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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Gender-Based Power and Couples' HIV Risk in Uttar Pradesh and Uttarakhand, North India</title>
<author><name sortKey="Agrawal, Alpna" sort="Agrawal, Alpna" uniqKey="Agrawal A" first="Alpna" last="Agrawal">Alpna Agrawal</name>
<affiliation><nlm:aff id="A1">School of Medicine, University of Texas Health Science Center at Houston</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Bloom, Shelah S" sort="Bloom, Shelah S" uniqKey="Bloom S" first="Shelah S." last="Bloom">Shelah S. Bloom</name>
<affiliation><nlm:aff id="A2">Department of Maternal and Child Health, University of North Carolina at Chapel Hill</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A4">Carolina Population Center, University of North Carolina at Chapel Hill</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Suchindran, Chirayath" sort="Suchindran, Chirayath" uniqKey="Suchindran C" first="Chirayath" last="Suchindran">Chirayath Suchindran</name>
<affiliation><nlm:aff id="A3">Department of Biostatistics, University of North Carolina at Chapel Hill</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A4">Carolina Population Center, University of North Carolina at Chapel Hill</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Curtis, Sian" sort="Curtis, Sian" uniqKey="Curtis S" first="Sian" last="Curtis">Sian Curtis</name>
<affiliation><nlm:aff id="A2">Department of Maternal and Child Health, University of North Carolina at Chapel Hill</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A4">Carolina Population Center, University of North Carolina at Chapel Hill</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Angeles, Gustavo" sort="Angeles, Gustavo" uniqKey="Angeles G" first="Gustavo" last="Angeles">Gustavo Angeles</name>
<affiliation><nlm:aff id="A2">Department of Maternal and Child Health, University of North Carolina at Chapel Hill</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A4">Carolina Population Center, University of North Carolina at Chapel Hill</nlm:aff>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">25565347</idno>
<idno type="pmc">4399762</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4399762</idno>
<idno type="RBID">PMC:4399762</idno>
<idno type="doi">10.1363/4019614</idno>
<date when="2014">2014</date>
<idno type="wicri:Area/Pmc/Corpus">001A71</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001A71</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Gender-Based Power and Couples' HIV Risk in Uttar Pradesh and Uttarakhand, North India</title>
<author><name sortKey="Agrawal, Alpna" sort="Agrawal, Alpna" uniqKey="Agrawal A" first="Alpna" last="Agrawal">Alpna Agrawal</name>
<affiliation><nlm:aff id="A1">School of Medicine, University of Texas Health Science Center at Houston</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Bloom, Shelah S" sort="Bloom, Shelah S" uniqKey="Bloom S" first="Shelah S." last="Bloom">Shelah S. Bloom</name>
<affiliation><nlm:aff id="A2">Department of Maternal and Child Health, University of North Carolina at Chapel Hill</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A4">Carolina Population Center, University of North Carolina at Chapel Hill</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Suchindran, Chirayath" sort="Suchindran, Chirayath" uniqKey="Suchindran C" first="Chirayath" last="Suchindran">Chirayath Suchindran</name>
<affiliation><nlm:aff id="A3">Department of Biostatistics, University of North Carolina at Chapel Hill</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A4">Carolina Population Center, University of North Carolina at Chapel Hill</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Curtis, Sian" sort="Curtis, Sian" uniqKey="Curtis S" first="Sian" last="Curtis">Sian Curtis</name>
<affiliation><nlm:aff id="A2">Department of Maternal and Child Health, University of North Carolina at Chapel Hill</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A4">Carolina Population Center, University of North Carolina at Chapel Hill</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Angeles, Gustavo" sort="Angeles, Gustavo" uniqKey="Angeles G" first="Gustavo" last="Angeles">Gustavo Angeles</name>
<affiliation><nlm:aff id="A2">Department of Maternal and Child Health, University of North Carolina at Chapel Hill</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A4">Carolina Population Center, University of North Carolina at Chapel Hill</nlm:aff>
</affiliation>
</author>
</analytic>
<series><title level="j">International perspectives on sexual and reproductive health</title>
<idno type="ISSN">1944-0391</idno>
<idno type="eISSN">1944-0405</idno>
<imprint><date when="2014">2014</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Context</title>
<p id="P1">Gender inequality is a long-recognized driver of the HIV epidemic. However, few studies have investigated the association between gender-based power and HIV risk in India, which has the world's third largest HIV epidemic.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">Population-based data collected in 2003 from 3,385 couples residing in Uttar Pradesh and Uttarakhand, North India, were used to examine associations between gender-based power (wife's autonomy and husband's inequitable gender attitudes) and indicators of couples' HIV risk (whether the husband had had premarital sex with someone other than his eventual spouse, extramarital sex in the past year or STI symptoms in the past year). Structural equation modeling was used to create composite variables for the gender-based power measures and test their associations with HIV risk measures.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">Twenty-four percent of husbands had had premarital sex, 7% had had extramarital sex in the past year and 6% had had STI symptoms in the past year. Structural equation models indicated that wives who reported higher levels of autonomy were less likely than other wives to have husbands who had had extramarital sex in the past year (direct association) and STI symptoms in the past year (indirect association). Moreover, husbands who endorsed more inequitable gender attitudes were more likely than others to report having had premarital sex with someone other than their spouse, which in turn was associated with having had extramarital sex and STI symptoms in the past year.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">If the associations identified in this study reflect a causal relationship between gender-based power and HIV risk behavior, then HIV prevention programs that successfully address inequitable gender roles may reduce HIV risks in North India.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">101504990</journal-id>
<journal-id journal-id-type="pubmed-jr-id">35828</journal-id>
<journal-id journal-id-type="nlm-ta">Int Perspect Sex Reprod Health</journal-id>
<journal-id journal-id-type="iso-abbrev">Int Perspect Sex Reprod Health</journal-id>
<journal-title-group><journal-title>International perspectives on sexual and reproductive health</journal-title>
</journal-title-group>
<issn pub-type="ppub">1944-0391</issn>
<issn pub-type="epub">1944-0405</issn>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">25565347</article-id>
<article-id pub-id-type="pmc">4399762</article-id>
<article-id pub-id-type="doi">10.1363/4019614</article-id>
<article-id pub-id-type="manuscript">NIHMS666391</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Gender-Based Power and Couples' HIV Risk in Uttar Pradesh and Uttarakhand, North India</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Agrawal</surname>
<given-names>Alpna</given-names>
</name>
<degrees>Ph.D.</degrees>
<role>medical student</role>
<email>alpna.a.agrawal@uth.tmc.edu</email>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Bloom</surname>
<given-names>Shelah S.</given-names>
</name>
<degrees>Sc.D.</degrees>
<role>research assistant professor</role>
<xref ref-type="aff" rid="A2">2</xref>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Suchindran</surname>
<given-names>Chirayath</given-names>
</name>
<degrees>Ph.D.</degrees>
<role>professor</role>
<xref ref-type="aff" rid="A3">3</xref>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Curtis</surname>
<given-names>Sian</given-names>
</name>
<degrees>Ph.D.</degrees>
<role>research assistant professor</role>
<xref ref-type="aff" rid="A2">2</xref>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Angeles</surname>
<given-names>Gustavo</given-names>
</name>
<degrees>Ph.D.</degrees>
<role>research assistant professor</role>
<xref ref-type="aff" rid="A2">2</xref>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
</contrib-group>
<aff id="A1"><label>1</label>
School of Medicine, University of Texas Health Science Center at Houston</aff>
<aff id="A2"><label>2</label>
Department of Maternal and Child Health, University of North Carolina at Chapel Hill</aff>
<aff id="A3"><label>3</label>
Department of Biostatistics, University of North Carolina at Chapel Hill</aff>
<aff id="A4"><label>4</label>
Carolina Population Center, University of North Carolina at Chapel Hill</aff>
<pub-date pub-type="nihms-submitted"><day>25</day>
<month>2</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="ppub"><month>12</month>
<year>2014</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>01</day>
<month>12</month>
<year>2015</year>
</pub-date>
<volume>40</volume>
<issue>4</issue>
<fpage>196</fpage>
<lpage>205</lpage>
<pmc-comment>elocation-id from pubmed: 10.1363/4019614</pmc-comment>
<abstract><sec id="S1"><title>Context</title>
<p id="P1">Gender inequality is a long-recognized driver of the HIV epidemic. However, few studies have investigated the association between gender-based power and HIV risk in India, which has the world's third largest HIV epidemic.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">Population-based data collected in 2003 from 3,385 couples residing in Uttar Pradesh and Uttarakhand, North India, were used to examine associations between gender-based power (wife's autonomy and husband's inequitable gender attitudes) and indicators of couples' HIV risk (whether the husband had had premarital sex with someone other than his eventual spouse, extramarital sex in the past year or STI symptoms in the past year). Structural equation modeling was used to create composite variables for the gender-based power measures and test their associations with HIV risk measures.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">Twenty-four percent of husbands had had premarital sex, 7% had had extramarital sex in the past year and 6% had had STI symptoms in the past year. Structural equation models indicated that wives who reported higher levels of autonomy were less likely than other wives to have husbands who had had extramarital sex in the past year (direct association) and STI symptoms in the past year (indirect association). Moreover, husbands who endorsed more inequitable gender attitudes were more likely than others to report having had premarital sex with someone other than their spouse, which in turn was associated with having had extramarital sex and STI symptoms in the past year.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">If the associations identified in this study reflect a causal relationship between gender-based power and HIV risk behavior, then HIV prevention programs that successfully address inequitable gender roles may reduce HIV risks in North India.</p>
</sec>
</abstract>
</article-meta>
</front>
</pmc>
</record>
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