13 14 Given the high vulnerabilities associated with HAI in commercial and non-commercial sex settings, a few research studies have assessed anal intercourse prevalence and associated factors among FSWs and the general population.15–17 Similar to findings from other countries in commercial sex settings,
selleck chemical Bosutinib studies on FSWs in India have also documented an increased trend for anal intercourse with clients.13 14 18 19 In India and elsewhere, the primary reason for FSWs selling anal sex is the extra money it brings from clients. It is also linked to associated factors such as economic hardship, debt status and lack of alternate source of income.14 18 Anal intercourse is usually demand driven, not preferred by FSWs and at times even forced by clients through violence.15 18 20 21 Intervention and research in the area are extensive among FSWs. However, there is paucity of behavioural research on clients’ self-reported anal intercourse and condom use during anal intercourse.
This paper examines the correlates of clients’ inconsistent condom use during anal intercourse with FSWs. The study has used cross-sectional survey data collected from clients of FSWs in three high-HIV prevalence states of India. Materials and methods Data source Data were derived from a cross-sectional bio-behavioural survey (called integrated behavioural and biological assessment (IBBA)) that was conducted among clients of FSWs as part of the evaluation of a large-scale HIV prevention programme in 12 districts across the three Indian states of Andhra Pradesh, Maharashtra and Tamil Nadu during 2009–2010. Men, of ages 18–60 years,
who reported purchasing sex from an FSW in the past month, were considered eligible respondents. These eligible respondents were identified with the help of FSWs, brokers, pimps, etc, at places of FSW solicitation/entertainment Brefeldin_A and recruited for the study. The survey used a two-stage cluster sampling design with time location clusters as primary sampling units. Clusters were randomly selected by using probability proportional to size in the first stage. From these selected clusters, respondents were then selected through systematic random sampling in the second stage. Behavioural information was collected through a structured, interviewer-administered questionnaire and blood and urine samples were collected to test for HIV and other sexually transmitted infections (STIs, gonorrhoea, chlamydia, syphilis). A detailed description of the survey methodology is available elsewhere.22 Prior oral or written informed consent was obtained from all respondents.