15th International AIDS Conference Bangkok, Thailand - July 11-16, 2004

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. ThOrC1369)

Hernandez A, Madhivanan P, Stein ES, Ekstrand ML, Paul S, Setia M, D'Souza B, Mathur M, Jerajani HR, Gogate A, Lindan CP
UCSF, San Francisco, United States

BACKGROUND: By the year 2002, India had an estimated 4.6 million people with HIV and the majority of these infections were due to sexual transmission. Gender of partner, however, is not specified. We evaluated men who had sex with women to determine the extent to which they also had sex with other men and hijras (male-female transgenders).

METHODS: Baseline data were collected on 1821 men from 2 public STI clinics in Mumbai screened for enrollment into a randomized, controlled trial of an HIV intervention. Men completed an interviewer-administered questionnaire, were evaluated for STIs, and received HIV testing and counseling.

RESULTS: Mean age was 28; 68% lived in slums; 69% were migrants; 70% were unmarried. HIV prevalence was 14%. All men had sex with women the past. 66% reported only having female partners (MSW); 23% also had male partners (MSM); 11% had had sex with hijras, but not men (MSH). 73% of MSH had >10 lifetime partners vs. 69% of MSM and 46% of MSW (p<0.01). 59% of MSH had >10 FSW partners vs. 53% and 41% of MSM and MSW, respectively (p<0.01). 29% of MSM reported having anal sex with an FSW compared to 27% of MSH and 7% of MSW (p<0.01). Unprotected sex was high with all partners, and did not differ by group. Among MSM, 25% were married. 30% of MSM had sex with another man in exchange for money or services. Almost all MSM (98%) had insertive anal sex and 13% had receptive sex.

CONCLUSIONS: Surveillance data from Mumbai indicate that 25% of men having primarily male-male sex and 60% of hijras are HIV infected. Men in our sample who have sex with women but who also have intercourse with other men and hijras act as bridge population from male and transgendered risk groups to women and spouses. Men need to be alerted of their increased risk of infection.

040711
ThOrC1369

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