Journal
AIDS CARE-PSYCHOLOGICAL AND SOCIO-MEDICAL ASPECTS OF AIDS/HIV
Volume 24, Issue 11, Pages 1401-1406Publisher
ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD
DOI: 10.1080/09540121.2012.672717
Keywords
men who have sex with men; MSM; depression; India; HIV; stigma
Categories
Funding
- NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES [P30AI060354] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE OF MENTAL HEALTH [K24MH094214] Funding Source: NIH RePORTER
- NIAID NIH HHS [P30 AI060354] Funding Source: Medline
- NIMH NIH HHS [K24 MH094214] Funding Source: Medline
- PHS HHS [P30A1060354] Funding Source: Medline
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Stigma has been shown to increase vulnerability to HIV acquisition in many settings around the world. However, limited research has been conducted examining its role among men who have sex with men (MSM) in India, whose HIV prevalence is far greater than the general population. In 2009, 210 MSM in Chennai completed an interviewer-administered assessment, including questions about stigma, sexual risk, demographics, and psychosocial variables. More than one fifth of the MSM reported unprotected anal sex (UAS) in the past three months. Logistic regression procedures were used to examine correlates of having experienced stigma. The 11-item stigma scale had high internal consistency reliability (Cronbach's alpha = 0.99). Almost 2/5 (39%) reported a high-level of experienced stigma (>= 12 mean scale-score) in their lifetime, and the mean stigma scale score was 12 (SD = 2.0). Significant correlates of having experienced prior stigma, after adjusting for age and educational attainment, included the following: identifying as a kothi (feminine acting/appearing and predominantly receptive in anal sex) compared to a panthi (masculine appearing, predominantly insertive) (AOR = 63.23; 95% CI: 15.92-251.14; p < 0.0001); being out about one's MSM behavior (AOR = 5.63; 95% CI: 1.46-21.73; p = 0.01); having clinically significant depressive symptoms (AOR = 2.68; 95% CI: 1.40-5.12; p = 0.003); and engaging in sex work in the prior three months (AOR = 4.89; 95% CI: 2.51-9.51; p < 0.0001). These findings underscore the need to address psychosocial issues of Indian MSM. Unless issues such as stigma are addressed, effective HIV prevention interventions for this hidden population remain a challenge.
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