Risk Behaviors of Homeless Men in India: A Potential Bridge Population for HIV Infection
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This study investigated whether homeless men are a bridge group for transmission of HIV to the general population in India. A cross-sectional study design was used to measure subjects’ past and current sexual activities. We surveyed 493 of 606 homeless men aged 18–49 years who live in public places in Kolkata, India, who were invited to take part in a structured interview, using a CD player and earphones. Almost two-thirds of respondents had never attended school. Sex with commercial sex worker (CSWs), multiple sex partners, and inconsistent condom use were common. About 90% of married homeless men visited CSWs, but only 3.3% consistently used condoms. AIDS awareness and risk perception were very low. Less education and being married but not currently living with wife were associated with high-risk sexual behaviors. Homeless men should be considered a potential bridge for HIV transmission from CSWs to the general population. Appropriate non-written communication strategies targeted to homeless people are urgently needed. Community intervention programs targeting the homeless, such as the ‘Popular Opinion Leader’ model, should be designed and evaluated.
KeywordsHomeless Risk group Sexual behavior HIV/AIDS STDs Condom use India
We thank Wendy Aft for editorial assistance. We also thank Mitun Bose for assistance throughout the entire research. The views expressed in this article are solely those of the authors and do not necessarily reflect official views of the Government of West Bengal, India. This work was supported by NIH Fogarty International Center grant D43 TW000013.
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