Sexual Behaviors and Partner-Specific Correlates of Heterosexual Anal Intercourse Among Truck Drivers and Their Wives in South India
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It is important to know about patterns of sexual behaviors among married couples in order to develop effective HIV prevention strategies for them. Herein we describe the sexual behaviors, estimate prevalence of anal intercourse (AI) among truck drivers (“truckers”) and their wives, and determine partner-specific demographic and behavioral correlates of AI. We carried out a cluster-sampled cross-sectional survey among 18–49 year-old wives and their trucker husbands in a south Indian district. Data were collected by same-gender research team members with color-coded computer-assisted interviews. We used random intercept logistic regression to identify the independent correlates of AI. Thirteen percent of 475 wives and 467 truckers reported ever having AI with their spouse. Of those who responded, 55 % of 40 wives and 47 % of 36 truckers never used condoms during AI. Of those who responded, 22 of 32 wives and 24 of 32 husbands felt that condoms were unnecessary during AI. Reporting ever having AI was associated with younger age and higher education of both husband and wife. AI reported by wives was associated with having sexual partner(s) other than husband (adjusted OR 8.8 [95 % CI 3.2–24.0]), correctly answering all HIV knowledge items (adjusted OR 4.9 [95 % CI 1.9–12.5]), husband’s sexual debut occurring before marriage (adjusted OR 1.9 [95 % CI 1.0–3.5]), and husband’s high HIV risk perception (adjusted OR 2.5 [95 % CI 1.2–5.4]). AI reported by truckers was associated with having sex with a male or transgender (adjusted OR 4.0 [95 % CI 1.2–13.3]). Reported prevalence of AI was high considering that in India anal sex is non-normative, heavily stigmatized and, criminal. Indian heterosexual mobile populations need to be informed about the greater risk of HIV infection consequent to unprotected AI.
KeywordsSexual behavior Heterosexual anal intercourse Truck drivers Wives South India
This work was supported by UCLA/Fogarty AIDS International Training & Research Program, Grant number D43 TW000013.
- Afifi, A., Clark, V., & May, S. (2004). Regression analysis with multicollinearity (4th ed.). Boca Raton, FL: Chapman & Hall/CRC.Google Scholar
- Bhatnagar, T., Brown, J., Saravanamurthy, P. S., Kumar, R. M., & Detels, R. (2013). Color-coded audio computer-assisted self-interviews (C-ACASI) for poorly educated men and women in a semi-rural area of south India: “Good, scary and thrilling”. AIDS and Behavior, 17, 2260–2268.PubMedCentralCrossRefPubMedGoogle Scholar
- Henrica, A. F. M., & Watts, C. (2003). WHO multi-country study on women’s health and life experiences: Core questionnaire, Version 10. Geneva, Switzerland: Department of Gender, Women and Health, Family and Community Health, World Health Organization.Google Scholar
- Herget, G. (2006). India: UNAIDS claims law criminalizing homosexuality hinders HIV prevention. HIV AIDS Policy and Law Review, 11, 35–36.Google Scholar
- Javanbakht, M., Guerry, S., Gorbach, P. M., Stirland, A., Chien, M., Anton, P., et al. (2010). Prevalence and correlates of heterosexual anal intercourse among clients attending public sexually transmitted disease clinics in Los Angeles County. Sexually Transmitted Diseases, 37, 369–376.CrossRefPubMedGoogle Scholar
- Judgement on IPC Section 377. (2009). Retrieved from http://www.nazindia.org/judgement_377.pdf.
- Manhart, L. E., Aral, S. O., Holmes, K. K., Critchlow, C. W., Hughes, J. P., Whittington, W. L., et al. (2004). Influence of study population on the identification of risk factors for sexually transmitted diseases using a case–control design: The example of gonorrhea. American Journal of Epidemiology, 160, 393–402.CrossRefPubMedGoogle Scholar
- Mukhopadadhyay, S., Nandi, R., Nundy, M., & Sivaramayya, J. (2000). Gender dimensions of HIV/AIDS: A community based study in Delhi. New Delhi, India: Institute of Social Studies-Trust.Google Scholar
- Nag, M. (1995). Sexual behaviour in India with risk of HIV/AIDS transmission. Health Transition Review, 5, 293–305.Google Scholar
- Rabe-Hesketh, S., & Skrondal, A. (2008). Multilevel and longitudinal modeling using Stata (2nd ed.). College Station, TX: Stata Press.Google Scholar
- Raizada, A., Gupta, S. B., & Kumar, A. (2002). Sexual practices other than peno-vaginal sex: Perceptions and practices in an urban community. Indian Journal of Community Medicine, 27, 177–180.Google Scholar
- Rodrigues, J. J., Mehendale, S. M., Shepherd, M. E., Divekar, A. D., Gangakhedkar, R. R., Quinn, T. C., et al. (1995). Risk factors for HIV infection in people attending clinics for sexually transmitted diseases in India. British Medical Journal, 311, 283–286.PubMedCentralCrossRefPubMedGoogle Scholar
- Savara, M., & Sridhar, C. R. (1992). Sexual behaviour of urban educated Indian men: Results of a survey. Journal of Family Welfare, 38, 30–43.Google Scholar
- Singh, S. K., Mondal, S., & Sharma, N. (2009). Sexual behaviour and practices: A study of male clients of female sex workers in Mumbai. Journal of Family Welfare, 55, 39–53.Google Scholar
- Skurnick, J. H., Kennedy, C. A., Perez, G., Abrams, J., Vermund, S. H., Denny, T., et al. (1998). Behavioral and demographic risk factors for transmission of human immunodeficiency virus type 1 in heterosexual couples: Report from the Heterosexual HIV Transmission Study. Clinical Infectious Diseases, 26, 855–864.CrossRefPubMedGoogle Scholar
- Solomon, S. S., Mehta, S. H., Latimore, A., Srikrishnan, A. K., & Celentano, D. D. (2010). The impact of HIV and high-risk behaviours on the wives of married men who have sex with men and injection drug users: Implications for HIV prevention. Journal of the International AIDS Society, 13, S7.PubMedCentralCrossRefPubMedGoogle Scholar
- van de Laar, M. J., Termorshuizen, F., Slomka, M. J., van Doornum, G. J. J., Ossewaarde, J. M., Brown, D. W., et al. (1998). Prevalence and correlates of herpes simplex virus type 2 infection: Evaluation of behavioural risk factors. International Journal of Epidemiology, 27, 127–134.CrossRefPubMedGoogle Scholar
- Verma, R. K., & Mahendra, V. S. (2004). Construction of masculinity in India: A gender and sexual health perspective. Journal of Family Welfare, 50, 71–78.Google Scholar