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Alcohol Use and Sex Risk Behaviors Among HIV-Infected Female Sex Workers (FSWs) and HIV-Infected Male Clients of FSWs in India

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Abstract

Unprotected heterosexual transactional sex plays a central role in the spread of HIV in India. Given alcohol’s association with risky sex in other populations and alcohol’s role in HIV disease progression, we investigated patterns of alcohol use in HIV-infected female sex workers (FSWs) and HIV-infected male clients of FSWs in Mumbai. Analyses identified factors associated with heavy alcohol use and evaluated the relationship between alcohol use and risky sex. We surveyed 211 female and 205 male individuals; 80/211 FSWs (38%) and 127/205 male clients (62%) drank alcohol in the last 30 days. Among females, 32 and 11% drank heavily and were alcohol-dependent, respectively; among males the respective proportions were 44 and 29%. Men’s heavy alcohol use was significantly associated with inconsistent condom use over the last year (AOR 2.40, 95% CI 1.21–4.77, P = 0.01); a comparable association was not seen in women. These findings suggest a need to address alcohol use both to avoid the medical complications of its heavy use in this population and to mitigate inconsistent condom use, the latter issue possibly requiring gender specific approaches. Such efforts to reduce drinking will be an important dimension to secondary HIV prevention in India.

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Acknowledgments

Funded by the National Institute on Alcohol Abuse and Alcoholism (R01AA016059-S1 and K24AA015674) and the Indian Council of Medical Research. We would like to thank Ms. Shabana Patel from the Network in Maharashtra by People Living with HIV (NMP+) for her oversight of study implementation in terms of helping ensure safe, confidential, and respectful treatment of our HIV-infected participants. We would like to thank the members of our partnering community based organizations in Mumbai for their assistance in implementing this study in the field, including the recruitment sites––ASHA, District Level Network registry, Drop-in HIV Center at the King Edward Memorial Hospital. From the NPM+ in Mumbai, this includes Ms. Bharti Sonawane, Ms. Aruna Bhere, Ms. Sunita, Mr. Anil Dalvi, and Mr. Hement Pawar. From ASHA Mahila Sanshta, this includes Ms. Mailee Tamang, Ms. Rupa, and Mr. Santosh Patankar. We thank Ms. Victoria Churchill and Mr. Joseph Novotny for their assistance with manuscript preparation. Finally, we are immensely grateful to the participants of this study who have, without hesitation, given their time and narrated their experiences and views regarding alcohol use and sexual behaviors.

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Authors and Affiliations

  1. Department of Medicine, Section of General Internal Medicine, Clinical Addiction Research and Education (CARE) Unit, Boston University School of Medicine/Boston Medical Center, 801 Massachusetts Ave., 2nd Floor, Boston, MA, 02118, USA

    Jeffrey H. Samet, Debbie M. Cheng, Carly Bridden & Anita Raj

  2. Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA

    Jeffrey H. Samet & Anita Raj

  3. Internal Medicine Residency Program, Brigham and Women’s Hospital, Boston, MA, USA

    Christine A. Pace

  4. Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA

    Debbie M. Cheng

  5. Data Coordinating Center, Boston University School of Public Health, Boston, MA, USA

    Sharon Coleman

  6. Network of Maharashtra by People Living with HIV & AIDS (NMP+), Pune, India

    Manoj Pardesi

  7. Population Council, New Delhi, India

    Niranjan Saggurti

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  1. Jeffrey H. Samet
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Correspondence to Jeffrey H. Samet.

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Samet, J.H., Pace, C.A., Cheng, D.M. et al. Alcohol Use and Sex Risk Behaviors Among HIV-Infected Female Sex Workers (FSWs) and HIV-Infected Male Clients of FSWs in India. AIDS Behav 14 (Suppl 1), 74–83 (2010). https://doi.org/10.1007/s10461-010-9723-y

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  • DOI: https://doi.org/10.1007/s10461-010-9723-y

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