title: Friends, Sisters, and Wives: Social Support and Social Risks in Peer Relationships Among Men Who Have Sex With Men (MSM) in India.
abstract: Globally, men who have sex with men (MSM) are at high risk for HIV. Many HIV-prevention efforts rely on community outreach and mobilization to engage MSM. This study examines peer relationships and their potential role in HIV prevention through 31 focus group discussions (FGDS) and 121 in-depth interviews (IDIs) with 363 MSM across 15 sites in India. Results indicate that MSM receive social support in friendships, sex-worker collaborations, constructed kin relationships, and romantic partnerships. Access to these relationships, however, is uneven across MSM, and can carry risks of disclosure of same-sex behavior and exclusion based on HIV- positive status. Positive peer relationships can serve as the basis of community empowerment, education, and couple-based interventions for MSM, and peer counselors can also provide a buffer against the social risks of peer relationships and facilitate linkage to care and continued engagement in treatment. These insights can improve HIV interventions for MSM in India and elsewhere.
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, Maryland.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Tomori
authors.affiliation: YR Gaitonde Centre for AIDS Research and Education, Chennai, India.
authors.forename: Aylur K
authors.initials: AK
authors.lastname: Srikrishnan
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Department of International Health.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Ridgeway
authors.affiliation: Johns Hopkins School of Medicine, Department of Medicine, Baltimore, Maryland.
authors.forename: Sunil S
authors.initials: SS
authors.lastname: Solomon
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, Maryland.
authors.forename: Shruti H
authors.initials: SH
authors.lastname: Mehta
authors.affiliation: YR Gaitonde Centre for AIDS Research and Education, Chennai, India.
authors.forename: Suniti
authors.initials: S
authors.lastname: Solomon
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, Maryland.
authors.forename: David D
authors.initials: DD
authors.lastname: Celentano
mesh_terms: D000328:Adult; D005260:Female; D017144:Focus Groups; D033062:Friends; D015658:HIV Infections / Q000517:prevention & control*; D006296:Health Services; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D007194:India; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D040242:Risk Reduction Behavior; D012309:Risk-Taking; D012725:Sexual Behavior; D035781:Siblings; D012944:Social Support; D018454:Spouses