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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. [ABSTRACT FROM AUTHOR]

Among 433 men who have sex with men in Maharashtra, India who completed an online survey, 23% reported hazardous drinking, 12% illicit substance, and 9% polysubstance use. The overall prevalence of depression and intimate partner violence (IPV) were 58% and 56%, respectively. Participants engaging in hazardous drinking had more sexual partners and were less likely to be married to women. Participants reporting illicit substance use or polysubstance use were more likely to have been out, had more sexual partners, or experienced IPV. Those reporting illicit substance use were more likely to engage in condomless anal sex. Based on our findings, we suggest that public health interventions integrate HIV, substance use, and mental health services. [ABSTRACT FROM AUTHOR]

This mixed-methods investigation combines a quantitative survey, focus groups, and in-depth interviews to examine sexual risk behaviors and HIV status disclosure among HIV-positivehijras(male-to-female transgender people) and HIV-positive men who have sex with men (MSM) in Chennai and Mumbai, India. From the survey results, the authors found a relatively high prevalence of inconsistent condom use for anal sex with male partners—about one-fifth to almost one-half, depending on the type of partner (regular, casual) and sexual role (receptive, insertive). One-quarter of MSM and two-fifths ofhijrasreported having disclosed their HIV status to their male regular partner. The qualitative data helped in understanding social and structural factors that created barriers to disclosure of HIV status and to condom use. Disclosure was not uniformly followed by safer sex, and nondisclosure did not always lead to unprotected sex. Implications for practice and policies and potential interventions are discussed. [ABSTRACT FROM PUBLISHER]