title: Burden and Correlates of HIV among Men Who Have Sex with Men in West Bengal, India: Analysis of Sentinel Surveillance Data.
abstract: BACKGROUND
  Little is known about the socio-behavioral risk factors for HIV acquisition among hard-to-reach men who have sex with men (MSM) population in India, particularly from the densely populated eastern part. Thus to measure the burden and correlates of HIV among MSM in West Bengal state of eastern India, a cross-sectional analysis of the national HIV Sentinel Surveillance (HSS) data was conducted.
  
  
  METHODS
  In 2011, between July and September, involving all sentinel sites of the state, 1237 consenting MSM were anonymously interviewed and tested for HIV following national guidelines. Using a short, structured questionnaire, information was collected on socio-behavioral factors along with sexual practices and was analyzed to determine burden of HIV and the role of its socio-behavioral correlates on HIV acquisition.
  
  
  RESULTS
  Among participants, mean age was 23.4 years, 44.55% were "Kothis" (usually receptive partner) and 25.1% admitted receiving money for sex with man. HIV sero-positivity was 5.09%. Using logistic regression method, for both bivariate and multivariate (with saturated model) analyses, transport-workers [adjusted odds ratio (AOR)=8.95, 95% confidence interval (95%CI): 1.09-73.71), large business-owners/self-employed (AOR=8.46, 95%CI: 1.25-57.49), small business-owners/cultivators (AOR=7.90, 95%CI: 1.67-37.38), those who visited the sentinel site for official purposes (AOR=7.60, 95%CI: 1.21-47.83) and paying money for having sex with men (AOR=3.03, 95%CI: 1.10-8.33) were strongly associated with higher HIV sero-positivity with than their counterparts. Using the parsimonious model for multivariate analysis, Kothis (AOR=4.64, 95%CI: 1.03-20.89), paying (AOR=2.96, 95%CI: 1.15-7.58) or receiving (AOR=2.06, 95%CI: 1.06-3.99) money for having sex with a man were associated with higher risk of HIV.
  
  
  CONCLUSIONS
  Focused intervention targeting the high risk MSM subgroups including Kothis, transport-workers, business-owners/self-employed and those who exchanged money for having sex with men, seemed to be the need of the hour for preventing the spread of HIV infection within and from this understudied population.
authors.affiliation: National Institute of Cholera and Enteric Diseases, P-33, Scheme-XM, Beliaghata, Kolkata, West Bengal, India.
authors.forename: Tanmay
authors.initials: T
authors.lastname: Mahapatra
authors.affiliation: National Institute of Cholera and Enteric Diseases, P-33, Scheme-XM, Beliaghata, Kolkata, West Bengal, India.
authors.forename: Subrata
authors.initials: S
authors.lastname: Biswas
authors.affiliation: National Institute of Cholera and Enteric Diseases, P-33, Scheme-XM, Beliaghata, Kolkata, West Bengal, India.
authors.forename: Srijita
authors.initials: S
authors.lastname: Nandi
authors.affiliation: National Institute of Cholera and Enteric Diseases, P-33, Scheme-XM, Beliaghata, Kolkata, West Bengal, India.
authors.forename: Piyali
authors.initials: P
authors.lastname: Ghosh
authors.affiliation: National Institute of Cholera and Enteric Diseases, P-33, Scheme-XM, Beliaghata, Kolkata, West Bengal, India.
authors.forename: Mallika
authors.initials: M
authors.lastname: Ghosh
authors.affiliation: Monitoring and Evaluation Division, West Bengal AIDS Prevention and Control Society, Salt Lake, Kolkata, West Bengal, India.
authors.forename: Soumya
authors.initials: S
authors.lastname: Mondal
authors.affiliation: National Institute of Cholera and Enteric Diseases, P-33, Scheme-XM, Beliaghata, Kolkata, West Bengal, India.
authors.forename: Malay K
authors.initials: MK
authors.lastname: Saha
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission; D006679:HIV Seropositivity; D018451:Homosexuality, Male; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011159:Population Surveillance; D012307:Risk Factors; D012725:Sexual Behavior; D012747:Sexual Partners; D012959:Socioeconomic Factors; D055815:Young Adult