Ganju
authors.affiliation: National AIDS Research Institute, MIDC, Pune, India.
authors.forename: Karikalan
authors.initials: K
authors.lastname: Nagarajan
authors.affiliation: Population Council, Golf Links, New Delhi, India.
authors.forename: Niranjan
authors.initials: N
authors.lastname: Saggurti
mesh_terms: D000328:Adult; D017280:Condoms / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000453:epidemiology*; D018451:Homosexuality, Male; D006801:Humans; D007194:India; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D012307:Risk Factors; D012309:Risk-Taking; D011477:Sex Work / Q000706:statistics & numerical data; D012725:Sexual Behavior / Q000706:statistics & numerical data; D014195:Travel / Q000706:statistics & numerical data*; D047568:Unsafe Sex / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: HIV; MEN; SEXUAL BEHAVIOUR