Reproductive Health | |
Exploring urban male non-marital sexual behaviours in Pakistan | |
Irfan Masood1  Mumraiz Khan1  Stephen Pearson2  Abdul Wajid1  Ali M Mir1  | |
[1] Population Council, No. 7, Street 62, F-6/3, Islamabad, Pakistan;Leeds Institute of Health Sciences, University of Leeds, Room G23, Charles Thackrah Building, 101 Clarendon Road, Leeds, LS2 9LJ, UK | |
关键词: Pakistan; Urban; Men; Behaviours; | |
Others : 811662 DOI : 10.1186/1742-4755-10-22 |
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received in 2013-02-05, accepted in 2013-03-27, 发布年份 2013 | |
【 摘 要 】
Background
In Pakistan, sexual practices outside marriage are proscribed by law. We aimed to assess the range and magnitude of non-marital sexual behaviours of urban men, focusing on men having sex with men.
Methods
In this cross sectional survey undertaken in six cities of Pakistan, we interviewed 2400 men aged 16–45 years selected through a multistage systematic sampling design. Sexual behaviours were assessed through a structured questionnaire. Multivariable analysis was used to identify association between various individual level characteristics and probability of engaging in sexual activities involving men.
Results
Nearly one-third (29 percent) reported having had non-marital sex in their lifetime. Of these men 16 percent reported premarital sex, while 11 percent reported engaging in both pre- and extramarital sex. Only two percent reported exclusive extramarital sex. In total 211 respondents, 9 percent reported ever having had sexual relations with men. While 62 respondents, 2.6 percent reported exclusive sex with males. Factors that were significantly associated with MSM behaviours were being less than 27 years (adjusted OR 5.4, 95% CI 3.8–7.7, p < 0.000), less than 10 years of schooling (adjusted OR 2.1, 95% CI 1.4–3.2, p < 0.000), being unemployed (adjusted OR 2.7, 95% CI 1.6–4.3, p < 0.000), being exposed to pornographic materials (adjusted OR 4.8, 95% CI 3.0–7.7, p < 0.000) and being a migrant (adjusted OR 2.1, 95% CI 1.3–3.4, p < 0.002). Factors significantly associated with exclusive homosexual behaviour were having sexual debut at a younger age i.e. 16–22 years (adjusted OR 12.5, 95% CI: 3.8–40.7, p < 0.000), being unemployed (adjusted OR 8.8, 95% CI: 3.0–26.0, p = 0.000), having had exposure to pornographic materials (adjusted OR 3.3, 95% CI: 1.5–7.2, p = 0.002).
Conclusions
To prevent the spread of STI’s in Pakistan, preventive interventions should focus on reaching out to young uneducated men offering them with appropriate counselling and skills to adopt “safe sex practices” through workplace orientation sessions; while for youth in schools, life skills education be included in the curriculum. Through public-private partnership stigmatised groups should be reached through established community networks and provided with information on accessing voluntary counseling and treatment centres.
【 授权许可】
2013 Mir et al.; licensee BioMed Central Ltd.
【 预 览 】
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20140709070801405.pdf | 531KB | download | |
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Figure 3. | 28KB | Image | download |
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Figure 1. | 16KB | Image | download |
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【 参考文献 】
- [1]2012 World Population Data Sheet. Washington, DC 20009 USA; 2012. [Population Reference Bureau]
- [2]National Aids Control Program: ART Center Progress Report. Islamabad: Government of Pakistan; 2009. [National Aids Control Program]
- [3]UNGASS: Pakistan Report: Progress report on the Declaration of Commitment on HIV/AIDS for the United Nations General Assembly Special Session on HIV/AIDS. Islamabad: National Aids Control Program, Ministry of Health, Government of Pakistan; 2010.
- [4]National Study of Reproductive Tract and Sexually Transmitted Infections: Survey of High Risk Groups in Lahore and Karachi. National AIDS Control Program Pakistan, FHI and DFID; 2005. http://gametlibrary.worldbank.org/FILES/681_National%20STI%20survey%20Pakistan%202004.pdf webcite
- [5]Country Progress Report Pakistan: Global AIDS Response Progress Report. Islamabad: National AIDS Control Program, Ministry of Inter-Provincial Coordination, Government of Pakistan; 2011.
- [6]UNAIDS: Global Aids Report. 2008. http://www.unaids.org/en/dataanalysis/epidemiology/2008reportontheglobalaidsepidemic/ webcite
- [7]Griensven FV, Lind VD, Wijngaarden JW, Baral S, Grulich A: The global epidemic of HIV infection among men who have sex with men. Curr Opin HIV AIDS 2009, 4:300-307.
- [8]UNAIDS: Terminology guidelines. 2011. http://www.unaids.org/en/media/unaids/contentassets/documents/unaidspublication/2011/JC2118_terminology-guidelines_en.pdf webcite
- [9]Mir AM, Wajid A, Reichenbach L, Khan M: STI prevalence and associated factors among urban men in Pakistan. Sex Transm Infect 2009, 85:199-200.
- [10]Mir AM, Reichenbach L, Wajid A, Khan M: Study of Sexually Transmitted Infections Among Urban Men in Pakistan: Identifying the Bridging Population. Islamabad: Population Council; 2008.
- [11]Seed J, Allen S, Mertens T, Hudes E, Serufilira A, Carael M: Male circumcision, sexually transmitted disease, and risk of HIV. J Acquir Immune Defic Syndr Hum Retrovirol 1995, 8:83-90.
- [12]Amon J, Brown T, Hogle J: Behavioural Surveillance Surveys BSS – Guidelines for repeated behavioural surveys in population at risk of HIV. Impact and DFID: FHI; 2000.
- [13]Mishra V, Vaessen M, Boerma JT, Arnold F, Way BB, Hong ACR, Sangha J: HIV testing in national population-based surveys: experience from the demographic and health surveys. Bull World Health Organ 2006, 84(7):537-545.
- [14]National Institute of Population Studies and Macro International Inc: Pakistan Demographic and Health Survey (PDHS) 1990/91. Islamabad; 1992.
- [15]Rehan N, Chaudhary I, Shah SK: Socio-sexual behaviour of hijras of Lahore. J Pak Med Assoc 2009, 59(6):380-384.
- [16]Collumbien M, Hawkes S: Missing men’s messages: does the reproductive health approach respond to men’s sexual health needs? Cult Health Sex 2000, 2(2):135-150.
- [17]Faisel A, Cleland J: Migrant men: a priority for HIV control in Pakistan? Sex Transm Infect 2006, 82:307-310.
- [18]Ministere de la Sante au Maroc GTZ: Enquete ’Connaissances, attitudes, et pratiques des jeunesconcernant les IST et le SIDA’ 2007 (French): A survey on the knowledge, attitude and behaviour of youth in relation to STIs and AIDS. Rabat, Morocco; 2007.
- [19]SNAP/UNICEF/UNAIDS: Baseline study on knowledge, attitudes, andpractices on sexual behaviours and HIV/AIDS prevention amongst youngpeople in selected states in Sudan. Khartoum, Sudan: Projects and Research Department; 2005. [HIV/AIDS KAPB Report]
- [20]UNAIDS: Men who have sex with men; The missing Piece. 2007. http://www.wisdomofwhores.com/wp-content/uploads/2010/12/MSM-the-missing-piece-Aug-2007.pdf webcite
- [21]UNAIDS: Aids Epidemic Update. 2006. http://data.unaids.org/pub/epireport/2006/2006_epiupdate_en.pdf webcite
- [22]Bokhari A, Nizamani NM, Jackson DJ: HIV risk in Karachi and Lahore, Pakistan: an emerging epidemic in injecting and commercial sex networks. Int J STD AIDS 2007, 18:486-492.
- [23]Hyder AA, Khan OA: HIV/AIDS in Pakistan: the context and magnitude of an emerging threat. J Epidemiol Community Health 1998, 52:579-585.
- [24]Khan S, Khan OA: The trouble with MSM. Am J Public Health 2006, 96:765-766.
- [25]Dandona L, Dandona R, Gutierrez JP, Kumar GA, McPherson S: Sex behaviour of men who have sex with men and risk of HIV in Andhra Pradesh, India. AIDS 2005, 19(6):611-619.
- [26]Gibson DR, Han L, Guo Y: High levels of unprotected sex with men and women among men who have sex with men: a potential bridge of HIV transmission in Beijing, China. AIDS Educ Prev 2004, 16(1):19-30.
- [27]Khan OA, Hyder AA: HIV/AIDS among men who have sex with men in Pakistan. Sex Health Exch 1998, 2:12-13. 15
- [28]Agha S: Sexual behaviour among truck drivers in Pakistan. Cult Health Sex 2002, 4:191-206.
- [29]UNAIDS: Response Survey (unpublished), Bangkok. 2006.
- [30]McIntyre JA: Sex, pregnancy, hormones, and HIV. Lancet 2005, 366:1141-1142.
- [31]Lau JTF, Thomas J: Risk behaviours of Hong Kong male residents travelling to mainland China: a potential bridge population for HIV infection. AIDS Care 2001, 13(1):71-81.
- [32]Napper LE, Fisher DG, Reynolds GL, Johnson ME: HIV risk behaviour self-report reliability at different recall periods. AIDS Behav 2010, 14:152-161.
- [33]Cleland J, Boerma JT, Carael M, Weir SS: Monitoring sexual behaviour in general populations: a synthesis of lessons of the past decade. Sex Transm Infect 2004, 80(2):ii1-ii7.