Population Council Research that makes a difference

XVIII International AIDS Conference (AIDS 2010)
18–23 July 2010

Abstract

"Understanding sexual behaviors outside marriage in Pakistan"
Ali Mohammad Mir, Abdul Wajid, Mumraiz Khan, and S. Javed

Background
Pakistan currently has low levels of HIV infection with an overall prevalence of less than 0.1%. However the recent emergence of a concentrated HIV epidemic in the high-risk groups places the country at an elevated risk of a generalized epidemic.

Methods
2,400 urban men aged 16–45 years were interviewed in a survey conducted in 2007 in six cities of Pakistan. The purpose of the study was to identify sexual behaviors and prevalence of six common sexually transmitted infections. Men admitting to recent sexual activity outside marriage in the last three months (n=243) were interviewed in-depth using an open-ended questionnaire. The interviews were carried out in all six cities and tried to elicit in detail sexual behaviors in terms of orientation, types of partners, reasons for preference, accessing and purchasing sex, and concepts of masculinity and vulnerability. Interviews were transcribed verbatim. Codes and themes were identified to analyze the data.

Results
A majority of the respondents were engaging in high-risk sexual activity by having multiple sexual partners that included men and women, as well as noncommercial sexual partners. Preference for men was not based on orientation but rather availability and affordability. Unpaid sex was quite common, and nonfinancial transactions such as giving gifts or favors were also reported. Mobile phones were mentioned as a major source for finding sexual partners. Group sex was not common. Most respondents knew of the risk they were exposing themselves to, but use of condoms was still low as it was considered as inhibiting pleasure.

Conclusion
Men indulging in high-risk sexual behaviors can in the long term serve as a bridge for transmitting the HIV infection into the general population. Future prevention campaigns must focus on mitigating risky behaviors and focus on individual sense of vulnerability.

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