sexual behaviour and hiv risk in men who - Karnataka Health ...

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per month when commercial sex is taking place is much higher in the ICVI group. Similarlythere was no difference between the two groups in terms of the proportion of the last tenclients who were new or occasional clients. There was a significant difference though in thereported number of repeat clients. In the ICVI, 95% of respondents said they had repeatclients, compared to 76% of the FTFI respondents (p=0.021) (Table 26). Similarly, moreICVI respondents reported ever having had a non commercial partner than did the FTFIrespondents (93% vs. 53%, p= 0.000). The number of such partners per respondent did notdiffer though the number of such partners in total is likely much higher in the ICVI sample,given the number reporting ever having had one or more non commercial partners (Table 27).Figure 3: Differences between ICVI and FTFI responses to sensitive questionsBeen forced to have sex inlast yearHad sex with female/s (notspouse)Had paid sex with female inlast yearEver injected drugsDoes not use condoms all thetimeEver sold sexHas repeat clientsHas NC partner/s0 10 20 30 40 50 60 70 80 90 100ICVIFTFI- 17 -
DISCUSSIONStudy limitationsA key limitation of this study was the cross-sectional survey design which provides asnapshot of MSM behaviours at a single time-point, but does not enable a comparison ofbehaviours over time. Unfortunately the IBBA study was conducted eight months later, inJuly 2008, during which time intensive project interventions were underway, makingcomparisons difficult. Without a control comparison group, it is always possible that thefindings presented here could have occurred by chance, independently of the interventionprogramme. The lack of biological data means that it is not possible to examine associationsbetween reported behaviours - which can be subject to reporting bias – and HIV / STI rates.The use of Ashodaya community members to conduct the interviews in this study couldpossibly be an additional study limitation. Thus, although it is possible that MSM may feelmore able to disclose information around sensitive issues with someone with whom they feelcan empathise with their lives and choices, it is likely that the fear of disclosing sensitive orsocially undesirable information to known members of the community who are in a positionof relative power may have impacted on the quality of the data collected. However, theinclusion of the ICVI survey technique, designed to help minimise reporting bias, helps toqualify the FTFI data presented here. Finally, although sampling was random and thus wethink, representative of the MSM population in Mysore, the small sample size means that isdifficult to draw firm conclusions about the community as a whole.Who, when and where?This study revealed that the MSM community in Mysore was quite heterogeneous in 2007.Although most respondents were long residents of Mysore or the surrounding area, therewere wide differences in age, education levels, marital status, and occupation, and Muslimswere over-represented. Many of the respondents had engaged in MSM sex for a long time,with a mean of over 12 years. Commercial sex between the respondents usually most oftentakes place in lodges or rented rooms, after pick-up in public places, whereas sex betweenNC partners more often took place at home, possibly between neighbours and friends. Stillmuch of the MSM sex seemed to take place in public places where sex is likely more risky ascondom use is more difficult; much of this sex however, is more likely to be thigh sex andmasturbation.Under-reporting of sex with womenOnly 1% of the respondents in the FTFI reported having sex with women (other than wives),though in the ICVI survey, 8% admitted this. Similarly none of the FTFI respondentsreported sex with female sex workers in the previous year compared with 12% of the ICVIsample, suggesting some under-reporting of what they might consider inexplicable MSMbehaviour. Under-reporting of behaviours that involve women might occur especially whenthe survey interviewers are themselves MSM. Married men all reported having (quitefrequent) sex with their wives as well as with men; very few of the wives knew of the natureof their husband‟s infidelities. Very few respondents reported using condoms with theirwives, despite an HIV rate of 23% in Mysore.- 18 -
Page 3 and 4: TABLE OF CONTENTSACKNOWLEDGMENTSLIS
Page 5 and 6: LIST OF ACRONYMSAIDSCHAFSWFTFIGPSHI
Page 7 and 8: NGO intervention with at-risk popul
Page 9 and 10: METHODSStudy design and sampling fr
Page 11 and 12: Figure 1: ICVI interview method1Exa
Page 13 and 14: Sexual behaviour characteristicsVer
Page 15 and 16: practised (Table 16). Sex with new
Page 17: said they drink with the male partn
Page 21 and 22: Other risk behaviours existAlcohol
Page 23 and 24: TABLESTable 1: Socio-demographic ch
Page 25 and 26: Table 3: Duration of MSM sex Mysore
Page 27: Table 5: Characteristics of sex in
Page 30 and 31: Table 8: Information of wife/female
Page 32 and 33: Table 10: Some characteristics of m
Page 34 and 35: Table 12:Information about known no
Page 36 and 37: Table 13:Information about unknown
Page 38 and 39: Table 15: Place of solicitation and
Page 40 and 41: Number of times condom is used out
Page 42 and 43: Among men who used condom with the
Page 44 and 45: Table 19:Information about buying s
Page 46 and 47: Table 21: Information on other beha
Page 48 and 49: Table 23: Programme exposureCharact
Page 50 and 51: Table 25: Comparison of selected be
Page 52 and 53: Table 27: Comparison of sexual beha
Page 54: APPENDIX 2: ICVI TOOL- 53 -

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