Abstract
Aim
The paper aims to track the changes in HIV-related risk behaviour among men aged 15–54 in high HIV prevalence states in India using three consecutive rounds of the Indian Demographic Health Survey in 2005–06, 2015–16 and 2019–21.
Methods
Findings are based on a nationally representative sample of 30,110, 16,822 and 19,517 men aged 15–54 during the periods 2005–2006, 2015–2016 and 2019–21, respectively, from the high HIV prevalent states in India, namely Maharashtra, Manipur, Mizoram Nagaland, Karnataka and Andhra Pradesh (including Telangana). Descriptive statistics, bivariate and multivariate analyses were used.
Results
High-risk sexual behaviour increased from 4.5% in 2005–06 to 6.4% in 2015–16 to 7.3% in 2019–21. The prevalence of high-risk sexual behaviour and HIV testing remains disproportionately higher among men with ≥10 years of schooling, residing in urban areas, belonging to economically better-off households, and perceiving that women do not have any sexual rights in all three-consecutive surveys of NFHS. The random part of the multilevel logistic regression revealed that variation in the high-risk sexual behaviour among men was higher at the household level than the community level in all three consecutive surveys of NFHS.
Conclusions
The study concluded that high-risk sexual behaviour and HIV testing increased over the past 15 years and remain disproportionately higher among younger, unmarried and urban men, who are mainly from economically better-off households. Men must be the focus and priority of HIV/AIDS research and education, which may strengthen the idea that men are solely responsible for sexual decision-making.
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Data availability
All data used in the study is archived in the public repository of Demographic and Health Survey (DHS). The data can be accessed using: https://dhsprogram.com/data/dataset_admin/index.cfm, which requires registration.
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Acknowledgments
The authors are grateful to the Demographic and Health Survey (DHS) Program for assembling and publishing accurate, nationally representative data on a range of health, biomarkers, and healthcare utilization indicators for populations in the age-range of 15 years and older. The authors are also grateful to NFHS’s project partners, International Institute for Population Sciences (IIPS), and the Ministry of Health and Family Welfare, government of India.
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SKS: conceptualization, supervision, manuscript preparation and review; SKS: data analysis, writing and manuscript preparation: DV: manuscript writing, review and editing. All the authors read and approved the manuscript.
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The necessary guidelines and ethics for undertaking the NFHS survey was approved by the IIPS Institutional Review Board and the ICF Institutional Review Board. The protocol was also reviewed by the U.S. Centers for Disease Control and Prevention (CDC). The agencies that conducted the field survey for the data collection had collected prior informed consent (signed and oral) for both the interviews and biomarker tests from the eligible respondents in accordance with the Human Subjects Protection. All methods in this study were carried out in accordance with relevant guidelines and regulations by the ICMR. There was no number/ID of the approval(s) mentioned in the NFHS report (http://rchiips.org/nfhs/factsheet_NFHS-5.shtml). This study is based on secondary data available in the public domain. Anyone can access the data without any legal or ethical considerations. Therefore, there is no ethical approval required for this study as this study did not involve human or animal participants directly.
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Singh, S.K., Sharma, S.K. & Vishwakarma, D. Tracking changes in HIV-related risk behaviour among men aged 15–54 in high HIV prevalence states in India: evidence from NFHSs. J Public Health (Berl.) (2023). https://doi.org/10.1007/s10389-023-02057-2
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DOI: https://doi.org/10.1007/s10389-023-02057-2