Indian men's use of commercial sex workers: Prevalence, condom use, and related gender attitudes

Michele R. Decker, Elizabeth Miller, Anita Raj, Niranjan Saggurti, Balaiah Donta, Jay G. Silverman

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background/Objectives: Commercial sex represents a critical context for HIV transmission within India and elsewhere. Despite research and programmatic attention to commercial sex workers (CSWs), less is known concerning the male CSW clients considered a bridge population for HIV transmission to the general population and thought to drive demand for the sex trafficking of women and girls. The current study assesses the prevalence of past year CSW contact, condom nonuse therein, and associations with demographic characteristics and gendered attitudes among a national sample of Indian men. Methods: The nationally representative Indian National Family Health Survey-3 was conducted across all Indian states in 2005-2006; the current sample was limited to 46,961 sexually active men. Analyses calculated the prevalence of past year CSW contact and inconsistent condom use; adjusted logistic regression models were used to evaluate associations of demographic characteristics, sexual entitlement and justification of wife abuse with past year CSW contact, and inconsistent condom use. Results: Approximately 1 in 100 Indian men (0.9%) reported past year CSW contact; over half of such men reported inconsistent condom use with CSWs. CSW contact was most common among men ages 15-24 (3.6%) and never married men (9.9%). Men's CSW contact related to higher levels of sexual entitlement (adjusted odds ratio = 1.64; 95% confidence interval 1.24 to 2.17) and justification of violence against wives (adjusted odds ratio = 1.41; 95% confidence interval: 1.03 to 1.93). Conclusions: Men's past year CSW contact was concentrated among young and unmarried Indian men; condom nonuse with CSWs was common. Traditional gender ideologies seemed to support men's CSW contact, bolstering consideration of this behavior as a gendered form of HIV risk. Findings provide direction for interventions to reduce men's CSW contact in the Indian context by describing high-risk subpopulations and indicating that gender ideologies should be addressed.

Original languageEnglish (US)
Pages (from-to)240-246
Number of pages7
JournalJournal of Acquired Immune Deficiency Syndromes
Volume53
Issue number2
DOIs
StatePublished - Feb 2010

Fingerprint

Sex Workers
Condoms
HIV
Human Trafficking
Logistic Models
Odds Ratio
Demography
Spouse Abuse
Confidence Intervals
Family Health
Health Surveys
Spouses
Violence
Population
India

Keywords

  • Commercial sex
  • Condom use
  • Gender attitudes
  • HIV risk
  • South Asia

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

Cite this

Indian men's use of commercial sex workers : Prevalence, condom use, and related gender attitudes. / Decker, Michele R.; Miller, Elizabeth; Raj, Anita; Saggurti, Niranjan; Donta, Balaiah; Silverman, Jay G.

In: Journal of Acquired Immune Deficiency Syndromes, Vol. 53, No. 2, 02.2010, p. 240-246.

Research output: Contribution to journalArticle

Decker, Michele R. ; Miller, Elizabeth ; Raj, Anita ; Saggurti, Niranjan ; Donta, Balaiah ; Silverman, Jay G. / Indian men's use of commercial sex workers : Prevalence, condom use, and related gender attitudes. In: Journal of Acquired Immune Deficiency Syndromes. 2010 ; Vol. 53, No. 2. pp. 240-246.
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abstract = "Background/Objectives: Commercial sex represents a critical context for HIV transmission within India and elsewhere. Despite research and programmatic attention to commercial sex workers (CSWs), less is known concerning the male CSW clients considered a bridge population for HIV transmission to the general population and thought to drive demand for the sex trafficking of women and girls. The current study assesses the prevalence of past year CSW contact, condom nonuse therein, and associations with demographic characteristics and gendered attitudes among a national sample of Indian men. Methods: The nationally representative Indian National Family Health Survey-3 was conducted across all Indian states in 2005-2006; the current sample was limited to 46,961 sexually active men. Analyses calculated the prevalence of past year CSW contact and inconsistent condom use; adjusted logistic regression models were used to evaluate associations of demographic characteristics, sexual entitlement and justification of wife abuse with past year CSW contact, and inconsistent condom use. Results: Approximately 1 in 100 Indian men (0.9{\%}) reported past year CSW contact; over half of such men reported inconsistent condom use with CSWs. CSW contact was most common among men ages 15-24 (3.6{\%}) and never married men (9.9{\%}). Men's CSW contact related to higher levels of sexual entitlement (adjusted odds ratio = 1.64; 95{\%} confidence interval 1.24 to 2.17) and justification of violence against wives (adjusted odds ratio = 1.41; 95{\%} confidence interval: 1.03 to 1.93). Conclusions: Men's past year CSW contact was concentrated among young and unmarried Indian men; condom nonuse with CSWs was common. Traditional gender ideologies seemed to support men's CSW contact, bolstering consideration of this behavior as a gendered form of HIV risk. Findings provide direction for interventions to reduce men's CSW contact in the Indian context by describing high-risk subpopulations and indicating that gender ideologies should be addressed.",
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