Abstract
Men who have sex with men (MSM) in India have an HIV seroprevalence 22 times greater than the country's general population and face unique challenges that may hinder the effectiveness of current HIV prevention efforts. To obtain an understanding of the logistical and sociocultural barriers MSM experience while accessing HIV prevention services, focus groups and key informant interviews were conducted with 55 MSM in Chennai, India. Qualitative data were analyzed using descriptive qualitative content analysis. Sixty-five percent of participants identified as kothi (receptive partners), 9% as panthi (insertive partners), 22% as double decker (receptive and insertive), and 4% did not disclose. Themes included: (a) fatigue with current HIV risk reduction messages; (b) increased need for non-judgmental and confidential services; and (c) inclusion of content that acknowledges individual and structural-level determinants of risk such as low self-esteem, depression, and social discrimination. MSM interventions may benefit from approaches that address multilevel psychosocial factors, including skills building and strategies to foster self-acceptance and increased social support.
Highlights
IntroductionHIV infections among men who have sex with men (MSM) have been increasing in recent years, in Asia (van Griensven & de Lind van Wijngaarden, 2010)
Approaches that address multilevel psychosocial factors, including skills building and strategies to foster self-acceptance and increased social support
HIV infections among men who have sex with men (MSM) have been increasing in recent years, in Asia. This increase is consistent with the MSM HIV epidemic in India, with current HIV prevalence estimates among Indian MSM ranging between 7% and 16.5% (Baral, Sifakis, Cleghorn, & Beyrer, 2007; HIV Sentinel Surveillance, 2007; Setia et al, 2008)
Summary
HIV infections among men who have sex with men (MSM) have been increasing in recent years, in Asia (van Griensven & de Lind van Wijngaarden, 2010) This increase is consistent with the MSM HIV epidemic in India, with current HIV prevalence estimates among Indian MSM ranging between 7% and 16.5% (Baral, Sifakis, Cleghorn, & Beyrer, 2007; HIV Sentinel Surveillance, 2007; Setia et al, 2008). HIV prevention efforts in India have primarily focused on heterosexual transmission, among female sex workers and their male clients, with little acknowledgment of the contribution of male homosexual behavior to the epidemic (Dandona et al, 2006) It is only within the past 5 years that the Indian National AIDS Control Programme included MSM in its list of core high-risk groups (Targeted Interventions, 2008). The majority of COMMUNITY APPROACH TO PREVENTION IN CHENNAI, INDIA prevention interventions for MSM in India currently involve condom distribution, peer-based HIV education via individual or group-level participation, voluntary HIV counseling and testing, and treatment of sexually transmitted infections (STIs)
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