Men who have sex with men and transgenders in Mumbai, India: an emerging risk group for STIs and HIV.

BACKGROUND: Men who have sex with men and transgenders are an important risk group for sexually transmitted infections (STIs) and human immunodeficiency virus (HIV). They have risky sexual behaviors but low risk perception. OBJECTIVES: To assess the sexual behavior, STIs, HIV and identify factors associated with HIV in men who have sex with men (MSM) and transgenders (TGs) in Mumbai. METHODS: Participants were enrolled from two clinics in Mumbai. They completed an interviewer-administered questionnaire and were evaluated for STIs and HIV infection. RESULTS: A total of 150 participants, 122 MSM and 28 TGs were evaluated; 17% of MSM and 68% of the TGs were HIV infected. HIV infection in MSM was associated with serological positivity for HSV2 IgG [adjusted odds ratio (aOR), 95% confidence interval (CI): 9.0 (2.2-36.9)], a positive Treponema pallidum hemagglutination assay (TPHA) [aOR (95% CI): 6.0 (1.5-24.0)], greater than five acts of receptive anal sex in the past six months [aOR (95% CI): 4.3 (1.2-15.0)] and per category increase in age (18-24 yrs, 25-29 yrs, > 30 yrs) [aOR (95% CI): 3.1 (1.3-7.1)] in multivariate analysis. Consistent condom use during receptive anal sex in the past six months was low (27%). Many MSM were married (22%) or had sex with females and may act as a 'bridge population'. HIV infection in TGs was associated with a positive TPHA [OR (95% CI): 9.8 (1.5-63.9)] and HSV 2 IgG [OR (95% CI): 6.7 (1.1-40.4)] in univariate analysis. CONCLUSION: Prior STIs were strongly associated with HIV infection in MSM and TGs. These groups should be the focus of intensive intervention programs aimed at STI screening and treatment, reduction of risky sexual behavior and promotion of HIV counseling and testing.

The changing image of the hero in Hindi films.

Beneath the surface of the Bollywood cinema is a percolating gay culture trying to break free, waiting for the moment to emerge from subtext into text. For now, in what we might now call a period of transition, the Bollywood hero has been (particularly in the past three decades) the focus of increased homoeroticization, with his body becoming a spectacle at every turn. Unfortunately, what has facilitated this is a veiled (and sometimes not-so-veiled) form of misogyny, in which the heroine's role is minimized such that, rather than another filmic character falling in love with the hero, the audience itself is invited to see the macho (and perhaps narcissistic) hero as unattached and therefore available for homoerotic desire.

Reaching out. India: beyond the monsoon.

PIP: Bombay has a teeming and mobile, yet comparatively invisible, population of approximately 600 male prostitutes who ply their trade on and from Chowpatty beach. These men, aged 12-50 years, masturbate and/or perform fellatio for male clients in exchange for financial reward ranging from US$0.75 - $2. Unprotected penetrative anal sex also takes place, though it is generally not acknowledged by the prostitutes. These men and their clients are therefore in great need of information and access to condoms for the practice of safer sex. Both self- and social denial of the practice of anal sex must, however, be overcome. To this end, Bombay Dost, the 1st openly gay organization in India, distributes condoms and information to gay men on railway platforms, and in public toilets and parks. These efforts are unfortunately not welcomed by the prostitutes of Chowpatty beach for fear that acceptance of the intervention would imply their practice of anal sex and a more substantial degree of homosexuality within their subpopulation. Recruiting and training men as health educators from their ranks may be a viable, effective promotion approach. Any interventions must also understand the friendly and supportive, yet competitive, relationships within this community.^ieng