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Introduction: Role of vaginal sex in heterosexual transmission of HIV has been investigated but that of heterosexual anal sex (HAS) is not fully understood. This paper examines practice of HAS among Female Sex Workers (FSWs) and its correlates in India where the HIV epidemic is being primarily driven by core groups like FSWs. Methods: Data for this paper are drawn from Round I survey of 9667 FSWs in the Integrated Biological and Behavioral Assessment (IBBA) from 23 districts of 4 high HIV prevalent states of India. Bivariate and multivariate analysis identified factors associated with HAS. Results: Ever having anal sex was reported by 11.9% FSWs (95% CI: 11.3%–12.6%). Typology (AOR 2.20, 95% CI 1.64–2.95) and literacy (AOR 1.28, 95% CI 1.10–1.49) were positively associated with practice of HAS. Longer duration in sex trade (AOR 1.69, 95% CI 1.44–1.99), entertaining larger number of clients the previous week (AOR 1.78, 95% CI 1.47–2.15), alcohol consumption (AOR 1.21, 95% CI 1.03–1.42) and inability to negotiate condom use (AOR 1.53, 95% CI 1.28–1.83) were also correlated with HAS. Self-risk perception for HIV (AOR 1.46, 95% CI 1.25–1.71) did not impede HAS. Although symptoms of sexually transmitted infections (STIs) in the last 12 months were associated with anal sex (AOR 1.39, 95% CI 1.13–1.72) there was no significant association between laboratory confirmed HIV and other STIs with HAS. Conclusion: Practice of HAS by FSWs might significantly contribute to HIV transmission in India. This study also shows that despite self-risk perception for HIV, even literate FSWs with longer duration in sex work report HAS. General messages on condom use may not influence safe HAS. FSWs need to be targeted with specific messages on HIV transmission during anal sex. Women controlled prevention methods, such as rectal microbicides and vaginal microbicides are needed. [ABSTRACT FROM AUTHOR]

Deletion in chemokine receptor CCR5 gene is reported to prevent development of tubal pathology among Dutch Caucasian C. trachomatisinfected women. Hence, a pilot study was undertaken, to evaluate the involvement of CCR5 gene in tubal pathology among Indian women with or without Chlamydia infection. Three hundred women with or without Chlamydia infection and with differentreproductive manifestations were screened for CCR5 gene using a standardized PCR. Only 6 C. trachomatis infected women without tubal block had heterozygous deletion for this gene. The rest had wild type CCR5 gene, that includes fertile women infected and non infected; infertile women infected and non infected with and without tubal block as well as infected women with history of recurrent spontaneous abortions. The study indicates no role of heterozygous CCR5 D32 gene deletion in prevention of tubal pathology in Chlamydiainfected Indian women. Only 2% heterozygous deletion in CCR5 gene is observed in the studied population. [ABSTRACT FROM AUTHOR]