Psychosocial Correlates of HIV-related Sexual Risk Factors among Male Clients in Southern India

Psychosocial theories suggest that individuals’ behavior is a reflection of their intention and ability to carry out a typical behavior. This study proposes to examine the psychosocial correlates of HIV-related sexual risk factor among male clients of female sex workers (FSWs). Data were used from a cross-sectional survey, collected using two-stage sampling, conducted among 2382 clients of FSWs in four states of India in November 2008. Clients were males who had engaged in paid sex with a FSW in the 12 months preceding the survey. Multiple logistic regression models were fitted to assess the effect of different psychosocial measure on HIV-related sexual risk factors: multiple sexual partners, inconsistent condom use and self reported sexually transmitted infections (STIs). The odds of inconsistent condom use with FSWs was more among clients with low self-efficacy (Adjusted Odds Ratio (AOR): 2.2, 95% Confidence Interval (CI): 1.7-3.0), low perceived social support (AOR: 1.8, 95% CI: 1.3-2.6), low perceived personal norms (AOR: 1.7, 95% CI: 1.2-2.3) and low perceived access to condoms (AOR: 1.5, 95% CI: 1.1-2.0) than others. Similarly, experience of STI-related symptoms in the last 12 months was associated with low self-efficacy, low perceived social support and low perceived vulnerability. Findings highlight strong influence of psychosocial attitudes on HIV-related sexual risk factors among male clients of FSWs, suggesting the need for designing HIV prevention strategies to address psychosocial issues like self-efficacy, vulnerability and social support.