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.
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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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Cocco, K. M., & Carey, K. B. (1998). Psychometric properties of the Drug Abuse Screening Test in psychiatric outpatients. Psychological Assessment, 10, 408–414.
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.
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.
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.
Eberstadt, N. (2002). The future of AIDS. Foreign Affairs, 81(6), 22–45.
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.
Ericksen, K. P., & Trocki, K. F. (1994). Sex, alcohol and sexually transmitted diseases: A national survey. Family Planning Perspectives, 26, 257–263.
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.
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.
Hosmer, D. W., & Lemeshow, S. (2000). Applied logistic regression. New York: Wiley.
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.
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.
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.
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.
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.
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.
Larrat, E. P., Zierler, S., & Mayer, K. (1994). Cocaine use and heterosexual exposure to human immunodeficiency virus. Epidemiology, 5, 398–403.
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.
Leigh, B. C. (2002). Alcohol and condom use: A meta-analysis of event-level studies. Sexually Transmitted Diseases, 29, 476–482.
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.
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.
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.
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.
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.
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.
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.
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.
Skinner, H. A. (1979). A multivariate assessment of the MAST. Journal of Studies on Alcohol, 40, 831–844.
Skinner, H. A. (1982a). The Drug Abuse Screening Test. Addictive Behaviors, 7, 363–371.
Skinner, H. A. (1982b). The Drug Abuse Screening Test (DAST): Guidelines for administration and scoring. Toronto: Addiction Research Foundation.
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.
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.
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.
UNAIDS/WHO Group on Global HIV/AIDS and STD Surveillance. (1997). Report on the global HIV/AIDS epidemic. Geneva: WHO.
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.
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.
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.
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.
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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
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DOI: https://doi.org/10.1023/A:1024043032111