Perception of Power Dynamics and Risky Sexual Behavior in Indian Men

• Main Author: Haley, Amber
• Format: Others
• Published: VCU Scholars Compass 2009
• Subjects: Epidemiology; Medicine and Health Sciences; Public Health
• Online Access: http://scholarscompass.vcu.edu/etd/1809; http://scholarscompass.vcu.edu/cgi/viewcontent.cgi?article=2808&context=etd

Background: Women account for about a third of all new cases of HIV in India. Based on research examining trends of HIV infection in women, male perception and behaviors have emerged as strong potential risk factors. However, there has been limited research examining the relationship between male’s attitudes toward women and their sexual risk-taking behaviors. This study examined the degree to which men’s beliefs about power dynamics in heterosexual relationships are related to risky sexual behaviors in Indian men. Methods: Data on Indian men from the 2005-2006 National Family Health Survey (NFHS-3) was analyzed (N= 44,727). The outcome variable, risky sexual behavior, was created using a composite variables characterized by multiple sexual partners, pay for sex, sexual relationships with individuals other than wife or girlfriend, or a history of sexually transmitted diseases in the past 12 months. Men’s beliefs about power dynamics in heterosexual relationships was examined using the following predictor variables: a) women’s role in decision-making, b) acceptability of domestic violence, and c) acceptability of refusing sex. Age, marital status, standard of living, education, religion, region, knowledge of HIV, alcohol use, and family history of domestic violence were examined as covariates. Multiple logistic regression was used to examine the association. Results: Men who believed that women should rarely OR=1.73 [CI 1.36, 2.20] or sometimes be involved with decision-making OR=1.33 [CI 1.13, 1.56] were more likely to report risky sexual behavior as compared to those who believed that women should be involved most of the time. Additionally, men who had favorable attitude towards perpetrating domestic violence were 56% more likely to report risky sexual behavior OR=1.56 [CI 1.37, 1.79]. Similarly, men who believed that it was never acceptable for a woman to refuse sex were 43% less likely to engage in risky sex OR=1.43 [CI 1.27, 1.69]. Conclusion: Men who expressed a preference for male-dominant decision making, acceptance of violence towards women, or the belief that women should not have autonomy in sexual matters are more likely to engage in behaviors that put themselves and their female partners at risk for HIV infection. Comprehensive HIV prevention programs should address power dynamics as a component of HIV risk.