Psychosocial risk factors for HIV sexual risk among Indian men who have sex with men

Abstract

Indian men who have sex with men (MSM) are at increased risk for HIV compared to the general Indian population. Psychosocial factors may be uniquely associated with HIV risk among Indian MSM and may moderate the beneficial impact of standard HIV prevention approaches. Psychiatric diagnostic interviews and psychosocial and sexual risk assessments were conducted among 150 MSM in Mumbai, India. Logistic regression was employed to examine the association of psychiatric disorders and psychosocial problems to recent sexual risk behavior. Twenty-five percent of participants reported engaging in unprotected anal sex (UAS) during their last sexual contact with a man. Men who were married to a woman were more likely to have engaged in UAS during their last sexual contact with a man (35% vs. 17%, p=0.018). In multivariable models, significant predictors of engaging in UAS were current major depression (adjusted odds ratio [AOR]=2.61; 95% confidence interval [CI] 1.07, 6.39) and number of stressful life events (AOR=0.91; 95% CI 0.83, 0.99). Alcohol dependence, anxiety, and self-esteem were not associated with engaging in UAS. Indian MSM with depression are at higher odds of engaging in UAS compared to MSM without depression. HIV prevention programs for Indian MSM may benefit from incorporating treatment or triage for mental health problems.

Keywords:

• men who have sex with men (MSM)
• Mumbai
• India
• mental health
• depression
• minority stress
• HIV

Acknowledgments

This project was supported by an internal grant from the Fenway Institute at Fenway Health for data collection and project costs. Investigator effort was partially supported by the National Institute on Drug Abuse of the National Institutes of Health under grant number 1R21DA0.33.720-01 (PI: Mimiaga) and the National Institute of Mental Health of the National Institutes of Health under grant K24 MH0.94.214 (PI: Safren). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Drug Abuse, the National Institute of Mental Health or the National Institutes of Health.