Skip to main content
Log in

Predictors of HIV Risk Among Men Seeking Treatment for Substance Abuse in India

  • Published:
Archives of Sexual Behavior Aims and scope Submit manuscript

Abstract

The purpose of this study was to investigate the prevalence and correlates of HIV risk among men receiving treatment for substance abuse in India. Consecutive inpatients from the major substance abuse hospital in southern India were screened using a structured interview and standardized measures to obtain demographic, psychiatric, sexual behavior, and substance use data at the time of admission. Seventy-seven percent of the 352 men who were screened reported that they were sexually active during the past year, and 13% reported that they had engaged in sexual practices associated with greater risk. The most common risk practices in the past year included having multiple sexual partners (7%), paying for sex (5%), and having unprotected anal sex (4%). Engaging in risky sexual practices was associated with the presence of a co-occurring psychiatric disorder and higher scores on a drug abuse screening measure. Assessing HIV risk in substance abuse settings can help to identify patients who may benefit from HIV-risk reduction programs.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

REFERENCES

  • Agarwal, A. K., Singh, G. B., Khundom, K. C., Singh, N. D., Singh, T., & Jana, S. (1999). The prevalence of HIV in female sex workers in Manipur, India. Journal of Communicable Diseases, 31, 23–28.

    Google Scholar 

  • Allen, J. P., Litten, R. Z., Fertig, J. B., & Babor, T. (1997). A review of research on the Alcohol Use Disorders Identification Test (AUDIT). Alcoholism: Clinical and Experimental Research, 21, 613–619.

    Google Scholar 

  • Avins, A. L., Lindan, C. P., Woods, W. J., Hudes, E. S., Boscarino, J. A., Kay, J., et al. (1997). Changes in HIV-related behaviors among heterosexual alcoholics following addiction treatment. Drug and Alcohol Dependence, 44, 47–55.

    Google Scholar 

  • Avins, A. L., Woods, W. J., Lindan, C. P., Hudes, E. S., Clark, W., & Hulley, S. B. (1994). HIV infection and risk behaviors among heterosexuals in alcohol treatment programs. JAMA, 271, 515–518.

    Google Scholar 

  • Bharadwaj, A., Biswas, R., & Shetty, K. J. (2001). HIV in Nepal: Is it rare or the tip of an iceberg? Tropical Doctor, 31, 211–213.

    Google Scholar 

  • Biswas, D., Hazarika, N. C., Hazarika, D., & Mahanta, J. (1999). Prevalence of communicable disease among restaurant workers along a highway in Assam, India. Southeast Asian Journal of Tropical Medicine and Public Health, 30, 539–541.

    Google Scholar 

  • Bohn, M. J., Babor, T. F., & Kranzler, H. R. (1995). The Alcohol Use Disorders Identification Test (AUDIT): Validation of a screening instrument for use in medical settings. Journal of Studies on Alcohol, 56, 423–432.

    Google Scholar 

  • Bryan, A. D., Fisher, J. D., & Benziger, T. J. (2001). Determinants of HIV risk among Indian truck drivers. Social Science and Medicine, 53, 1413–1426.

    Google Scholar 

  • Carey, K. B., Carey, M. P., & Chandra, P. S. (in press). Psychometric evaluation of the AUDIT and DAST with psychiatric patients in India. Journal of Clinical Psychiatry.

  • Carey, M. P., Carey, K. B., Maisto, S. A., Gleason, J. R., Gordon, C. M., & Brewer, K. K. (1999). HIV-risk behavior among outpatients at a state psychiatric hospital: Prevalence and risk modeling. Behavior Therapy, 30, 389–406.

    Google Scholar 

  • Carey, M. P., Carey, K. B., Maisto, S. A., Gordon, C. M., & Vanable, P. A. (2001). Prevalence and correlates of sexual activity and HIV-related risk behavior among psychiatric outpatients. Journal of Consulting and Clinical Psychology, 69, 500–505.

    Google Scholar 

  • Carey, M. P., Carey, K. B., Weinhardt, L. S., & Gordon, C. M. (1997). Behavioral risk for HIV infection among adults with a severe and persistent mental illness: Patterns and psychological antecedents. Community Mental Health Journal, 33, 133–142.

    Google Scholar 

  • Carey, M. P., Weinhardt, L. S., & Carey, K. B. (1995). Prevalence of infection with HIV among the seriously mentally ill: Review of research and implications for practice. Professional Psychology: Research and Practice, 26, 262–268.

    Google Scholar 

  • Castilla, J., Barrio, G., Belza, M. J., & de la Fuente, L. (1999). Drug and alcohol consumption and sexual risk behaviour among young adults: Results from a national survey. Drug and Alcohol Dependence, 56, 47–53.

    Google Scholar 

  • Centers for Disease Control and Prevention. (1998). Trends in sexual risk behaviors among high school students—United States, 1991–1997. Morbidity and Mortality Weekly Report, 47, 749–752.

    Google Scholar 

  • Channabasavanna, S. M., Ray, R., & Kaliaperumal, V. (1990). Patterns and problems of non-alcoholic drug dependence in Karnataka. Bangalore, India: Department of Health and Family Welfare, Government of Karnataka.

    Google Scholar 

  • Cocco, K. M., & Carey, K. B. (1998). Psychometric properties of the Drug Abuse Screening Test in psychiatric outpatients. Psychological Assessment, 10, 408–414.

    Google Scholar 

  • Cook, R. L., Pollock, N. K., Rao, A. K., & Clark, D. B. (2002). Increased prevalence of herpes simplex virus type 2 among adolescent women with alcohol use disorders. Journal of Adolescent Health, 30, 169–174.

    Google Scholar 

  • Cournos, F., Guido, J. R., Coomaraswamy, S., Meyer-Bahlburg, H., Sugden, R., & Horwath, E. (1994). Sexual activity and risk of HIV infection among patients with schizophrenia. American Journal of Psychiatry, 151, 228–232.

    Google Scholar 

  • Drake, R. E., Wallach, M. A., Teague, G. B., Freeman, D. H., Paskus, T. S., & Clark, T. A. (1991). Housing instability and homelessness among rural schizophrenic patients. American Journal of Psychiatry, 148, 330–336.

    Google Scholar 

  • Eberstadt, N. (2002). The future of AIDS. Foreign Affairs, 81(6), 22–45.

    Google Scholar 

  • Eicher, A. D., Crofts, N., Benjamin, S., Deutschmann, P., & Rodger, A. J. (2000). A certain fate: Spread of HIV among young injecting drug users in Manipur, north-east India. AIDS Care, 12, 497–504.

    Google Scholar 

  • Ericksen, K. P., & Trocki, K. F. (1994). Sex, alcohol and sexually transmitted diseases: A national survey. Family Planning Perspectives, 26, 257–263.

    Google Scholar 

  • Gerbert, B., Bronstone, A., McPhee, S., Pantilat, S., & Allerton, M. (1998). Development and testing of an HIV-risk screening instrument for use in health care settings. American Journal of Preventive Medicine, 15, 103–113.

    Google Scholar 

  • Hays, R. D., Merz, J. F., & Nicholas, R. (1995). Response burden, reliability, and validity of the CAGE, Short MAST, and AUDIT alcohol screening measures. Behavior Research Methods, Instruments, and Computers, 27, 277–280.

    Google Scholar 

  • Hosmer, D. W., & Lemeshow, S. (2000). Applied logistic regression. New York: Wiley.

    Google Scholar 

  • Kalichman, S. C., Carey, M. P., & Carey, K. B. (1996). Human immunodeficiency virus (HIV) risk among the seriously mentally ill. Clinical Psychology: Science and Practice, 3, 130–143.

    Google Scholar 

  • Kalichman, S. C., Heckman, T., & Kelly, J. A. (1996). Sensation seeking as an explanation for the association between substance use and HIV-related risky sexual behavior. Archives of Sexual Behavior, 25, 141–154.

    Google Scholar 

  • Kalichman, S. C., Kelly, J. A., Johnson, J. R., & Bulto, M. (1994). Factors associated with risk for HIV infection among chronic mentally ill adults. American Journal of Psychiatry, 151, 221–227.

    Google Scholar 

  • Kelly, J. A., McAuliffe, T. L., Sikkema, K. J., Murphy, D. A., Somlai, A. M., Mulry, G., et al. (1997). Reduction in risk behavior among adults with severe mental illness who learned to advocate for HIV prevention. Psychiatric Services, 48, 1283–1288.

    Google Scholar 

  • Kelly, J. A., Murphy, D. A., Sikkema, K. J., Mulry, G. W., Fernandez, M. I., Miller, J. G., et al. (1995). Predictors of high and low levels of HIV risk behavior among adults with chronic mental illness. Psychiatric Services, 46, 813–818.

    Google Scholar 

  • Kumar, B., & Gupta, S. (2000). Rising HIV prevalence in STD clinic attenders at Chandigarh (north India)—a relatively low prevalence area [Letter to the editor]. Sexually Transmitted Infections, 76, 59.

    Google Scholar 

  • Larrat, E. P., Zierler, S., & Mayer, K. (1994). Cocaine use and heterosexual exposure to human immunodeficiency virus. Epidemiology, 5, 398–403.

    Google Scholar 

  • Laumann, E. O., Gagnon, J. H., Michael, R. T., & Michaels, S. (1994). The social organization of sexuality: Sexual practices in the United States. Chicago: University of Chicago Press.

    Google Scholar 

  • Leigh, B. C. (2002). Alcohol and condom use: A meta-analysis of event-level studies. Sexually Transmitted Diseases, 29, 476–482.

    Google Scholar 

  • Maisto, S. A., Carey, M. P., Carey, K. B., Gordon, C. M., & Gleason, J. R. (2000). Use of the AUDIT and the DAST-10 to identify alcohol and drug use disorders among adults with a severe and persistent mental illness. Psychological Assessment, 12, 186–192.

    Google Scholar 

  • McCusker, J. J., Westenhouse, J., Stoddard, A. M., Zapka, J. G., Zorn, M. W., & Mayer, K. H. (1990). Use of drugs and alcohol by homosexually active men in relation to sexual practices. Journal of Acquired Immune Deficiency Syndromes, 7, 729–736.

    Google Scholar 

  • Mueser, K. T., Doonan, R., Penn, D. L., Blanchard, J. J., Bellack, A. S., Nishith, P., et al. (1996). Emotion recognition and social competence in chronic schizophrenia. Journal of Abnormal Psychology, 105, 271–275.

    Google Scholar 

  • Ramrakha, S., Caspi, A., Dickson, N., Moffitt, T. E., & Paul, C. (2000). Psychiatric disorders and risky sexual behaviour in young adulthood: Cross sectional study in birth cohort. BMJ, 321, 263–266.

    Google Scholar 

  • Rosenberg, S. D., Goodman, L. A., Osher, F. C., Swartz, M. S., Essock, S. M., Butterfield, M. I., et al. (2001). Prevalence of HIV, hepatitis B, and hepatitis C in people with severe mental illness. American Journal of Public Health, 91, 31–37.

    Google Scholar 

  • Saunders, J. B., Aasland, O. G., Babor, T. F., De La Fuente, J. R., & Grant, M. (1993). Development of the Alcohol Use Disorders Screening Test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption—II. Addiction, 88, 791–804.

    Google Scholar 

  • Scheidt, D. M., & Windle, M. (1996). Individual and situational markers of condom use and sex with nonprimary partners among alcoholic inpatients: Findings from the ATRISK study. Health Psychology, 15, 185–192.

    Google Scholar 

  • Shillington, A. M., Cottler, L. B., Compton, W. M., & Spitznagel, E. L. (1995). Is there a relationship between “heavy drinking” and HIV high risk sexual behaviors among general population subjects? International Journal of the Addictions, 30, 1453–1478.

    Google Scholar 

  • Skinner, H. A. (1979). A multivariate assessment of the MAST. Journal of Studies on Alcohol, 40, 831–844.

    Google Scholar 

  • Skinner, H. A. (1982a). The Drug Abuse Screening Test. Addictive Behaviors, 7, 363–371.

    Google Scholar 

  • Skinner, H. A. (1982b). The Drug Abuse Screening Test (DAST): Guidelines for administration and scoring. Toronto: Addiction Research Foundation.

    Google Scholar 

  • Suresh Kumar, M., & Ray, R. (2002). Rapid assessment survey of drug abuse in India. New Delhi, India: Ministry of Social Justice and Empowerment and United Nations International Drug Control Programme.

    Google Scholar 

  • Susser, E., Valencia, E., & Conover, S. (1993). Prevalence of HIV infection among psychiatric patients in a New York City men's shelter. American Journal of Public Health, 83, 568–570.

    Google Scholar 

  • Thappa, D. M., Singh, S., & Singh, A. (1999). HIV infection and sexually transmitted diseases in a referral STD centre in south India [Letter to the editor]. Sexually Transmitted Infections, 75, 191.

    Google Scholar 

  • UNAIDS/WHO Group on Global HIV/AIDS and STD Surveillance. (1997). Report on the global HIV/AIDS epidemic. Geneva: WHO.

    Google Scholar 

  • Weinhardt, L. S., & Carey, M. P. (2000). Does alcohol lead to sexual risk behavior? Findings from event-level research. Annual Review of Sex Research, 11, 125–157.

    Google Scholar 

  • Weinhardt, L. S., Carey, M. P., Carey, K. B., Maisto, S. A., & Gordon, C. M. (2001). The relation of alcohol use to HIV-risk sexual behavior among adults with a severe and persistent mental illness. Journal of Consulting and Clinical Psychology, 69, 77–84.

    Google Scholar 

  • Wenzel, S. L., Koegel, P., & Gelberg, L. (2000). Antecedents of physical and sexual victimization among homeless women: A comparison to homeless men. American Journal of Community Psychology, 28, 367–390.

    Google Scholar 

  • Woods, W. J., Lindan, C. P., Hudes, E. S., Boscarino, J. A., Clark, W. W., & Avins, A. L. (2000). HIV infection and risk behaviors in two cross-sectional surveys of heterosexuals in alcoholism treatment. Journal of Studies on Alcohol, 61, 262–266.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Michael P. Carey.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Carey, M.P., Chandra, P.S., Carey, K.B. et al. Predictors of HIV Risk Among Men Seeking Treatment for Substance Abuse in India. Arch Sex Behav 32, 339–349 (2003). https://doi.org/10.1023/A:1024043032111

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1024043032111

Navigation