Levels of HIV risk behaviour and AIDS knowledge in Thai men having sex with men

Abstract

Although many of the earliest cases of AIDS and HIV infection in Thailand were men who had sex with other men (MHSWM), transmission by heterosexual intercourse and needle sharing rapidly became dominant. This resulted in comparatively little attention being given to studies of risk behaviour and seroprevalence in groups of MHSWM with a consequent lack of information about these populations relevant to designing effective interventions. In the Partner Relations Survey, 3.3% of male Thais described their orientation as bisexual or homosexual, most probably an underestimate of the occurrence of same sex behaviour in Thai males. This paper briefly reviews the situation and presents results from a survey in the northeast of Thailand among men who have sex with men. Substantial levels of risk behaviour were found in MHSWM in the Northeast, with high rates of partner exchange and low levels of consistent condom use in insertive and receptive anal intercourse. Significant defects in AIDS knowledge existed implying a strong need for enhanced and expanded interventions in this community. Factors relevant to the design of interventions are highlighted and recommendations for further studies of MHSWM in Thailand are presented.

PIP: The percentage of boys and men in Thailand which identifies itself as bisexual or homosexual is most likely larger than the 3.3% suggested by data in the Partner Relations Survey. Accordingly, this study was conducted with the purpose of examining the sexual behavior, AIDS knowledge, and networks of sexual contacts of men who have sex with men in northeast Thailand. Findings are based upon information from 157 surveyed men aged 15-57 of mean and median ages 26.4 and 24 years, respectively. 95.5% of the participants were single and 77.1% lived in the metropolitan area. Examination of the data indicates that these men have a great deal of unprotected sexual intercourse with many different partners of varying types; partners include male and female prostitutes as well as strangers. Only low levels of consistent condom use exist during insertive and receptive anal intercourse. Moreover, most men with lovers have substantial levels of sex outside of the relationships without protection. Significant deficiencies in AIDS knowledge point clearly to the need for HIV preventive interventions in the community. These interventions should attempt to increase the levels of condom use and safer sex practice, reduce the number of partners, improve the recognition and early treatment of sexually transmitted diseases which may enhance HIV transmission, and improve the knowledge of AIDS/HIV and its prevention. While interventions could be made at the policy level or through the mass media to increase the awareness and perceptions of personal risk in the general population, interpersonal interventions are most likely to be effective. Recommendations are made for the further study of men who have sex with men in Thailand, while opening sections discuss the background of the Thai AIDS epidemic, the prevalence of male homosexual behavior, and behavioral and seroprevalence studies to date.