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Correlates of HIV Testing Uptake among Kothi-Identified Men who have Sex with Men in Public Sex Environments in Chennai, India

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Abstract

Kothi-identified men who have sex with men in India are highly marginalized and are at high-risk for HIV. This study examines HIV testing among 132 self-reported HIV-negative and unknown serostatus kothis recruited from public sex environments in Chennai, India. Using logistic regression we identified variables associated with HIV testing uptake (i.e., being tested and knowing the result). Sixty-one percent reported HIV testing uptake. At the bivariate level, married men, those with low HIV transmission knowledge, those who engaged in unprotected anal sex and unprotected receptive anal sex were at lower odds of reporting testing uptake. In multivariate analysis, married men and those with low levels of HIV transmission knowledge were at decreased odds of being tested, as were kothis who experienced forced sex. Culturally competent programs engaging married kothis are needed. Interventions to facilitate HIV prevention education and systemic interventions to combat sexual violence may facilitate HIV testing uptake among kothis.

Resumen

En India, hombres Kothi que tienen sexo con hombres son altamente marginalizados y tienen un mayor riesgo de contraer VIH. Este estudio examina la toma de pruebas de VIH entre 132 Kothis que auto reportaron ser VIH-negativo y que no tienen conocimiento de ser seropostitivo. Los participantes fueron reclutados de áreas donde hay actividades sexuales en lugares públicos en Chennai, India. Utilizando regresión logística se identificaron variables asociadas con la toma de prueba VIH (i.e., hacerse el examen y recibir los resultados). Sesenta y uno por ciento indicó haberse hecho exámenes de VIH. Al nivel de los análisis bivariados, los hombres casados; aquellos con bajo conocimiento sobre la transmisión de VIH; aquellos que tienen sexo anal sin protección; y aquellos que reciben sexo anal sin protección tuvieron menores cuotas de tomarse pruebas de HIV. Los análisis multivariados indicaron que las cuotas de hacerse los exámenes de VIH son más bajos entre hombres casados y entre los que tienen poco conocimiento sobre la transmisión de VIH, y entre los Kothis que han sido forzados a tener sexo. Programas que sean competentes culturalmente y que incorporen Kothis casados son necesarios. Intervenciones que faciliten la educación sobre VIH e intervenciones sistémicas que combaten la violencia sexual podrían ayudar que más Kothis se hagan exámenes de VIH.

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Acknowledgments

This study was supported, in part, by the Canada Research Chairs Program and the Social Sciences and Humanities Research Council of Canada. The authors gratefully acknowledge the support of Sekar Balasubramaniam, Director, Social Welfare Association for Men (SWAM), and Sunil Menon, Director, Sahodaran, as well as each agency’s project staff and volunteers. We also thank all participants for sharing their experiences. Gratitude to Drs. D. Bybee and P. Silverschanz, University of Michigan, for assisting with data analysis, and Dr. B. Perron, University of Michigan, for feedback on sections of the manuscript.

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Authors and Affiliations

  1. School of Social Work, University of Michigan, 1080 S. University Ave., Rm. 2736, Ann Arbor, MI, 48109-1106, USA

    Michael R. Woodford

  2. Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada

    Peter A. Newman

  3. Indian Network of People Living with HIV/AIDS, Chennai, Tamil Nadu, India

    Venkatesan Chakrapani & Murali Shunmugam

  4. Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada

    Lisa Kakinami

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  1. Michael R. Woodford
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  2. Peter A. Newman
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  3. Venkatesan Chakrapani
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  4. Murali Shunmugam
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  5. Lisa Kakinami
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Correspondence to Michael R. Woodford.

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Woodford, M.R., Newman, P.A., Chakrapani, V. et al. Correlates of HIV Testing Uptake among Kothi-Identified Men who have Sex with Men in Public Sex Environments in Chennai, India. AIDS Behav 16, 53–62 (2012). https://doi.org/10.1007/s10461-011-9974-2

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