An integrated approach to the determinants of HIV contagion in India
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The AIDS explosion in India continues to be a serious concern (Irwin, Millen and Fallows 2003). Given the magnitude of AIDS cases in one of the most densely populated nations in the world, as well as the established gendered conduit to the infection, this dissertation studies HIV contagion in India by answering the following three research questions: (i) What are the factors that influence HIV infection in India? (ii) How does gender intersect with other variables to influence HIV infection? (iii) What are the similarities and differences between men and women in determinants of HIV contagion in India? Built upon existing models in the literature, this study proposes an integrated theoretical model to explain HIV infection in India. It argues that HIV contagion in India is determined by demographic determinants, socioeconomic status, behavioral factors, social-support, HIV awareness, and interaction between gender and some of the aforementioned factors. The data for this study came from the National Family Health Survey-2, collected in 2005–06, which was a nationally representative sample consisting of approximately 198,754 respondents representing all states and regions of India. The sample included both men and women between the ages of 15 to 54. After filtering the sample in terms of HIV testing, the sample size was reduced to 105,657 individuals. The dependent variable for this analysis is HIV status, a binary variable indicating HIV positive or negative status as derived from the blood test results. The predictors in the study include age, gender, region of the country, religious affiliation, urban/nonurban location, marital status, literacy, wealth index, work status, scheduled caste or tribe affiliation, number of sex partners, condom usage, domestic violence, availing paid sex, attitudes towards individuals who live with AIDS, and basic knowledge of AIDS and other STDs. Logistic regression is the main method of data analysis. Major findings include: (i) Gender, age, residence, region, Islamic affiliation, being divorced and widowed, literacy, work status, number of sex partners, and basic AIDS awareness significantly predict HIV in India in the pooled sample of men and women. (ii) Gender interacts with age, marital status (not married and widowed), number of sex partners, and AIDS awareness in impacting HIV differently for men and women. (iii) There are some distinct similarities and differences between men and women in how HIV is contracted. In addition, exposure to physical violence in a domestic setting is a special conduit to the HIV infection for women, but paid sex does not have a significant effect for men. Overall, this research provides a comprehensive approach to analyzing HIV contagion in India and may help understand the determination process of HIV infection in other parts of the world. The findings of this study may help the development of policies or programs that can control HIV and AIDS in India.