CSIRO Publishing blank image blank image blank image blank imageBooksblank image blank image blank image blank imageJournalsblank image blank image blank image blank imageAbout Usblank image blank image blank image blank imageShopping Cartblank image blank image blank image You are here: Journals > Sexual Health   
Sexual Health
Journal Banner
  Publishing on sexual health from the widest perspective
blank image Search
blank image blank image
blank image
  Advanced Search

Journal Home
About the Journal
Editorial Structure
For Advertisers
Online Early
Current Issue
Just Accepted
All Issues
Special Issues
Sample Issue
For Authors
General Information
Submit Article
Author Instructions
Open Access
For Referees
Referee Guidelines
Review an Article
Annual Referee Index
For Subscribers
Subscription Prices
Customer Service
Library Recommendation

blue arrow e-Alerts
blank image
Subscribe to our Email Alert or RSS feeds for the latest journal papers.

red arrow Connect with us
blank image
facebook twitter logo LinkedIn

red arrow Interview with Kit Fairley
blank image
Hear Kit Fairley speak about what is sexual health.


Article << Previous     |     Next >>   Contents Vol 8(2)

Primary prevention lessons learned from those with HIV in Chennai, India

Ellen Setsuko Hendriksen A B F, A. K. Sri Krishnan C, Snigda Vallabhaneni D, Sethu Johnson C, Sudha Raminani B, N. Kumarasamy C, Suniti Solomon C, Kenneth K. H. Mayer B D and Steven S. Safren B E

A University of California, Los Angeles, CA 90024, USA.
B The Fenway Institute, Boston, MA 02215, USA.
C YRG Centre for AIDS Research and Education, Chennai 600113, India.
D Brown University, Providence, RI 02912, USA.
E Harvard Medical School–Massachusetts General Hospital, Boston, MA 02114, USA.
F Corresponding author. Email: ehendriksen@partners.org

Sexual Health 8(2) 199-206 http://dx.doi.org/10.1071/SH10015
Submitted: 12 February 2010  Accepted: 9 September 2010   Published: 18 May 2011

PDF (134 KB) $25
 Export Citation

Background: As each HIV-infected individual represents a breakdown of HIV primary prevention measures, formative data from representative individuals living with HIV can help shape future primary prevention interventions. Little is known about sexual behaviours and other transmission risk factors of high-risk group members who are already HIV-infected in Chennai, India. Methods: Semi-structured qualitative interviews were conducted with 27 HIV-infected individuals representing each high-risk group in Chennai (five men who have sex with men (MSM), five female commercial sex workers (CSW), four truckers and other men who travel for business, four injecting drug users (IDU), five married male clients of CSW, and four wives of CSW clients, MSM, truckers, and IDU). Results: Themes relevant to HIV primary prevention included: (1) HIV diagnosis as the entry into HIV education and risk reduction, (2) reluctance to undergo voluntary counselling and testing, (3) gender and sexual roles as determinants of condom use, (4) misconceptions about HIV transmission, and (5) framing and accessibility of HIV education messages. Conclusions: These qualitative data can be used to develop hypotheses about sexual risk taking in HIV-infected individuals in South India, inform primary prevention intervention programs, and improve primary prevention efforts overall.

Additional keywords: AIDS, education, MSM, sex workers, sexual behaviour.


[1]  UNAIDS. AIDS epidemic update: 2007. Geneva: UNAIDS; 2007.

[2]  Panda S, Kumar MS, Lokabiraman S, Jayashree K, Satagopan MC, Solomon S, et al Risk factors for HIV infection in injection drug users and evidence for onward transmission of HIV to their sexual partners in Chennai, India. J Acquir Immune Defic Syndr 2005; 39: 9–15.
CrossRef | PubMed |

[3]  Go VF, Srikrishnan AK, Sivaram S, Murugavel GK, Galai N, Johnson SC, et al High HIV prevalence and risk behaviors in men who have sex with men in Chennai, India. J Acquir Immune Defic Syndr 2004; 35: 314–9.
CrossRef | PubMed |

[4]  Gangakhedkar RR, Bentley ME, Divekar AD, Gadkari D, Mehendale SM, Shepherd ME, et al Spread of HIV infection in married monogamous women in India. JAMA 1997; 278: 2090–2.
CrossRef | CAS | PubMed |

[5]  Simoes EA, Babu PG, Jeyakumari HM, John TJ. The initial detection of human immunodeficiency virus 1 and its subsequent spread in prostitutes in Tamil Nadu, India. J Acquir Immune Defic Syndr 1993; 6: 1030–4.
| CAS | PubMed |

[6]  Bryan AD, Fisher JD, Benziger TJ. Determinants of HIV risk among Indian truck drivers. Soc Sci Med 2001; 53: 1413–26.
CrossRef | CAS | PubMed |

[7]  Singh YN, Malaviya AN. Long distance truck drivers in India: HIV infection and their possible role in disseminating HIV into rural areas. Int J STD AIDS 1994; 5: 137–8.
| CAS | PubMed |

[8]  National AIDS Control Organisation (NACO). HIV data. New Delhi: NACO; 2007. Available online at: http://www.nacoonline.org/Quick_Links/ HIV_Data [verified October 2009].

[9]  Newmann S, Sarin P, Kumarasamy N, Amalraj E, Rogers M, Madhivanan P, et al Marriage, monogamy and HIV: a profile of HIV-infected women in south India. Int J STD AIDS 2000; 11: 250–3.
CrossRef | CAS | PubMed |

[10]  Bhattacharya G. Sociocultural and behavioural contexts of condom use in heterosexual married couples in India: challenges to the HIV prevention program. Health Educ Behav 2004; 31: 101–17.
CrossRef | PubMed |

[11]  Steinbrook R. HIV in India – a downsized epidemic. N Engl J Med 2008; 358: 107–9.
CrossRef | CAS | PubMed |

[12]  National AIDS Control Organisation (NACO). State-wise number of NGOs and AIDS prevention centres functioning in India. New Delhi: NACO; 2005. Available online at: http://www.indiastat.com/india/ShowData.asp?secid=383385&ptid=44&level=3 [verified October 2009].

[13]  Chandrasekaran P, Dallabetta G, Loo V, Rao S, Gayle H, Alexander A. Containing HIV/AIDS in India: the unfinished agenda. Lancet Infect Dis 2006; 6: 508–21.
CrossRef | PubMed |

[14]  Verma R, Shekhar A, Khobragade S, Adhikary R, George B, Ramesh BM, et al Scale-up and coverage of Avahan: a large-scale HIV-prevention programme among female sex workers and men who have sex with men in four Indian states. Sex Transm Infect 2010; 86: i76–82.
CrossRef | PubMed |

[15]  Pandey A, Reddy DC, Ghys PD, Thomas M, Sahu D, Bhattacharya M, et al Improved estimates of India’s HIV burden in 2006. Indian J Med Res 2009; 129: 50–8.
| PubMed |

[16]  Subramanian T, Gupte MD, Dorairaj VS, Periannan V, Mathai AK. Psycho-social impact and quality of life of people living with HIV/AIDS in South India. AIDS Care 2009; 21: 473–81.
CrossRef | PubMed |

[17]  Thomas BE, Rehman R, Suryanarayanan D, Josephine K, Dilip M, Dorairaj VS, et al How stigmatizing is stigma in the life of people living with HIV: a study on HIV positive individuals from Chennai, South India. AIDS Care 2005; 17: 795–801.
| CAS | PubMed |

[18]  Chakrapani V, Newman PA, Shunmugam M. Secondary HIV prevention among kothi-identified MSM in Chennai, India. Cult Health Sex 2008; 10: 313–27.
CrossRef | PubMed |

[19]  Thomas BE, Chandra S, Selvi KJ, Suriyanarayanan D, Swaminathan S. Gender differences in sexual behaviour among people living with HIV in Chennai, India. Indian J Med Res 2009; 129: 690–4.
| CAS | PubMed |

[20]  Sri Krishnan AK, Hendriksen E, Vallabhaneni S, Johnson SL, Raminani S, Kumarasamy N, et al Sexual behaviors of individuals with HIV living in South India: A qualitative study. AIDS Educ Prev 2007; 19: 334–45.
CrossRef | CAS | PubMed |

[21]  Ickovics JR. Bundling HIV prevention: integrating services to promote synergistic gain. Prev Med 2008; 46: 222–5.
CrossRef | PubMed |

[22]  Rotheram-Borus MJ, Swendeman D, Flannery D. Family wellness, not HIV prevention. AIDS Behav 2009; 13: 409–13.
CrossRef | PubMed |

[23]  Ickovics JR, Kershaw TS, Westdahl C, Magriples U, Massey Z, Reynolds H, et al Group prenatal care and perinatal outcomes: a randomized controlled trial. Obstet Gynecol 2007; 110: 330–9.
| PubMed |

[24]  Carey MP, Carey KB, Maisto SA, Gordon CM, Schroder KE, Vanable PA. Reducing HIV-risk behavior among adults receiving outpatient psychiatric treatment: results from a randomized controlled trial. J Consult Clin Psychol 2004; 72: 252–68.
CrossRef | PubMed |

[25]  Dinkelman T, Levinsohn J, Majelantle R. When knowledge is not enough: HIV/AIDS information and risky behavior in Botswana. National Bureau of Economic Research Working Paper 12418. Cambridge: National Bureau of Economic Research Working Paper; 2006. Available online at: http://www.nber.org/papers/w12418 [verified March 2009].

[26]  Jana S, Baus I, Rotheram-Borus MJ, Newman PA. The Sonagachi Project: a sustainable community intervention program. AIDS Educ Prev 2004; 16: 405–14.
CrossRef | PubMed |

[27]  Schoepf BG. AIDS action – research with women in Kinshasa, Zaire. Soc Sci Med 1993; 37: 1401–13.
CrossRef | CAS | PubMed |

[28]  Calsyn DA, Hatch-Maillette M, Tross S, Doyle SR, Crits-Christoph P, Song YS, et al Motivational and skills training HIV/sexually transmitted infection sexual risk reduction groups for men. J Subst Abuse Treat 2009; 37: 138–50.
CrossRef | PubMed |

[29]  Darbes L, Crepaz N, Lyles C, Kennedy G, Rutherford G. The efficacy of behavioral interventions in reducing HIV risk behaviors and incident sexually transmitted diseases in heterosexual African Americans. AIDS 2008; 22: 1177–94.
CrossRef | PubMed |

[30]  Fortenberry JD, McFarlane M, Bleakley A, Bull S, Fishbein M, Grimley DM, et al Relationships of stigma and shame to gonorrhea and HIV screening. Am J Public Health 2002; 92: 378–81.
CrossRef | PubMed |

[31]  Lieber E, Li L, Wu Z, Rotheram-Borus MJ, Guan J, NIMH Collaborative HIV Prevention Trial Group. HIV/STD stigmatization fears as health-seeking barriers in China. AIDS Behav 2006; 10: 463–71.
CrossRef | PubMed |

[32]  Maman S, Mbwambo JK, Hogan NM, Weiss E, Kilonzo GP, Sweat MD. High rates and positive outcomes of HIV-serostatus disclosure to sexual partners: reasons for cautious optimism from a voluntary counseling and testing clinic in Dar es Salaam, Tanzania. AIDS Behav 2003; 7: 373–82.
CrossRef | PubMed |

[33]  Roura M, Urassa M, Busza J, Mbata D, Wringe A, Zaba B. Scaling up stigma? The effects of antiretroviral roll-out on stigma and HIV testing: early evidence from rural Tanzania. Sex Transm Infect 2009; 85: 308–12.
CrossRef | CAS | PubMed |

Subscriber Login

Legal & Privacy | Contact Us | Help


© CSIRO 1996-2016