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Dmello MK, Kumar S, Badiger S, Purushottam J. Factors determining sexual behaviour amongst siddi tribe migrating to Udupi district, India: A cross-sectional study. Niger Postgrad Med J 2021; 28:225-231. [PMID: 34708711 DOI: 10.4103/npmj.npmj_606_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Afro-Indians, locally known as Siddi, are the tribal community descended from the Bantu populace from eastern Africa found in Goa, Gujarat and Karnataka along the Indian west coast. This study determines knowledge, attitude and sexual behaviour amongst the Siddi population in the Udupi district. Materials and Methods A cross-sectional study was conducted from October 2018 to September 2019; men and women aged above 18 years who lived in the locality at the time of the survey were included in the study. Results A total of 108 Siddi individuals participated in this study. The mean age of the respondents was 31.8 ± 9.5 years. More than half (51.8%) of the respondents received information on sexual matters through friends. Awareness regarding the usage of condoms and other preventive measures was poor (34.7%). Around 65.7% of the respondents felt that sex education in school encourages sex amongst youngsters. The mean age at the first sexual intercourse amongst men and women was 20.3 years and 16.2 years, respectively. About 18.7% of the respondents had sex with a new partner in the migrated place within the last 1 month, of which 80% were married. Only 5% of the respondents used condoms while indulging in sex with a new partner at the migrated place. Factors such as age at marriage, age at the first sexual act and attitude towards sexual activity were significantly associated with a new sex partner at the arrival site. Conclusion There is a high prevalence of unsafe sexual practices amongst the migrated Siddi tribe at the place of destination. This poses the risk of sexually transmitted infections amongst the migrant tribes and local communities at the place of destination and the location of origin. The study finding shows that measures should be taken to create awareness, and change in attitude towards sexual matter should be channelised at an early age amongst the Siddi population.
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Affiliation(s)
- Mackwin Kenwood Dmello
- Department of Public Health, K S Hegde Medical Academy, Nitte (Deemed to be University), Mangalore, Karnataka, India
| | - Sudeep Kumar
- Department of Community Health, Nitte (Deemed to be University), Mangalore, Karnataka, India
| | - Sanjeev Badiger
- Department of Community Medicine, A.J. Institute of Medical Sciences and Research Centre, Mangalore, Karnataka, India
| | - Jagannath Purushottam
- Department of Public Health, K S Hegde Medical Academy, Nitte (Deemed to be University), Mangalore, Karnataka, India
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Steward WT, Satyanarayana VA, Heylen E, Srikrishnan AK, Vasudevan CK, Krishnan G, Solomon D, Ekstrand ML. Alcohol use, expectancies and HIV-related sexual risk: a cross-sectional survey of male migrant workers in South India. AIDS Care 2017; 30:656-662. [PMID: 29084445 DOI: 10.1080/09540121.2017.1394964] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Male migrant workers (MMWs) in India are vulnerable to developing alcohol-related problems and engaging in unprotected sex, putting them at risk of HIV. Research has shown that alcohol-related expectancies mediate vulnerability to alcoholism. We examined which expectancies were associated with sexual risk and drinking. We surveyed 1085 heterosexual MMWs in two South Indian municipalities, assessing expectancies, sex under the influence, and unprotected sex with female sex workers (FSW) and casual female partners in the prior 30 days. Men more strongly endorsed positive than negative expectancies (t = 53.59, p < .01). In multivariate logistic regression, the expectancy of having more fun helped drive the combination of alcohol and unprotected sex with FSW partners (OR = 1.22, p < .05), whereas the expectancy of better sex helped drive a similar combination with casual partners (OR = 1.24, p < .01). Men concerned about alcohol-induced deficits were less likely to drink with FSW partners (OR = 0.81, p < .01), but more likely to have unprotected sex with them (OR = 1.78, p < .01). To reduce risk, MMWs would benefit from combination prevention approaches that use behavioral strategies to address drinking norms and awareness of risk, while using biomedical strategies to reduce viral transmission when risk does occur.
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Affiliation(s)
- Wayne T Steward
- a Center for AIDS Prevention Studies, Department of Medicine , University of California San Francisco , San Francisco , USA
| | - Veena A Satyanarayana
- b Department of Clinical Psychology , National Institute of Mental Health and Neuro Sciences (NIMHANS) , Bengaluru , India
| | - Elsa Heylen
- a Center for AIDS Prevention Studies, Department of Medicine , University of California San Francisco , San Francisco , USA
| | - Aylur K Srikrishnan
- c Y.R. Gaitonde Centre for AIDS Research and Education (YRGCARE) , Chennai , India
| | | | | | | | - Maria L Ekstrand
- a Center for AIDS Prevention Studies, Department of Medicine , University of California San Francisco , San Francisco , USA
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Horyniak D, Wagner KD, Armenta RF, Cuevas-Mota J, Hendrickson E, Garfein RS. Cross-border injection drug use and HIV and hepatitis C virus seropositivity among people who inject drugs in San Diego, California. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2017; 47:9-17. [PMID: 28683432 DOI: 10.1016/j.drugpo.2017.06.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 06/07/2017] [Accepted: 06/13/2017] [Indexed: 01/06/2023]
Abstract
BACKGROUND The prevalence of HIV and Hepatitis C Virus (HCV) are significantly lower among people who inject drugs (PWID) in San Diego, CA, USA compared with PWID in Tijuana, Mexico, located directly across the border. We investigated associations between cross-border injection drug use (IDU), HIV and HCV seroprevalence and engagement in injecting risk behaviours while on each side of the border. METHODS Using baseline interviews and serologic testing data from STAHR II, a longitudinal cohort study of PWID in San Diego, bivariate and multivariable logistic regression analyses examined associations between recent (past six months) cross-border IDU and HIV and HCV antibody seropositivity, socio-demographics, drug use characteristics, and participants' connections to, and perceptions about Mexico. Chi-squared tests and McNemar tests examined associations between cross-border IDU and injecting risk behaviours. RESULTS Of the 567 participants (93% U.S.-born, 73% male, median age 45 years), 86 (15%) reported recent cross-border IDU. Cross-border IDU was not associated with HIV (OR: 0.85, 95% CI: 0.37-1.95) or HCV seropositivity (OR: 1.01, 95% CI: 0.62-1.65). Age, identifying as Hispanic or Latino/a, and being concerned about risk of violence when travelling to Mexico were independently associated with decreased odds of recent cross-border IDU. Injecting cocaine at least weekly, having ever lived in Mexico and knowing PWID who reside in Mexico were associated with increased odds of recent cross-border IDU. PWID who reported cross-border IDU were significantly less likely to engage in receptive needle sharing, equipment sharing, and public injection while in Mexico compared with in San Diego (all p<0.001). CONCLUSION Prevalence of HIV and HCV infection was similar among PWID who had and had not injected in Mexico, possibly due to practising safer injecting while in Mexico. Research is needed to elucidate contextual factors enabling U.S. PWID to inject safely while in Mexico.
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Affiliation(s)
- Danielle Horyniak
- Division of Global Public Health, Department of Medicine, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA; Behaviours and Health Risks Program, Burnet Institute, 85 Commercial Rd., Melbourne, VIC 3004, Australia; School of Public Health and Preventive Medicine, 99 Commercial Rd., Melbourne, VIC 3004, Australia.
| | - Karla D Wagner
- School of Community Health Sciences, University of Nevada Reno, 1664 N. Virginia St., Reno, NV 89557, USA.
| | - Richard F Armenta
- Division of Epidemiology, Department of Family Medicine and Public Health, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA.
| | - Jazmine Cuevas-Mota
- Division of Global Public Health, Department of Medicine, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA.
| | - Erik Hendrickson
- Division of Global Public Health, Department of Medicine, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA.
| | - Richard S Garfein
- Division of Global Public Health, Department of Medicine, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA.
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Cassels S, Jenness SM, Biney AAE, Dodoo FNA. Geographic mobility and potential bridging for sexually transmitted infections in Agbogbloshie, Ghana. Soc Sci Med 2017; 184:27-39. [PMID: 28501018 PMCID: PMC5525941 DOI: 10.1016/j.socscimed.2017.05.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 04/11/2017] [Accepted: 05/02/2017] [Indexed: 11/24/2022]
Abstract
Short-term mobility can significantly influence the spread of infectious disease. In order for mobile individuals to geographically spread sexually transmitted infections (STIs), individuals must engage in sexual acts with different partners in two places within a short time. In this study, we considered the potential of mobile individuals as bridge populations - individuals who link otherwise disconnected sexual networks and contributed to ongoing STI transmission. Using monthly retrospective panel data, we examined associations between short-term mobility and sexual partner concurrency in Agbogbloshie, Ghana. We also examined bridging by the location of sex acts and the location of sexual partners in concurrent triads, and whether mobile individuals from our sample were more likely to be members of geographic bridging triads. Although reported rates of sexual partnership concurrency were much higher for men compared to women, mobility was only associated with increased concurrency for women. Additionally, this association held for middle-distance mobility and short-duration trips for women. Taking into account the location of sex acts and the location of sexual partners, about 22% of men (21.7% and 22.4% for mobile and non-mobile men, respectively) and only 3% of women (1.4% and 3.3% for mobile and non-mobile women, respectively) were potential bridges for STIs over the last year. Our results highlight the gendered nature of mobility and sexual risk behavior, reflecting the normative social context that encourages women to conceal certain types of sexual behavior.
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Affiliation(s)
- Susan Cassels
- Department of Geography, University of California, Santa Barbara, CA 93106-4060, United States.
| | - Samuel M Jenness
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA 30322, United States
| | - Adriana A E Biney
- Regional Institute for Population Studies, University of Ghana, P.O. Box LG 96, Legon, Accra, Ghana
| | - F Nii-Amoo Dodoo
- The Pennsylvania State University & University of Ghana, 211 Oswald Tower, University Park, PA 16802, United States
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Abstract
Objective: To quantify the space-time dimensions of human mobility in relationship to the risk of HIV acquisition. Methods: We used data from the population cohort located in a high HIV prevalence, rural population in KwaZulu-Natal, South Africa (2000–2014). We geolocated 8006 migration events (representing 1 028 782 km traveled) for 17 743 individuals (≥15 years of age) who were HIV negative at baseline and followed up these individuals for HIV acquisition (70 395 person-years). Based on the complete geolocated residential history of every individual in this cohort, we constructed two detailed time-varying migration indices. We then used interval-censored Cox proportional hazards models to quantify the relationship between the migration indices and the risk of HIV acquisition. Results: In total, 17.4% of participants migrated at least once outside the rural study community during the period of observation (median migration distance = 107.1 km, interquartile range 18.9–387.5). The two migration indices were highly predictive of hazard of HIV acquisition (P < 0.01) in both men and women. Holding other factors equal, the risk of acquiring HIV infection increased by 50% for migration distances of 40 km (men) and 109 km (women). HIV acquisition risk also increased by 50% when participants spent 44% (men) and 90% (women) of their respective time outside the rural study community. Conclusion: This in-depth analysis of a population cohort in a rural sub-Saharan African population has revealed a clear nonlinear relationship between distance migrated and HIV acquisition. Our findings show that even relatively short-distance migration events confer substantial additional risk of acquisition.
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Rai T, Lambert HS, Ward H. Migration as a risk and a livelihood strategy: HIV across the life course of migrant families in India. Glob Public Health 2016; 12:381-395. [PMID: 27002744 PMCID: PMC5327870 DOI: 10.1080/17441692.2016.1155635] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Migrant workers are understood to be vulnerable to HIV. However, little is known about the experience of migration-based households following HIV infection. This qualitative study examined the migration-HIV relationship beyond the point of infection, looking at how it affects livelihood choices, household relationships and the economic viability of migrant families. We conducted semi-structured interviews with 33 HIV-positive migrant men and women recruited from an anti-retroviral therapy (ART) centre in north India. Following infection among the migrant men, contact with free, public-sector HIV services was often made late, after the development of debilitating symptoms, abandonment of migrant work and return to native villages. After enrolment at the ART centre participants’ health eventually stabilised but they now faced serious economic debt, an inflexible treatment regimen and reduced physical strength. Insecure migrant job markets, monthly drug collection and discriminatory employment policies impeded future migration plans. HIV-positive wives of migrants occupied an insecure position in the rural marital household that depended on their husbands’ health and presence of children. The migration-HIV relationship continued to shape the life course of migrant families beyond the point of infection, often exposing them again to the economic insecurity that migration had helped to overcome, threatening their long-term survival.
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Affiliation(s)
- Tanvi Rai
- a School of Public Health , Imperial College London , London , UK
| | - Helen S Lambert
- b School of Social and Community Medicine , University of Bristol , Bristol , UK
| | - Helen Ward
- a School of Public Health , Imperial College London , London , UK
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Rai T, Lambert HS, Ward H. Complex routes into HIV care for migrant workers: a qualitative study from north India. AIDS Care 2015; 27:1418-23. [PMID: 26608276 PMCID: PMC4706014 DOI: 10.1080/09540121.2015.1114988] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Migrant workers are designated a bridge population in the spread of HIV and therefore if infected, should be diagnosed and treated early. This study examined pathways to HIV diagnosis and access to care for rural-to-urban circular migrant workers and partners of migrants in northern India, identifying structural, social and individual level factors that shaped their journeys into care. We conducted a qualitative study using in-depth interviews with HIV-positive men (n = 20) and women (n = 13) with a history of circular migration, recruited from an antiretroviral therapy centre in one district of Uttar Pradesh, north India. Migrants and partners of migrants faced a complex series of obstacles to accessing HIV testing and care. Employment insecurity, lack of entitlement to sick pay or subsidised healthcare at destination and the household's economic reliance on their migration-based livelihood led many men to continue working until they became incapacitated by HIV-related morbidity. During periods of deteriorating health they often exhausted their savings on private treatments focused on symptom management, and sought HIV testing and treatment at a public hospital only following a medical or financial emergency. Wives of migrants had generally been diagnosed following their husbands' diagnosis or death, with access to testing and treatment mediated via family members. For some, a delay in disclosure of husband's HIV status led to delays in their own testing. Diagnosing and treating HIV infection early is important in slowing down the spread of the epidemic and targeting those at greatest risk should be a priority. However, despite targeted campaigns, circumstances associated with migration may prevent migrant workers and their partners from accessing testing and treatment until they become sick. The insecurity of migrant work, the dominance of private healthcare and gender differences in health-seeking behaviour delay early diagnosis and treatment initiation.
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Affiliation(s)
- Tanvi Rai
- a School of Public Health , Imperial College London , London , UK
| | - Helen S Lambert
- b School of Social and Community Medicine , University of Bristol , Bristol , UK
| | - Helen Ward
- a School of Public Health , Imperial College London , London , UK
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Ward H, Gregson S, Watts C, Garnett GP. Translational epidemiology: developing and applying theoretical frameworks to improve the control of HIV and other sexually transmitted infections. J Infect Dis 2015; 210 Suppl 2:S547-8. [PMID: 25381373 PMCID: PMC4231646 DOI: 10.1093/infdis/jiu559] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Helen Ward
- Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London
| | - Simon Gregson
- Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London
| | - Charlotte Watts
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, United Kingdom
| | - Geoffrey P Garnett
- Integrated Delivery Department, Bill and Melinda Gates Foundation, Seattle, Washington
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