HIV TESTING AND COUNSELING AMONG MEN ATTENDING SEXUALLY-TRANSMITTED DISEASE CLINICS IN PUNE, INDIA - CHANGES IN CONDOM USE AND SEXUAL-BEHAVIOR OVER TIME

Objectives: To describe changes in sexual behavior and condom use amon g male heterosexual clients at two public sexually transmitted disease (STD) clinics in Pune, after exposure to HIV testing, counseling, and condom promotion. Design: From 13 May 1993 to 11 April 1997, 6819 het erosexual men were screened for HIV infection as part of the HIV Netwo rk for Prevention Trials study. A total of 1628 HIV-seronegative men a greed to return at 3-month intervals for repeated HIV counseling and t esting. Counseling at each visit focused on reinforcing messages of mo nogamy, condom use with sexual partners,and provision of government-pr ovided condoms. Methods: Data were collected at baseline an at subsequ ent 3-month intervals, on demographics, previous STD diagnoses, medica l history, sexual behavior, knowledge of HIV/AIDS, and practices relat ed to the prevention of HIV. STD were assessed through physical examin ation and specimen collection, and blood was drawn for HIV-1 and HIV-2 antibody testing. Results: The level of consistent condom use with se x workers increased proportionately with follow-up time: at 6 months m en were 2.8 times more likely to consistently use condoms (P < 0.001), at 18 months they were 3.6 times more likely (P < 0.001), and after 2 4 months they were 4.7 times more likely to be using condoms every tim e. The risk of HIV seroconversion in men was lowest for those who repo rted 'always' using condoms (adjusted relative risk, 0.68; P = 0.42; H IV incidence, 4.0) compared with those who reported 'never' using a co ndom (adjusted relative risk, 2.94; P < 0.001; HIV incidence, 14.0). C onclusion: Ongoing counseling and testing was positively associated wi th risk-reduction behaviors amongst a large proportion of men recruite d for this study. (C) 1998 Lippincott Williams & Wilkins.