Abstract
ObjectivesThere is a lack of information on sexual violence (SV) among men who have sex with men and transgendered individuals (MSM-T) in southern India. As SV has been associated with HIV vulnerability, this study examined health related behaviours and practices associated with SV among MSM-T.DesignData were from cross-sectional surveys from four districts in Karnataka, India.MethodsMultivariable logistic regression models were constructed to examine factors related to SV. Multivariable negative binomial regression models examined the association between physician visits and SV.ResultsA total of 543 MSM-T were included in the study. Prevalence of SV was 18% in the past year. HIV prevalence among those reporting SV was 20%, compared to 12% among those not reporting SV (p = .104). In multivariable models, and among sex workers, those reporting SV were more likely to report anal sex with 5+ casual sex partners in the past week (AOR: 4.1; 95%CI: 1.2–14.3, p = .029). Increased physician visits among those reporting SV was reported only for those involved in sex work (ARR: 1.7; 95%CI: 1.1–2.7, p = .012).ConclusionsThese results demonstrate high levels of SV among MSM-T populations, highlighting the importance of integrating interventions to reduce violence as part of HIV prevention programs and health services.
Highlights
Sexual violence has been recognized as a human rights priority, with significant implications for public health policy [1]
Added to the ever-present stigma and discrimination against MSM-T, some MSM-T in India engage in commercial sex work [8,10], raising the potential for these particular MSM-T to be at especially high risk, given the known vulnerabilities associated with sex work [14,15,16]
Because of the high levels of marginalization and stigmatization of MSM-T populations in India, verbal consent was obtained for all respondents in lieu of written consent, as MSM-T are reluctant to sign their names to documents
Summary
Sexual violence has been recognized as a human rights priority, with significant implications for public health policy [1]. MSM-T identity is highly nuanced and diverse in India [10,11,12], to varying degrees, stigma and discrimination have contributed to social and structural vulnerability [8]. It was not until 2009 that ‘homosexual intercourse’ was decriminalised in a Delhi court [6,13], overturning a discriminatory law that had been part of the Indian Penal Code since 1860 [6,7]. Added to the ever-present stigma and discrimination against MSM-T, some MSM-T in India engage in commercial sex work [8,10], raising the potential for these particular MSM-T to be at especially high risk, given the known vulnerabilities associated with sex work [14,15,16]
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