AIDS and Behavior

, 13:318 | Cite as

Sexual Behavior and Risk Factors for HIV Infection Among Homosexual and Bisexual Men in Thailand

  • Andrea Li
  • Anchalee Varangrat
  • Wipas Wimonsate
  • Tareerat Chemnasiri
  • Chalinthorn Sinthuwattanawibool
  • Praphan Phanuphak
  • Rapeepun Jommaroeng
  • Sten Vermund
  • Frits van Griensven
Original Paper

Abstract

HIV prevalence and associated risk behaviors were examined among Thai bisexually active men (MSMW, n = 450) and men who have sex with men only (MSM-only, n = 1,125). Cross sectional venue-day-time sampling was used to collect data. Chi-square and logistic regression were used to identify HIV risk factors. HIV prevalence was 8.2% among MSMW and 21.2% among MSM-only. Consistent condom use with male partners was higher among MSMW (77.6%) than MSM-only (62.9%), and lower with female partners (44.4%). Lack of family confidant, migration, concern about acquiring HIV infection, and self-reported STD were associated with HIV prevalence among MSMW. Older age, lower educational level, residing in Bangkok or Chiang Mai, living away from family, recruitment from a sauna, increased frequency of visiting the surveyed venue, practicing receptive or both receptive and insertive anal intercourse, inconsistent condom use with male paying partners, and a history of drug use were associated with HIV prevalence in MSM-only.

Keywords

Homosexuality Bisexuality Thailand Human immunodeficiency virus Sexual behavior 

Notes

Acknowledgments

Andrea Li is a medical student III at Vanderbilt University, Nashville, TN, and participated in this project as an intern with the Thailand Ministry of Public Health—U.S. Centers for Disease Control and Prevention Collaboration (TUC). The authors thank the personnel of TUC, the Rainbow Sky Association of Thailand and the Thai Red Cross Society for their contributions to this work. This study was supported by TUC. Disclaimer: the findings and conclusions in this paper are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.

References

  1. Adimora, A. A., & Fullilove, R. E. (2006). Men who have sex with men and women: Pieces of the U.S. HIV epidemic puzzle. Sexually Transmitted Diseases, 10, 596–598. doi:10.1097/01.olq.0000233666.67788.fc.CrossRefGoogle Scholar
  2. Anonymous. (1988). Leads from the MMWR. Number of sex partners and potential risk of sexual exposure to human immunodeficiency virus. Journal of the American Medical Association, 260(14), 2020–2021. doi:10.1001/jama.260.14.2020
  3. Bankole, A., Darroch, J. E., & Singh, S. (1999). Determinants of trends in condom use in the United States, 1988–1995. Family Planning Perspectives, 31(6), 264–271. doi:10.2307/2991536.PubMedCrossRefGoogle Scholar
  4. Beesey, A. (2000). HIV vulnerability and mobile populations: Thailand and its borders. Development Bulletin (Canberra), June(52), 38–41.Google Scholar
  5. Beyrer, C., Eiumtrakul, S., Celentano, D. D., Nelson, K. E., Ruckphaopunt, S., & Khamboonruang, C. (1995). Same-sex behavior, sexually transmitted diseases and HIV risks among young northern Thai men. AIDS (London, England), 9(2), 171–176.Google Scholar
  6. Beyrer, C., Razak, M. H., Jittiwutikarn, J., Suriyanon, V., Vongchak, T., Srirak, N., et al. (2004). Methamphetamine users in northern Thailand: Changing demographics and risks for HIV and STD among treatment-seeking substance abusers. International Journal of STD & AIDS, 15(10), 697–704. doi:10.1258/0956462041944376.CrossRefGoogle Scholar
  7. Boulton, M., Hart, G., & Fitzpatrick, R. (1992). The sexual behaviour of bisexual men in relation to HIV transmission. AIDS Care, 4(2), 165–175. doi:10.1080/09540129208253088.PubMedCrossRefGoogle Scholar
  8. Caceres, C. F., & van Griensven, G. J. (1994). Male homosexual transmission of HIV-1. AIDS (London, England), 8(8), 1051–1061. doi:10.1097/00002030-199408000-00004.Google Scholar
  9. Centers for Disease Control and Prevention. (2006). HIV prevalence among populations of men who have sex with men—Thailand, 2003 and 2005. Morbidity and Mortality Weekly Report, 55(31), 844–848.Google Scholar
  10. Central Intelligence Agency. (2007). The World Factbook Thailand. Retrieved on September 17, 2007 from https://www.cia.gov/library/publications/the-world-factbook/geos/th.html#People.
  11. Colby, D. J. (2003). HIV knowledge and risk factors among men who have sex with men in Ho Chi Minh City, Vietnam. Journal of Acquired Immune Deficiency Syndromes, 32(1), 80–85.PubMedGoogle Scholar
  12. Colfax, G. N., Mansergh, G., Guzman, R., Vittinghoff, E., Marks, G., Rader, M., et al. (2001). Drug use and sexual risk behavior among gay and bisexual men who attend circuit parties: A venue-based comparison. Journal of Acquired Immune Deficiency Syndromes, 28(4), 373–379.PubMedGoogle Scholar
  13. Ekstrand, M. L., Coates, T. J., Guydish, J. R., Hauck, W. W., Collette, L., & Hulley, S. B. (1994). Are bisexually identified men in San Francisco a common vector for spreading HIV infection to women? American Journal of Public Health, 84(6), 915–919.PubMedCrossRefGoogle Scholar
  14. Girault, P., Saidel, T., Song, N., de Lind Van Wijngaarden, J. W., Dallabetta, G., Stuer, F., et al. (2004). HIV, STIs, and sexual behaviors among men who have sex with men in Phnom Penh, Cambodia. AIDS Education and Prevention, 16(1), 31–44. doi:10.1521/aeap.16.1.31.27727.PubMedCrossRefGoogle Scholar
  15. Hanenberg, R. W., Kunasol, P., & Sokal, D. C. (1994). Impact of Thailand’s HIV-control programme as indicated by the decline of sexually transmitted diseases. Lancet, 344, 243–245. doi:10.1016/S0140-6736(94)93004-X.PubMedCrossRefGoogle Scholar
  16. Hightow, L. B., Leone, P. A., Macdonald, P. D., McCoy, S. I., Sampson, L. A., & Kaplan, A. H. (2006). Men who have sex with men and women: A unique risk group for HIV transmission on North Carolina College campuses. Sexually Transmitted Diseases, 33(10), 585–593. doi:10.1097/01.olq.0000216031.93089.68.PubMedCrossRefGoogle Scholar
  17. Izazola-Licea, J. A., Gortmaker, S. L., de Gruttola, V., Tolbert, K., & Mann, J. (2003). Sexual behavior patterns and HIV risks in bisexual men compared to exclusively heterosexual and homosexual men. Salud p’Ublica de M’Exico., 45(Supp 5), S662–S671. doi:10.1590/S0036-36342003001100012.Google Scholar
  18. Jackson, P. (1997). Kathoey><Gay><Man: The historical emergence of gay male identity in Thailand. In L. Manderson & M. Jolly (Eds.), Sites of desire, economies of pleasure (pp. 166–190). Chicago: University of Chicago Press.Google Scholar
  19. Kunawararak, P., Beyrer, C., Natpratan, C., Feng, W., Celentano, D. D., de Boer, M., et al. (1995). The epidemiology of HIV and syphilis among male commercial sex workers in northern Thailand. AIDS (London, England), 9(5), 517–521.Google Scholar
  20. Mansergh, G., Colfax, G. N., Marks, G., Rader, M., Guzman, R., & Buchbinder, S. (2001). The circuit party men’s health survey: Findings and implications for gay and bisexual men. American Journal of Public Health, 91(6), 953–958.PubMedCrossRefGoogle Scholar
  21. Mansergh, G., Naorat, S., Jommaroeng, R., Jenkins, R. A., Jeeyapant, S., Kanggarnrua, K., et al. (2006). Adaptation of venue-day-time sampling in Southeast Asia to access men who have sex with men for HIV assessment in Bangkok. Field Methods, 18(2), 135–152. doi:10.1177/1525822X05282267.CrossRefGoogle Scholar
  22. Maticka-Tyndale, E., Elkins, D., Haswell-Elkins, M., Rujkarakorn, D., Kuyyakanond, T., & Stam, K. (1997). Contexts and patterns of men’s commercial sexual partnerships in northeastern Thailand: Implications for AIDS prevention. Social Science and Medicine, 44(2), 199–213. doi:10.1016/S0277-9536(96)00146-3.PubMedCrossRefGoogle Scholar
  23. Montgomery, J. P., Mokotoff, E. D., Gentry, A. C., & Blair, J. M. (2003). The extent of bisexual behaviour in HIV-infected men and implications for transmission to their female sex partners. AIDS Care, 15(6), 829–837. doi:10.1080/09540120310001618676.PubMedCrossRefGoogle Scholar
  24. Nagachinta, T., Duerr, A., Suriyanon, V., Nantachit, N., Rugpao, S., Wanapirak, C., et al. (1997). Risk factors for HIV-1 transmission from HIV-seropositive male blood donors to their regular female partners in northern Thailand. AIDS (London, England), 11(14), 1765–1772. doi:10.1097/00002030-199714000-00014.Google Scholar
  25. Nelson, K. E., Eiumtrakul, S., Celentano, D. D., Beyrer, C., Galai, N., Kawichai, S., et al. (2002). HIV infection in young men in northern Thailand, 1991–1998: Increasing role of injection drug use. Journal of Acquired Immune Deficiency Syndromes, 29(1), 62–68.PubMedGoogle Scholar
  26. Phanuphak, P., Muller, O., Sarangbin, S., & Sittitrai, W. (1994a). Knowledge, attitudes and behaviour among HIV-positive and HIV-negative clients of a confidential HIV counselling and testing centre in Thailand. AIDS (London, England), 8(9), 1315–1319.Google Scholar
  27. Phanuphak, P., Muller, O., Sarangbin, S., & Sittitrai, W. (1994b). Knowledge, attitudes and behaviour among HIV-positive and HIV-negative clients of a confidential HIV counselling and testing centre in Thailand. AIDS (London, England), 8(9), 1315–1319.Google Scholar
  28. Podhisita, C., Wawer, M. J., Pramualratana, A., Kanungsukkasem, U., & McNamara, R. (1996). Multiple sexual partners and condom use among long-distance truck drivers in Thailand. AIDS Education and Prevention, 8(6), 490–498.PubMedGoogle Scholar
  29. Sittitrai, W., Phanuphak, P., Barry, J., & Brown, T. (1992). Thai sexual behavior and risk of HIV infection. Bangkok: Thai Red Cross Society.Google Scholar
  30. Skeldon, R. (2000). Population mobility and HIV vulnerability in Southeast Asia: An assessment and analysis. Bangkok: United Nations Development Programme.Google Scholar
  31. Stokes, J., McKirnan, D. J., Doll, L., & Burzette, R. G. (1996). Bisexual men, sexual behavior, and HIV/AIDS. In B. Firestein (Ed.), Bisexuality: The psychology and politics of an invisible minority. Newbury Park, CA: Sage.Google Scholar
  32. Thai Working Group on HIV/AIDS Projection. (2001). HIV/AIDS projections for Thailand 2000–2020. Thailand Ministry of Public Health.Google Scholar
  33. Thailand Ministry of Public Health. (2003). Reported AIDS cases by transmission category, 1984–2003. Nonthaburi, Thailand: Department of Epidemiology, Thailand Ministry of Public Health.Google Scholar
  34. Thailand Ministry of Public Health. (2004). Guidelines for the care and treatment of HIV/AIDS in children and adults in Thailand (8th ed.). Nonthaburi, Thailand: Division of AIDS, Department of Disease Control, Thailand Ministry of Public Health.Google Scholar
  35. Thailand Ministry of Public Health. (2006). HIV sero-surveillance in Thailand: Result of the 23rd round, June 2005. Nonthaburi, Thailand: Thailand Ministry of Public Health.Google Scholar
  36. van Griensven, F., Kilmarx, P. H., Jeeyapant, S., Manopaiboon, C., Korattana, S., Jenkins, R. A., et al. (2004). The prevalence of bisexual and homosexual orientation and related health risks among adolescents in northern Thailand. Archives of Sexual Behavior, 33(2), 137–147. doi:10.1023/B:ASEB.0000014328.49070.8c.PubMedCrossRefGoogle Scholar
  37. van Griensven, F., Naorat, S., Kilmarx, P. H., Jeeyapant, S., Manopaiboon, C., Chaikummao, S., et al. (2006). Palmtop-assisted self-interviewing for the collection of sensitive behavioral data: Randomized trial with drug use urine testing. American Journal of Epidemiology, 163(3), 271–278. doi:10.1093/aje/kwj038.PubMedCrossRefGoogle Scholar
  38. van Griensven, F., Thanprasertsuk, S., Jommaroeng, R., Mansergh, G., Naorat, S., Jenkins, R. A., et al. (2005). Evidence of a previously undocumented epidemic of HIV infection among men who have sex with men in Bangkok, Thailand. AIDS (London, England), 19(5), 521–526. doi:10.1097/01.aids.0000162341.50933.e8.Google Scholar
  39. Wangroongsarb, Y., Weniger, B. G., Wasi, C., Traisupa, A., Kunasol, P., Rojanapithayakorn, W., et al. (1985). Prevalence of HTLV-III/LAV antibody in selected populations in Thailand. The Southeast Asian Journal of Tropical Medicine and Public Health., 16(4), 517–520.PubMedGoogle Scholar
  40. Weinhardt, L. S., Carey, M. P., Johnson, B. T., & Bickham, N. L. (1999). Effects of HIV counseling and testing on sexual risk behavior: A meta-analytic review of published research, 1985–1997. American Journal of Public Health, 89(9), 1397–1405.PubMedCrossRefGoogle Scholar
  41. Wold, C., Seage, G. R., III, Lenderking, W. R., Mayer, K. H., Cai, B., Heeren, T., et al. (1998). Unsafe sex in men who have sex with both men and women. Journal of Acquired Immune Deficiency Syndromes, 17(4), 361–367.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Andrea Li
    • 1
    • 2
  • Anchalee Varangrat
    • 2
  • Wipas Wimonsate
    • 2
  • Tareerat Chemnasiri
    • 2
  • Chalinthorn Sinthuwattanawibool
    • 2
  • Praphan Phanuphak
    • 3
  • Rapeepun Jommaroeng
    • 3
    • 4
  • Sten Vermund
    • 1
  • Frits van Griensven
    • 2
    • 5
  1. 1.Vanderbilt University School of MedicineNashvilleUSA
  2. 2.Thailand Ministry of Public Health—U.S. Centers for Disease Control and Prevention CollaborationNonthaburiThailand
  3. 3.Thai Red Cross SocietyBangkokThailand
  4. 4.The Rainbow Sky Association of ThailandBangkokThailand
  5. 5.Division of HIV/AIDS PreventionCenters for Disease Control and PreventionAtlantaUSA

Personalised recommendations