4%), Puducherry (1.2%), Gujarat (3%), and Tamil Nadu selleck chemicals (2.41%) (Table 1). Almost all the group IV states have recorded lower levels (<5%) of HIV prevalence among the MSM population. Table 1 Human immunodeficiency virus (HIV)/sexually transmitted infection (STI) prevalence among men who have sex with men (MSM) in India Overall, HIV prevalence among MSM has decreased at the national level, from 8.5% in 2003 to 4.43% in 2010–11 (Figure 1). Almost all of the group I, II, and III states have shown a declining trend in HIV prevalence, although the proportion has been varied across the states. However, the low prevalence states of Punjab (0.4% in 2007 to 2.1% in 2010–11)

and Bihar (0% in 2007 to 4.2% in 2010–11) have shown rising trends since 2007 (Figure 2). The declining trend in HIV prevalence also correlated with the declining trend in the prevalence of STIs (syphilis, NG, and CT) in almost all states in group I, II, and III (Table 1). The reported proportion

of MSM suffering from at least one STI symptom also declined in all the states in 2009 compared with 2006. Figure 1 Trend of mean human immunodeficiency virus prevalence (%) among men who have sex with men in India. Figure 2 State-wise trend of human immunodeficiency virus (HIV) prevalence (%) of men who have sex with men from consistent HIV surveillance sites in India. HIV/AIDS knowledge and sexual behavior of MSM Knowledge about HIV transmission and prevention among MSM has varied significantly between different studies and between states (Table 2). According to the data from the BSS conducted in 2009, MSM in some states have shown to have higher and more accurate knowledge of HIV and its transmission and prevention than the MSM in other states.

For instance, in group I states, a greater proportion of MSM from the state of Tamil Nadu (32%) reported comprehensive and correct knowledge about HIV, as compared with MSM in Karnataka (22%) or Andhra Pradesh (57%), as per BSS 2009. The proportion of MSM who reported comprehensive correct knowledge about HIV in Manipur from the group II states is 30.3%. In group IV states, 21% of MSM from Uttar Pradesh report having correct knowledge about HIV transmission. Table 2 Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome knowledge and sexual risk behaviors of men who have sex Entinostat with men (MSM) in India Further, the proportion of MSM reporting condom use the last time they engaged in sex with commercial or noncommercial male partners also varied across states. Recent data from the BSS 2009 show that condom use is significantly higher in group I states (ranging between 91% in Maharashtra and 100% in Andhra Pradesh and Karnataka for commercial sex partners and between 89.3% in Maharashtra and 97% in Andhra Pradesh for noncommercial sex partners). There were rates of 72% and 69.