1Centre for Sexuality and Health Research and Policy (C-SHaRP), Chennai, India, 2The Humsafar Trust, Mumbai, India, 3Solidarity and Action Against The HIV Infection in India (SAATHII), Kolkata, India, 4Madras Christian College, Department of Social Work, Chennai, India,
Background: Available evidence indicates that alcohol consumption is associated with sexual risk behaviors. HIV prevention interventions among hijras/transgender people in India, however, do not explicitly address alcohol-related sexual risk behaviours. In this analysis from a multi-site study, we report findings on alcohol consumption and sexual risk behaviors of hijras/transgender people.
Methods: During the last quarter of 2011, we conducted a survey among hijras/transgender people (n=150) accessing sex work sites and drop-in centres of four community-based organizations in four cities (Chennai, Kumbakonam, Mumbai and Sangli) in Maharashtra and Tamil Nadu. We analysed frequency of alcohol consumption and its association with condom use in anal sex. |
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Results: Participants' (n=150) mean age was 31 years. Forty-four percent have completed high school; 43% completed primary education and 12% were illiterate. Nearly half (46%) earned less than INR 5000/month. About half (53%) were living alone. Over two-thirds (77%) self-identified as hijras, 17% as jogtas, and 7% as 'transgender'. More than two-thirds (70%) reported having had sex in exchange for money in past 3 months. About two-thirds (67%) reported having consumed alcohol in past 3 months, among which one-third (n=34/103) consumed alcohol more than 5 days a week. Ninety-six percent (n=144/150) reported having had anal sex in past month. Among those who did not use condom in the last anal sex (27%; n=37/144), more than half (62%; n=23/37) reported having consumed alcohol before sex (p< .001). That is, people who reported having consumed alcohol before last anal sex are more likely not to use condoms and more likely to have received money for sex in past 3 months (p< .05).
Conclusions: High prevalence of alcohol consumption and its association with inconsistent condom use among hijras/transgender people, especially those in sex work, call for addressing alcohol-related sexual risk behaviours in HIV interventions and link those who abuse alcohol to alcohol-dependence treatment.
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