Correlates of paid sex among men who have sex with men in Chennai, India
Correlates of paid sex among men who have sex with men in Chennai, India
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DOI：
10.1136/sti.2008.031484
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发表时间：
2008-11-01
影响因子：
3.6
通讯作者：
Kakinami, L.
中科院分区：
文献类型：
--
作者：
Newman, P. A.;Chakrapani, V.;Kakinami, L.
目的：为了评估有偿性行为的相关性，在与男性发生性关系的男性（MSM）在Chennai.Methods：200 MSM招募从公共性环境中使用时空抽样进行了随机调查。预测因素与有偿性行为的关联用x2检验和多元Logistic回归进行评估。结果：参与者的平均年龄为28.5岁（SD 8.7）。大多数（71.5%）是科西人; 60%的人不到高中教育，三分之二的人月收入不到2000印度卢比。超过三分之一（35.0%）的人报告每天/每周骚扰; 40.5%的人报告在过去一年中强迫性行为。有偿性行为的发生率为59.5%（95%CI 52.7%~ 66.3%）。单变量分析表明，有偿性行为与kothi身份（chi（2）= 14.46; p < 0.01），低于高中教育（chi（2）= 4.79; p < 0.05），骚扰（chi（2）= 11.75; p < 0.01）和强迫性行为（chi（2）= 3.98; p < 0.05）相关。调整后的分析显示，有偿性行为与kothi身份（调整后的优势比（AOR）2.62，95%CI 1.34至5.10）和骚扰（AOR 2.34，95%CI 1.16至4.72）相关。有有偿性行为的男男性行为者（与无有偿性行为者相比）在过去一个月内平均有31名性伴（与4名性伴相比，t = 6.17，p < 0.001），71.2%的人坚持使用安全套（与46.4%相比，卡方2 = 18.34; p < 0.01）。总体而言，32.5%的人从来没有测试过艾滋病毒。结论：流行率的骚扰和性暴力对男男性接触者谁从事有偿性行为，主要是kothis，建议干预措施应针对结构性因素，将这些人在艾滋病毒/性传播感染和其他健康损害的条件的风险增加。在贫穷、受教育程度低、骚扰和性暴力的情况下，个人一级、以知识为基础和以安全套为重点的预防性干预措施的效力可能受到限制。
Objectives: To assess correlates of paid sex among men who have sex with men (MSM) in Chennai, India.Methods: A randomised survey was conducted among 200 MSM recruited from public sex environments using time-space sampling. The association of predictors with paid sex was assessed with x 2 tests and multiple logistic regression.Results: Participants' mean age was 28.5 years (SD 8.7). Most (71.5%) were kothis; 60% had less than high school education and two-thirds had a monthly income less than 2000 Indian rupees. More than one-third (35.0%) reported daily/weekly harassment; 40.5% reported forced sex in the past year. The prevalence of paid sex was 59.5% (95% CI 52.7% to 66.3%). Univariate analyses indicated that paid sex was associated with kothi identity (chi(2) = 14.46; p < 0.01), less than high school education (chi(2) = 4.79; p < 0.05), harassment (chi(2) = 11.75; p < 0.01) and forced sex (chi(2) = 3.98; p < 0.05). Adjusted analyses revealed that paid sex was associated with kothi identity (adjusted odds ratio (AOR) 2.62, 95% CI 1.34 to 5.10) and harassment (AOR 2.34, 95% CI 1.16 to 4.72). MSM who engaged in paid sex (versus no paid sex) had a mean of 31 partners in the past month (versus 4, t = 6.17, p < 0.001) and 71.2% used condoms consistently (versus 46.4%, chi(2) = 18.34; p < 0.01). Overall, 32.5% were never tested for HIV.Conclusions: Epidemic rates of harassment and sexual violence against MSM who engage in paid sex, predominantly kothis, suggest that interventions should target structural factors placing these men at increased risk of HIV/sexually transmitted infections and other health-compromising conditions. The effectiveness of individual-level, knowledge-based and condom-focused preventive interventions may be constrained in the context of poverty, low education, harassment and sexual violence.