A rapid situation and response assessment of the female regular sex partners of male drug users in South Asia: factors associated with condom use during the last sexual intercourse.

OBJECTIVES: We carried out a rapid assessment among the female regular sex partners of drug users/injecting drug users recruited from Bangladesh, Bhutan, India, Nepal and Sri Lanka with the objective of designing appropriate responses targeting them. We examined the correlates of condom use among them. METHODS: Data was collected from 4612 female regular sex partners recruited by different NGO partners spread across the five countries in the region. We carried out univariate and multivariate logistic regression analysis to determine variables associated with condom use during their last sexual intercourse. RESULTS: Of the total sample, 22% admitted to using drugs ever in their life and 21% reported condom use during the last sexual act. A fourth of the participants have not heard of HIV/AIDS and only 17% have been tested for HIV. In a multivariate model, women engaged in sex work, from Nepal, used drugs before last sexual intercourse, heard of HIV/AIDS, ever used drugs and approached by someone with information on HIV were likely to have used condoms during the last sexual intercourse about twice or more: (AOR=4, 95% CI: 3, 5.3; AOR=3.4, 95% CI: 2.4, 4.9; AOR=2.5, 95% CI: 1.9, 3.3; AOR=2.1, 95% CI: 1.5, 3; AOR=2, 95% CI: 1.5, 2.6; AOR=1.7, 95% CI: 1.4, 2 respectively). Condom use was negatively associated with women with a single sex partner (AOR=0.6, 95% CI: 0.5, 0.7). CONCLUSIONS: Condom use is low among the female regular sex partners and is primarily associated with women exhibiting risky practices. Apart from sustaining and expanding HIV prevention programmes that aim to increase the HIV/AIDS related knowledge and scale-up HIV testing among the drug users and their regular sex partners, there is an urgent need to reach out to the women in stable marital relationship with drug users. This study has demonstrated that it is feasible to access this population and the priority is to design and implement individual, couple and group level interventions that ensure consistent condom use with their primary partners.