205186 Influence of gender norms, sexual norms, and women's autonomy on couples' HIV risk in North India

Tuesday, November 10, 2009: 8:50 AM

Alpna Agrawal, MPH , Department of Maternal and Child Health and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
Shelah S. Bloom, ScD , Dept. of Maternal & Child Health, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
Chirayath M. Suchindran, PhD , Dept. of Biostatistics, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
Background: India ranks third in the world in the number of HIV/AIDS cases. Gender-based power factors are believed to contribute significantly to disease spread in the country, where few studies have examined this. Methods: The study uses population-based data from 2003 collected among 3,385 married couples living in North India. Outcomes examined were whether or not husbands reported extramarital or paid sex and reported STI symptoms. Three major predictors were tested: husbands' gender role norms; husband's sexual norms; and wives' autonomy, a scale widely used in the Demographic Health Surveys. Estimated models used structural equation modeling controlling for socio-demographic effects. Results: Husbands reporting sexual norms that are taboo in Indian society were more likely to engage in risky sex and report STI symptoms (p<.001). Husbands with dominant attitudes regarding women's roles were more likely to report risky sex (p<.01). Wives' autonomy was only associated with husbands' reported STI symptoms (p<.05). Conclusions: Men's attitudes, not only women's are important in evaluating the effect of gender inequity on HIV spread. The study findings demonstrate that men's gender role norms and sexual norms are important determinants of HIV risk in North India. Programs that screen and target men who ascribe to dominant gender role norms and taboo sexual norms may be successful in reducing HIV risk in the general population.

Learning Objectives:
1. Describe diverse measures of gender inequity and their differential effect on HIV risk 2. Explain the methodological value of applying structural equation modeling to identify social determinants of HIV risk 3. Discuss the potential programmatic effect of addressing gender-based norms and attitudes on reducing HIV susceptibility

Keywords: HIV/AIDS, Gender

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: 1. Doctoral candidate in Department of Maternal and Child Health. Abstract is a paper from Agrawal's dissertation on gender inequity and HIV/AIDS risk in North India. 2. Previous oral presentation at APHA was on related topic of HIV stigma in North India.
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.

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