title: Comparison of Sexual Risk, HIV/STI Prevalence and Intervention Exposure Among Men Who Have Sex with Men and Women (MSMW) and Men Who Have Sex with Men Only (MSMO) in India: Implications for HIV Prevention.
abstract: Using data from a cross-sectional bio-behavioral survey conducted among men who have sex with men (n = 3833) in India, we examined differences related to HIV-related sexual risk, HIV/STI prevalence and intervention exposures between men who have sex with men and women (MSMW, 35 % of the sample) and men who have sex with men only (MSMO). Among MSMW, 93 % reported having female regular partners, 14 % had female paid partners, and all types of male partners (regular 55 %; casual 77.1 %; paying 47 %; paid 19 %). Logistic regression revealed that MSMW had higher odds of being aged 26 years and above (AOR 4.45, 95 % CI 3.66-5.42), lower odds of inconsistently using condoms with male partners (AOR 0.82, 95 % CI 0.67-0.98) and lower odds of having kothi (feminine/mostly receptive) identity (AOR 0.07, 95 % CI 0.06-0.09). HIV intervention exposure and HIV/STI prevalence did not differ significantly between MSMW and MSMO (HIV 13.1 vs. 12.2 %; active syphilis 3.5 vs. 3.1 %, respectively). Concurrent sexual partnerships with men and women pose risk of HIV transmission/acquisition for MSM and their male and female partners. All subgroups of MSM require tailored information and skills to consistently use condoms with different types of partners of either gender.
authors.affiliation: , No 11 Avatar Apartments, 27 Balakrishnan Road, Valmikingar, Thiruvanmiyur, Chennai, 600041, India. ramaklak@gmail.com.
authors.forename: Lakshmi
authors.identifier: http://orcid.org/0000-0003-4846-9361
authors.initials: L
authors.lastname: Ramakrishnan
authors.affiliation: FHI 360 India, New Delhi, India. sramanathan@fhi360.org.
authors.forename: Shreena
authors.initials: S
authors.lastname: Ramanathan
authors.affiliation: Centre for Sexuality and Health Research and Policy (C-SHaRP), Chennai, India. venkatesan.chakrapani@gmail.com.
authors.forename: Venkatesan
authors.initials: V
authors.lastname: Chakrapani
authors.affiliation: Centre for Sexuality and Health Research and Policy (C-SHaRP), Chennai, India. pgoswami@fhi360.org.
authors.forename: Prabuddhagopal
authors.initials: P
authors.lastname: Goswami
authors.affiliation: National AIDS Research Institute, Pune, Maharashtra, India. sucheta.ibba@gmail.com.
authors.forename: Sucheta
authors.initials: S
authors.lastname: Deshpande
authors.affiliation: , No 11 Avatar Apartments, 27 Balakrishnan Road, Valmikingar, Thiruvanmiyur, Chennai, 600041, India. yadavdiwakar7@gmail.com.
authors.forename: Diwakar
authors.initials: D
authors.lastname: Yadav
authors.affiliation: FHI 360 India, New Delhi, India.
authors.forename: Shrabanti
authors.initials: S
authors.lastname: Sen
authors.affiliation: FHI 360 India, New Delhi, India. bgeorge@fhi360.org.
authors.forename: Bitra
authors.initials: B
authors.lastname: George
authors.affiliation: National AIDS Research Institute, Pune, Maharashtra, India. rparanjape@nariindia.org.
authors.forename: Ramesh
authors.initials: R
authors.lastname: Paranjape
mesh_terms: D000328:Adult; D001727:Bisexuality; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission*; D018451:Homosexuality, Male; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012309:Risk-Taking; D012725:Sexual Behavior; D012747:Sexual Partners; D000072339:Sexual and Gender Minorities; D047568:Unsafe Sex; D055815:Young Adult
keywords: Bisexual behavior; Bisexual concurrency; Condom use; HIV; India; Men who have sex with men; Men who have sex with men and women