185917 HIV Risk and Sexual Networks of Railway Workers in Southwest India

Tuesday, October 28, 2008: 1:15 PM

Eric R. Wright, PhD , Center for Health Policy, Department of Public Health, IU School of Medicine, Indiana University-Purdue University Indianapolis, Indianapolis, IN
Jacob John, MD , Department of Psychiatry, Christian Medical College, Tamil Nadu, India
Aruna Mullangi, MD , Railway women Empowerment and AIDS Prevention Society, Vijayawada, India
Harrish Jagganath, MA , Railway women Empowerment and AIDS Prevention Society, Vijayawada, India
Harold Kooreman, MA , IU Center for Health Policy, Indiana University-Purdue University Indianapolis, Indianapolis, IN
Background: With an estimated 2 to 3.1 million people living with HIV/AIDS in India, government and international leaders remain deeply concerned about the potential for dramatic growth in the epidemic. Studies conducted in India and elsewhere suggest that population mobility is an important factor in the spread of HIV, yet little research has examined risk behavior in or around the Indian Railway system. The current study explores the sexual networks of men working for the Indian Railways.

Methods: In-person surveys, which included a sexual network battery, were completed by 199 male employees. Workers were asked to describe the demographic characteristics of their five most recent sex partners as well as the types of sexual activities in which they engaged.

Results: Participants provided information on 532 partners. On average, sexually active men had 2.8 partners (SD = 2.3) in the past 12 months. Partners were typically female (92.1%). Wives were the most commonly reported partners (41.5%) followed by friends/coworkers/colleagues (14.8%) commercial sex workers (13.2%) and mistresses (10.9%). The most frequent sexual activities were vaginal (90.6%) and oral sex (56.5%). Participants related that many of their partners engaged in high HIV-risk behaviors including having multiple sexual partners (23.5%), participating in commercial sex work (14.3%), and being a man who has sex with men (4.7%). Nearly 62% of men reported never using condoms during sex.

Conclusions: Analysis of the sexual behavior of male railway workers in India shows this population is at high risk for contracting and spreading HIV throughout India.

Learning Objectives:
Identify the reasons that HIV is spreading throughout the railway community. Discuss how the Indian Railway serves as a conduit for HIV infection, especially for women. Recognize the need to provide culturally appropriate prevention services to the Indian community. Articulate the role women need to play in prevention efforts.

Keywords: HIV Risk Behavior, India

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Eric R. Wright is director of the Center for Health Policy, a partner with the Center for Urban Policy and the Environment. He is also a professor in the School of Public and Environmental Affairs and associate director of the Indiana Consortium for Mental Health Services Research. He also holds adjunct appointments in the Department of Public Health, the IU School of Medicine, and in the Department of Environments for Health, IU School of Nursing. As a medical sociologist, Dr. Wright’s research interests center on social responses to health problems, health policy, and the social organization and effectiveness of health services and public health programs. Currently, Dr. Wright is cochair of the Indiana University Healthcare Reform Faculty Study Group, a group commissioned by the state of Indiana to draft proposals for the redesign of the healthcare system in Indiana. Dr. Wright recently completed a research project funded by the National Institute of Mental Health that investigating the role mental health treatment programs play in shaping the HIV risk of people with serious mental illness. He is or has been the principal or co-principal investigator on several other major, funded research and evaluation projects, including the Indianapolis Network Mental Health Study, the Central State Hospital Discharge Study, and the Indiana Youth Access Project. He was also the principal investigator of a comprehensive evaluation of the Dawn Project, a system of care initiative in Indianapolis, and for a new mental health screening program being implemented for children in the child welfare system by the Indiana Department of Child Services. Dr. Wright has published two books on teaching and more than 50 evaluation reports and peer-reviewed papers that have appeared in sociology and interdisciplinary health journals, including the Journal of Health and Social Behavior, Social Networks, Sociological Focus, AIDS Care, Journal of Behavioral Health Services and Research, and Psychiatric Services.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: HIV and Asia: Emerging Issues
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