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Gender-Based Power and Couples’ HIV Risk In Uttar Pradesh and Uttarakhand, North India By Alpna Agrawal, CONTEXT: Gender inequality is a long-recognized driver of the HIV epidemic. However, few studies have investi- Shelah S. Bloom, gated the association between gender-based power and HIV risk in India, which has the world’s third largest HIV Chirayath epidemic. Suchindran, Siân Curtis and METHODS: Population-based data collected in 2003 from 3,385 couples residing in Uttar Pradesh and Uttara- Gustavo Angeles khand, North India, were used to examine associations between gender-based power (wife’s autonomy and hus- band’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 Alpna Agrawal is a medical student, year). Structural equation modeling was used to create composite variables for the gender-based power measures School of Medicine, and test their associations with HIV risk measures. University of Texas Health Science Center RESULTS: Twenty-four percent of husbands had had premarital sex, 7% had had extramarital sex in the past year at Houston, USA. and 6% had had STI symptoms in the past year. Structural equation models indicated that wives who reported Shelah S. Bloom is research assistant higher levels of autonomy were less likely than other wives to have husbands who had had extramarital sex in professor, and Siân the past year (direct association) or STI symptoms in the past year (indirect association). Moreover, husbands who Curtis is research