Background

HIV rates are increasing dramatically in India. Estimates suggest that over 5 million adults are infected, and AIDS is expected to emerge as the most significant cause of adult mortality in the next decade. The state of Maharashtra has among the highest HIV rates in the country, concentrated in Mumbai and Pune. Migrant populations moving in and out of Mumbai increase the potential for disease transmission into the general population, while also changing the social context of drinking in Mumbai. Alcohol use is widely associated with sexual risks, STDs, and social harm including early sexual debut, multiple partners, inconsistent condom use, lack of protection during intercourse, unwanted pregnancies, and sexual violence. As HIV/AIDS infection rates increase particularly in Mumbai, more research is needed to analyze how alcohol may influence the spread of the disease.

Through a training grant from the World AIDS Foundation, ICR began collaborating with IIPS to increase IIPS’s qualitative research capacity for studies of substance use and reproductive health. A pilot study, part of the training grant, identified the need for further study of the social epidemiology of alcohol use, and its role in promoting risky sexual behavior that can lead to HIV transmission. ICR is now conducting RISHTA: Male Sexual Health in India, which is an intervention study that works to engage males in reproductive health education, sexual risk and early HIV/STD treatment in three urban communities in Mumbai, India. A corresponding supplement works with married women who are at increased HIV and sexual violence risk due to their husbands’ alcohol and sexual related risk. Alcohol, Sexual Risk and HIV Prevention in Mumbai, India focuses on communities characterized by long term and recent migration from rural areas of the western, southern and northern states, and the factors that promote male social drinking and link alcohol and sexuality in the media, among male drinkers, and between male drinkers and their sexual partners. The study has broad applications for India, since alcohol is being produced and widely marketed and serves a number of social, psychological and physiological functions across classes.