Continued increase in HIV prevalence among MSM: recent evidences from two high prevalent states of India
R. Adhikary1, P. Goswami1, S. Kallam2, L. Ramakrishnan3, A. Gautam4, G. Brahmam5, T. Subramaniam6, M. Mainkar7, R. Paranjape7
1Family Health International, New Delhi, India, 2Family Health International, Hyderabad, India, 3Family Health International, Chennai, India, 4Family Health International, Mumbai, India, 5National Institute of Nutrition, Hyderabad, India, 6National Institute of Epidemiology, Chennai, India, 7National AIDS Research Institute, Pune, India
Background: Two rounds of cross-sectional surveys were conducted among MSM in 4 districts each of Andhra Pradesh and Tamil Nadu states, to measure changes in HIV/STI prevalence and key behavioral indicators. Round 1 (R1) and round 2 (R2) surveys were implemented in 2006-07 and 2009, respectively.
Methods: For each round a time location sampling method with a two stage probability strategy was used to recruit 3,229 MSM (R1 1,621, R2: 1,608) in Andhra Pradesh and 3,243 MSM (R1 1,621, R2:1,622) in Tamil Nadu. Eligible and voluntary MSM aged of 18 years or above were interviewed, counseled, and had biological specimen collected by trained field staff.
Results: In Tamil Nadu, the HIV prevalence among MSM increased sharply in Chennai (R1 4.8%, R2 10.9%, p< .001) and Coimbatore (R1 6.5%, R2 11.1%, p< .001). In Salem it remained stable (R1 5.5%, R2 4.8%, p>0.5), whereas in Madurai the HIV prevalence decreased significantly between R1 and R2: 22.3% and 14.4% respectively (p< .001). In Andhra Pradesh , the HIV prevalence continued to increase in Guntur (R1 13.1%, R2 20.8%, p< .001) and in Hyderabad (R1 24.7%, R2 28.9%, p< .01). In East Godavari the HIV prevalence between the two rounds was not found significantly different (R1 22.2%, R2 20.8%, p>.05). However, in Vizag, the prevalence went down from R1 to R2: 9.3% and 4.9%, respectively (p< .05).
Conclusions: Despite a number of on-going intervention projects, there is a significant increase in HIV prevalence among MSM in two districts of each Tamil Nadu and Andhra Pradesh states. There is an immediate need for further assessments to understand the dynamics of the HIV epidemic among MSM in these two states, and to strengthen the existing interventions.