Patterns of condom use by men who have sex with men before and after the Avahan intervention in Andhra Pradesh state of India

G Anil Kumar,Lalit Dandona,Ramesh Poluru,Michel Alary,Rakhi Dandona,S Anil Chandran

doi:10.1186/1471-2458-14-64

Abstract

BackgroundTwo rounds of integrated biological and behavioural assessment (IBBA) surveys were done among men who have sex with men (MSM) in Andhra Pradesh during 2006 and 2009. Avahan, the India AIDS initiative, funded by the Bill and Melinda Gates Foundation implemented HIV prevention interventions among MSM starting around the time of the first round of IBBA.MethodsData on socio-demographic, sex behaviour characteristics and HIV status of MSM from the two IBBA rounds were used. Changes in the rates of consistent condom use over the past one month by MSM with various types of partners between the two rounds were assessed. Multivariate analysis was performed to assess associations between various factors and inconsistent condom use for sex with regular partners as well as HIV in MSM.ResultsA significant increase in consistent condom use by MSM was noted from 2006 to 2009 for paid male partners (19.5% to 93.8%), occasional male partners (13.2% to 86.2%), and paid female partners (25.9% to 94.2%). Consistent condom use with regular sex partners also increased but remained lower with regular male partner (75.8%) and very low with regular female partners (15.7%). MSM who used condoms inconsistently with their regular male partner were also more likely to use condoms inconsistently with their regular female partner. Multivariate analysis showed MSM who used condoms inconsistently with regular male partner had higher odds of HIV (odds ratio 1.8; 95% CI 1.2-2.7). MSM who received condoms from Avahan had the lowest odds (odds ratio 0.3; 95% CI 0.1-0.5) of inconsistent condom use with regular male partners.ConclusionsCondom use by MSM increased markedly after implementation of Avahan, though a causal association cannot be assessed with the available data. The relatively lower condom use with regular partners of MSM suggests that additional programme effort is needed to address this aspect specifically.

Highlights

Two rounds of integrated biological and behavioural assessment (IBBA) surveys were done among men who have sex with men (MSM) in Andhra Pradesh during 2006 and 2009
Condom use by MSM increased markedly after implementation of Avahan, though a causal association cannot be assessed with the available data
Consistent condom use with different sex partners The proportion of MSM who reported consistent condom use for each sex episode over the past one month with paid male partners improved considerably from 19.5% in IBBA round 1 to 93.8% in IBBA round 2, and a similar trend was seen for occasional male partners as well (Figure 1)

Summary

Introduction

Two rounds of integrated biological and behavioural assessment (IBBA) surveys were done among men who have sex with men (MSM) in Andhra Pradesh during 2006 and 2009. The India AIDS initiative, funded by the Bill and Melinda Gates Foundation implemented HIV prevention interventions among MSM starting around the time of the first round of IBBA. Various MSM programmes were started in India in the last decade to reduce HIV including in Andhra Pradesh which is one of the high HIV prevalence states in India [6,7]. Two rounds of integrated biological and behavioural assessment (IBBA) surveys were conducted among MSM in Andhra Pradesh in April-June 2006 and April-June 2009 to assess the effect of intervention programme [9]. The first IBBA round was within six months of start of the Avahan MSM programmes, and can be considered as baseline for this intervention

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Conclusion