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Prevention Science

, Volume 13, Issue 5, pp 483–492 | Cite as

Demographic and Behavioral Correlates of HIV Risk among Men and Transgender Women Recruited from Gay Entertainment Venues and Community-based Organizations in Thailand: Implications for HIV Prevention

  • Peter A. Newman
  • Sung-Jae Lee
  • Surachet Roungprakhon
  • Suchon Tepjan
Article

Abstract

High HIV prevalence among men who have sex with men (MSM) and transgender women in Thailand suggest a vital need for targeted interventions. We conducted a cross-sectional survey to examine and compare sexual risk behaviors, and demographic and behavioral correlates of risk, among MSM and transgender women recruited from gay entertainment venue staff and community-based organization (CBO) participants. We used venue-based sampling across nine sites in Bangkok and Chiang Mai. Among 260 participants (57.3% gay-identified, 26.9% heterosexual/bisexual-identified, 15.8% transgender; mean age = 26.7 years), nearly one-fifth (18.5%) reported unprotected anal sex (UAS), half (50.4%) sex in exchange for money, and one-fifth (20.0%) STI diagnosis (past year). Nearly one-fourth (23.1%) reported oral erectile dysfunction medication use and nearly one-fifth (19.2%) illicit drug use (past 3 months). Overall, 43.1% indicated that healthcare providers exhibited hostility towards them. Gay entertainment venue staff were significantly more likely to self-identify as heterosexual/bisexual (versus gay or transgender female), and to have less than high school degree education, higher monthly income, to have engaged in sex in exchange for money, sex with women and unprotected vaginal sex, but were significantly less likely to have engaged in UAS than CBO participants. Targeted interventions for younger MSM and transgender women, for non gay-identified men, and strategies to address structural determinants of risk, including low education and discrimination from healthcare providers, may support HIV prevention among MSM and transgender women, and serve broader national HIV prevention efforts in Thailand.

Keywords

Men who have sex with men Transgender women HIV Sexual risk behaviors Thailand 

Notes

Acknowledgments

This study was funded in part by the Social Sciences and Humanities Research Council of Canada, the Canadian Institutes of Health Research, and the Canada Research Chairs Program. Dr. Lee was supported by the National Institute of Mental Health (NIMH 5K01MH085503).

References

  1. AVERT. (2009). South East Asian HIV and AIDS statistics. Last updated June 25, 2009. Retrieved from http://www.avert.org/aidssoutheastasia.htm
  2. Baral, S., Sifakis, F., Cleghorn, F., & Beyrer, C. (2007). Elevated risk for HIV infection among men who have sex with men in low and middle-income countries 2000–2006: A systematic review. PLoS Medicine, 4, 1901–1911.CrossRefGoogle Scholar
  3. 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, 844–848.Google Scholar
  4. Chemnasiri, T., Netwong, T., Visarutratana, S., Varangrat, A., Li, A., Phanuphak, P., et al. (2010). Inconsistent condom use among young men who have sex with men, male sex workers, and transgenders in Thailand. AIDS Education and Prevention, 22, 100–109.PubMedCrossRefGoogle Scholar
  5. Fisher, D. G., Reynolds, G. L., & Napper, L. E. (2010). Use of crystal methamphetamine, Viagra, and sexual behavior. Current Opinion in Infectious Diseases, 23, 53–56.PubMedCrossRefGoogle Scholar
  6. Fleming, D. T., & Wasserheit, J. N. (1999). From epidemiological synergy to public health policy and practice: The contribution of other sexually transmitted diseases to sexual transmission of HIV infection. Sexually Transmitted Infections, 75, 3–17.PubMedCrossRefGoogle Scholar
  7. Frankel, M. R., Shapiro, M. F., Duan, N., Morton, S. C., Berry, S. H., Brown, J. A., et al. (1999). National probability samples in studies of low-prevalence diseases. Part II: Designing and implementing the HIV cost and services utilization study sample. Health Services Research, 34, 969–992.PubMedGoogle Scholar
  8. Gillespie, S. R., Kadiyala, S., & Greener, R. (2007). Is poverty or wealth driving HIV transmission? AIDS, 21, S5–S16.PubMedCrossRefGoogle Scholar
  9. Grant, R. M., Lama, J. R., Anderson, P. L., McMahan, V., Liu, A. Y., Vargas, L., et al. (2010). Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. The New England Journal of Medicine, 363, 2587–2599.PubMedCrossRefGoogle Scholar
  10. Hargreaves, J. R., & Glynn, J. R. (2002). Educational attainment and HIV-1 infection in developing countries: A systematic review. Tropical Medicine & International Health, 7, 489–498.CrossRefGoogle Scholar
  11. Jenkins, C., Pramoj na Ayutthaya, P., & Hunter, A. (2005). Katoey in Thailand: HIV/AIDS and life opportunities. Washington, DC: POLICY Project, USAID. Retrieved from http://www.soros.org/initiatives/health/focus/sharp/articles_publications/publications/compendium_20070319/health_methodologies/katoey_20070402.pdf
  12. Koblin, B. A., Husknik, M. J., Colfax, G., Huang, Y., Madison, M., Mayer, K., et al. (2006). Risk factors for HIV infection among men who have sex with men. AIDS, 20, 731–739.PubMedCrossRefGoogle Scholar
  13. Li, A., Varangrat, A., Wimonsate, W., Chemnasiri, T., Sinthuwattanawibool, C., Phanuphak, P., et al. (2009). Sexual behavior and risk factors for HIV infection among homosexual and bisexual men in Thailand. AIDS and Behavior, 13, 318–327.PubMedCrossRefGoogle Scholar
  14. Mahajan, A. P., Sayles, J. N., Patel, V. A., Remien, R. H., Sawires, S. R., Ortiz, D. J., et al. (2008). Stigma in the HIV/AIDS epidemic: A review of the literature and recommendations for the way forward. AIDS, 22, S67–S79.PubMedCrossRefGoogle Scholar
  15. Makadon, H. J. (2006). Improving health care for the lesbian and gay communities. The New England Journal of Medicine, 354, 895–897.PubMedCrossRefGoogle Scholar
  16. Mansergh, G., Shouse, R. L., Marks, G., Guzman, R., Rader, M., Buchbinder, S., et al. (2006). Methamphetamine and sildenafil (Viagra) use are linked to unprotected receptive and insertive anal sex, respectively, in a sample of men who have sex with men. Sexually Transmitted Infections, 82, 131–134.PubMedCrossRefGoogle Scholar
  17. Mayer, K. H., Colfax, G., & Guzman, R. (2006). Club drugs and HIV infection: A review. Clinical Infectious Diseases, 42, 1463–1469.CrossRefGoogle Scholar
  18. Monitoring the AIDS Pandemic (MAP) Report 2005. (2005). Male-male sex and HIV/AIDS in Asia. Retrieved from http://www.mapnetwork.org/docs/MAP_&M%20Book_04July05_en.pdf
  19. Newman, P. A., Rhodes, F., & Weiss, R. (2004). Correlates of sex trading among drug-using men who have sex with men. American Journal of Public Health, 94, 1998–2003.PubMedCrossRefGoogle Scholar
  20. Newman, P. A., Chakrapani, V., Cook, C., Shunmugam, M., & Kakinami, L. (2008). Correlates of paid sex among men who have sex with men in Chennai, India. Sexually Transmitted Infections, 84, 434–438.PubMedCrossRefGoogle Scholar
  21. Newman, P. A., Roungprakhon, S., Tepjan, S., & Yim, S. (2010). Preventive HIV vaccine acceptability and behavioral risk compensation among high-risk men who have sex with men and transgenders in Thailand. Vaccine, 28, 958–964.PubMedCrossRefGoogle Scholar
  22. Phillips, A. E., Gomez, G. B., Boily, M. C., & Garnett, P. (2010). A systematic review and meta-analysis of quantitative interviewing tools to investigate self-reported HIV and STI associated behaviours in low- and middle-income countries. International Journal of Epidemiology, 39, 1541–1555.PubMedCrossRefGoogle Scholar
  23. Pliplat, T., Kladsawas, K., van Griensven, F., & Wimonsate, W. (2008). Proceedings from Department of Disease Control Annual Conference, Ministry of Public Health, 2008: Results of the HIV surveillance among men who have sex with men (MSM) in Bangkok, Chiangmai and Phuket. Thailand: Bi-Tech Convention Centre.Google Scholar
  24. Prestage, G., Jin, F., Kippax, S., Zablotska, I., Imrie, J., & Grulich, A. (2009). Use of illicit drugs and erectile dysfunction medications and subsequent HIV infection among gay men in Sydney, Australia. The Journal of Sexual Medicine, 6, 2311–2320.PubMedCrossRefGoogle Scholar
  25. Reidy, W. J., Spielberg, F., Wood, R., Binson, D., Woods, W. J., & Goldbaum, G. M. (2009). HIV risk associated with gay bathhouses and sex clubs: Findings from 2 Seattle surveys of factors related to HIV and sexually transmitted infections. American Journal of Public Health, 99, S165–S172.PubMedCrossRefGoogle Scholar
  26. Rietmeijer, C. A., Wolitski, R. J., Fishbein, M., Corby, N. H., & Cohn, D. L. (1998). Sex hustling, injection drug use, and non-gay identification by men who have sex with men: Associations with high-risk sexual behaviors and condom use. Sexually Transmitted Diseases, 25, 353–360.PubMedCrossRefGoogle Scholar
  27. Rojanapithayakorn, W., & Hanenberg, R. (1996). The 100% Condom Program in Thailand. AIDS, 10, 1–17.PubMedCrossRefGoogle Scholar
  28. Sangani, P., Rutherford, G., & Wilkinson, D. (2007). Population-based interventions for reducing sexually transmitted infections, including HIV infection. Cochrane Database of Systematic Reviews, 4. Retrieved from http://apps.who.int/rhl/reviews/CD001220.pdf
  29. SPSS, Inc. (2008). SPSS base 17.0 for Windows user’s guide. Chicago, IL: SPSS Inc.Google Scholar
  30. 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
  31. UNAIDS. (2007). Men who have sex with men: The missing piece in the national responses to AIDS in Asia and the Pacific. Retrieved from http://www.unescobkk.org/fileadmin/user_upload/hiv_aids/Images/in_house_doc_covers/Recommended_resources/MSM_the_missing_piece__Aug_2007_.pdf
  32. UNAIDS. (2008). 2008 Report on the global AIDS epidemic: Executive summary. Retrieved from http://data.unaids.org/pub/GlobalReport/2008/JC1511_GR08_ExecutiveSummary _en.pdf
  33. UNAIDS. (2010). UNIADS report on the global AIDS epidemic 2010. Retrieved from http://www.unaids.org/globalreport/Global_report.htm
  34. 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, 19, 521–526.PubMedCrossRefGoogle Scholar
  35. van Griensven, F., Varangrat, A., Wimonsate, W., Tanpradech, S., Kladsawad, K., Chemnasiri, T., et al. (2010). Trends in HIV prevalence, estimated HIV incidence and risk behavior among men who have sex with men in Bangkok, Thailand, 2003 to 2007. Journal of Acquired Immune Deficiency Syndromes, 53, 234–239.CrossRefGoogle Scholar
  36. Wheeler, D. P., Lauby, J. L., Liu, K. L., Van Sluytman, L. G., & Murrill, C. (2008). A comparative analysis of sexual risk characteristics of Black men who have sex with men and women. Archives of Sexual Behavior, 37, 697–707.PubMedCrossRefGoogle Scholar
  37. Wong, W., Chaw, J. K., Kent, C. K., & Klausner, J. D. (2005). Risk factors for early syphilis among gay and bisexual men seen in an STD clinic: San Francisco, 2002–2003. Sexually Transmitted Diseases, 32, 458–463.PubMedCrossRefGoogle Scholar

Copyright information

© Society for Prevention Research 2012

Authors and Affiliations

  • Peter A. Newman
    • 1
  • Sung-Jae Lee
    • 2
  • Surachet Roungprakhon
    • 3
  • Suchon Tepjan
    • 1
  1. 1.Centre for Applied Social Research, Factor-Inwentash Faculty of Social WorkUniversity of TorontoTorontoCanada
  2. 2.Semel Institute for Neuroscience and Human Behavior, Center for Community HealthUniversity of California, Los AngelesLos AngelesUSA
  3. 3.Rajamangala University of Technology Phra NakhonBangkokThailand

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