209039 HIV prevention for non gay-identified men who have sex with men in Mumbai, India

Monday, November 9, 2009: 4:30 PM

Paige Passano, MPH , Bixby Center for Population, Health, and Sustainability, School of Public Health, University of California Berkeley, Berkeley, CA
Background: A street intervention for males who have sex with males (MSM) funded by USAID was conducted by Population Services International (PSI) Mumbai from 2004-2006 to prevent STIs/HIV among homosexual and bisexual men. Baseline surveys were conducted at two PSI sites to gather data on population size, partner type, and risk behaviors. Methods: Trained field researchers screened 2, 152 men in Mumbai's main red-light district (Kamathipura) using time-location sampling. Men were screened regardless of appearance/mannerisms. Findings: In Kamathipura, 440 of the 2,152 men screened (20.4%) reported oral or anal sex with a male in the past 12 months, as did 350 men out of 1085 (32.3%) at Cotton Green truck stop. Despite strong societal disapproval of homosexuality, a surprising frequency and openness about same-sex behavior was observed in both locations. Over 75% of MSM surveyed reported concurrent sex with females in the past 12 months. Condom and lubricant use varied according to access, partner type, and sexual position. Conclusions: Straight-acting MSM who lack contact with gay social networks are likely to be overlooked or misclassified by MSM community-based organizations and mainstream HIV prevention agencies. Rather than focus on sexual identity, the intervention strategy pioneered by PSI focused on self-protection - regardless of type of sex (oral, anal, vaginal) or choice of partners (male, female or transgender). All agencies working with high-risk males could benefit from sensitization and field-based training on how to deliver safer sex messages to MSM (and their male & female partners) within their intervention areas.

Learning Objectives:
1. Discuss challenges of reaching non-gay identified MSM with appropriate messages in the context of HIV /STI prevention intervention aimed more generally at high risk males. 2. Name one reason that gay community-based organization might overlook non-gay identified MSM, and one reason why mainstream HIV prevention agencies might also fair to reach this group with appropriate interventions. 3. What types of training are required to prepare the HIV prevention agencies to address the needs of MSM among the populations they currently serve?

Keywords: HIV Interventions, Gay Men

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I designed and managed this this initiative while working for Populations Services International from 2004-2007
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.