Male Use of Female Sex Work in India: A Nationally Representative Behavioural Survey
Author Information
Author(s): Gaffey Michelle F., Venkatesh Srinivasan, Dhingra Neeraj, Khera Ajay, Kumar Rajesh, Arora Paul, Nagelkerke Nico, Jha Prabhat
Primary Institution: Centre for Global Health Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital and Dalla Lana School of Public Health, University of Toronto
Hypothesis
Heterosexual transmission of HIV in India is driven by the male use of female sex workers (FSW), but few studies have examined the factors associated with using FSW.
Conclusion
In 2006, over 8 million men aged 15-49 years in India had at least one female sex worker partner in the preceding year, with higher prevalence in high-HIV states.
Supporting Evidence
- About 4% of men used female sex workers in the previous year, representing about 8.5 million clients.
- Unmarried men were far more likely than married men to use female sex workers overall.
- FSW use was higher among men in high-HIV states than in low-HIV states.
Takeaway
The study found that many men in India use female sex workers, especially in areas with high HIV rates, which can spread HIV to their wives.
Methodology
The study used multi-stage, stratified cluster sampling to select a nationally representative sample of men aged 15-49 years and analyzed data from surveys conducted by India's National AIDS Control Organisation.
Potential Biases
Men, especially unmarried men, may exaggerate their non-regular partner use, which could skew the results.
Limitations
The study may be affected by social desirability bias, leading to potential over-reporting of non-regular partners and female sex worker use.
Participant Demographics
The study included 31,040 men aged 15-49 years from various states in India, with a focus on high-HIV and low-HIV regions.
Statistical Information
P-Value
0.0001
Confidence Interval
95% CI 11.4–12.2
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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