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Young Men Who Have Sex with Men at High Risk for HIV, Bangkok MSM Cohort Study, Thailand 2006–2014

AIDS and Behavior volume 22, pages 2137–2146 (2018)Cite this article

Abstract

High HIV incidence has been reported in young men who have sex with men (YMSM) in North America and Western Europe, but there are limited data from Southeast Asia suggesting MSM may be the driver of the HIV epidemic in this region. We described HIV incidence and risk factors among 494 YMSM enrolled in a cohort study in Bangkok, Thailand. The HIV incidence was 7.4 per 100 person-years. In multivariable analysis, reporting use of an erectile dysfunction drug in combination with club drugs, having receptive or both insertive and receptive anal intercourse with men, having hepatitis A infection, having rectal Chlamydia trachomatis, having hepatitis B infection prior to HIV seroconversion, and reporting not always using condoms with male steady partners were significantly associated with HIV incidence in YMSM. Reduction in new HIV infections in YMSM are critical to reach targets set by Thailand and the region.

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References

  1. UNAIDS (2015) UNAIDS AIDSinfo. Geneva. http://aidsinfo.unaids.org/. Accessed 1 June 2017.

  2. Figueroa JP, Cooper CJ, Edwards JK, et al. Understanding the high prevalence of HIV and other sexually transmitted infections among socio-economically vulnerable men who have sex with men in Jamaica. PLoS ONE. 2015;10(2):e0117686.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  3. Garofalo R, Hotton AL, Kuhns LM, Gratzer B, Mustanski B. Incidence of HIV infection and sexually transmitted infections and related risk factors among very young men who have sex with men. J Acquir Immune Defic Syndr. 2016;72(1):79–86.

    Article  PubMed Central  PubMed  Google Scholar 

  4. Hoenigl M, Chaillon A, Morris SR, Little SJ. HIV infection rates and risk behavior among young men undergoing community-based testing in San Diego. Sci Rep. 2016;6:25927.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  5. Pathela P, Jamison K, Braunstein SL, Schillinger JA, Varma JK, Blank S. Incidence and predictors of HIV infection among men who have sex with men attending public sexually transmitted disease clinics, New York City, 2007–2012. AIDS Behav. 2017;21(5):1444–51.

    Article  PubMed  Google Scholar 

  6. Baral SD, Grosso A, Holland C, Papworth E. The epidemiology of HIV among men who have sex with men in countries with generalized HIV epidemics. Curr Opin HIV AIDS. 2014;9(2):156–67.

    Article  PubMed  Google Scholar 

  7. Tanser F, de Oliveira T, Maheu-Giroux M, Barnighausen T. Concentrated HIV subepidemics in generalized epidemic settings. Curr Opinion HIV AIDS. 2014;9(2):115–25.

    Article  Google Scholar 

  8. WHO (2013) HIV/AIDS: definition of key terms, consolidated ARV guidelines. http://www.who.int/hiv/pub/guidelines/arv2013/intro/keyterms/en/. Accessed 1 August 2017.

  9. Dong Z, Xu J, Zhang H, et al. HIV incidence and risk factors in Chinese young men who have sex with men–a prospective cohort study. PLoS ONE. 2014;9(5):e97527.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  10. van Griensven F, Thienkrua W, McNicholl J, et al. Evidence of an explosive epidemic of HIV infection in a cohort of men who have sex with men in Thailand. AIDS. 2013;27(5):825–32.

    Article  PubMed  Google Scholar 

  11. Xu J, An M, Han X, et al. Prospective cohort study of HIV incidence and molecular characteristics of HIV among men who have sex with men(MSM) in Yunnan Province. China BMC Infect Dis. 2013;13:3.

    Article  PubMed  Google Scholar 

  12. Huang SW, Wang SF, Cowo AE, et al. Molecular epidemiology of HIV-1 infection among men who have sex with men in Taiwan in 2012. PLoS ONE. 2015;10(6):e0128266.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  13. Kelley CF, Vaughan AS, Luisi N, et al. The effect of high rates of bacterial sexually transmitted infections on HIV incidence in a cohort of black and white men who have sex with men in Atlanta. Georgia AIDS Res Hum Retrovir. 2015;31(6):587–92.

    Article  PubMed  Google Scholar 

  14. Jansen K, Thamm M, Bock CT, et al. High prevalence and high incidence of coinfection with hepatitis B, hepatitis C, and syphilis and low rate of effective vaccination against hepatitis B in HIV-positive men who have sex with men with known date of HIV seroconversion in Germany. PLoS ONE. 2015;10(11):e0142515.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  15. Beebeejaun K, Degala S, Balogun K, et al. Outbreak of hepatitis A associated with men who have sex with men (MSM), England, July 2016 to January 2017. Euro Surveill. 2017. https://doi.org/10.2807/1560-7917.ES.2017.22.5.30454.

    PubMed Central  Article  PubMed  Google Scholar 

  16. Chen GJ, Lin KY, Sun HY, et al. Incidence of acute hepatitis A among HIV-positive patients during an outbreak among MSM in Taiwan: impact of HAV vaccination. Liver Int. 2017. https://doi.org/10.1111/liv.13468.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Tseng YT, Sun HY, Chang SY, et al. Seroprevalence of hepatitis virus infection in men who have sex with men aged 18–40 years in Taiwan. J Formos Med Assoc. 2012;111(8):431–8.

    Article  PubMed  Google Scholar 

  18. Werber D, Michaelis K, Hausner M, et al. Ongoing outbreaks of hepatitis A among men who have sex with men (MSM), Berlin, November 2016 to January 2017 - linked to other German cities and European countries. Euro Surveill. 2017;22(5):30457.

    Article  PubMed Central  Google Scholar 

  19. CATIE. Fact Sheets-Hepatitis A. http://www.catie.ca/en/fact-sheets/sti/hepatitis-a. Accessed 1 June 2017.

  20. Mustanski BS, Newcomb ME, Du Bois SN, Garcia SC, Grov C. HIV in young men who have sex with men: a review of epidemiology, risk and protective factors, and interventions. J Sex Res. 2011;48(2–3):218–53.

    Article  PubMed Central  PubMed  Google Scholar 

  21. Poon CM, Lee SS. Sex networking of young men who have sex with men in densely connected saunas in Hong Kong. Sex Transm Dis. 2013;40(12):933–8.

    Article  PubMed  Google Scholar 

  22. Kramer SC, Drewes J, Kruspe M, Marcus U. Factors associated with sexual risk behaviors with non-steady partners and lack of recent HIV testing among German men who have sex with men in steady relationships: results from a cross-sectional internet survey. BMC Public Health. 2015;15:702.

    Article  PubMed Central  PubMed  Google Scholar 

  23. Rice CE, Maierhofer C, Fields KS, Ervin M, Lanza ST, Turner AN. Beyond anal sex: sexual practices of men who have sex with men and associations with HIV and other sexually transmitted infections. J Sex Med. 2016;13(3):374–82.

    Article  PubMed Central  PubMed  Google Scholar 

  24. Ferrer L, Loureiro E, Meulbroek M, et al. High HIV incidence among men who have sex with men attending a community-based voluntary counselling and testing service in Barcelona, Spain: results from the ITACA cohort. Sex Transm Infect. 2016;92(1):70–5.

    Article  PubMed  Google Scholar 

  25. Schilder AJ, Anema A, Pai J, et al. Association between childhood physical abuse, unprotected receptive anal intercourse and HIV infection among young men who have sex with men in Vancouver, Canada. PLoS ONE. 2014;9(6):e100501.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  26. Lowry R, Dunville R, Robin L, Kann L. Early sexual debut and associated risk behaviors among sexual minority youth. Am J Prev Med. 2017;52(3):379–84.

    Article  PubMed  Google Scholar 

  27. Xu R, Dai W, Zhao G, et al. Early sexual debut and HIV infection among men who have sex with men in Shenzhen. China Biomed Res Int. 2016;2016:2987472.

    PubMed  Google Scholar 

  28. AIDS TB and STIs Control Division (2015) HIV/AIDS epidemic and status of prevention and alleviation efforts, Bangkok, 2010–2014. Bangkok, Thailand.

  29. van Griensven F, Holtz TH, Thienkrua W, et al. Temporal trends in HIV-1 incidence and risk behaviours in men who have sex with men in Bangkok, Thailand, 2006–13: an observational study. Lancet HIV. 2015;2(2):e64–70.

    Article  PubMed  Google Scholar 

  30. van Griensven F, Thienkrua W, et al. Sex frequency and sex planning among men who have sex with men in Bangkok, Thailand: implications for pre- and post-exposure prophylaxis against HIV infection. J Int AIDS Soc. 2010;13:13.

    Article  PubMed Central  PubMed  Google Scholar 

  31. Bureau of Epidemiology, Department of Disease Control, Thailand Ministry of Public Health (2013). Thailand HIV sentinel surveillance.

  32. UNAIDS. Thailand launches new AIDS strategy to ‘Get to Zero’ 2012. http://www.unaids.org/en/resources/presscentre/featurestories/2012/june/20120622thaizero. Accessed 1 June 2017.

  33. Balaji AB, Bowles KE, Le BC, Paz-Bailey G, Oster AM. High HIV incidence and prevalence and associated factors among young MSM, 2008. AIDS. 2013;27(2):269–78.

    Article  PubMed Central  PubMed  Google Scholar 

  34. Cunha CB, Friedman RK, de Boni RB, et al. Chlamydia trachomatis, Neisseria gonorrhoeae and syphilis among men who have sex with men in Brazil. BMC Public Health. 2015;15:686.

    Article  PubMed Central  PubMed  Google Scholar 

  35. Kelly BC, Parsons JT. Prescription drug misuse and sexual risk taking among HIV-negative MSM. AIDS Behav. 2013;17(3):926–30.

    Article  PubMed  Google Scholar 

  36. Bordi L, Rozera G, Scognamiglio P, et al. Monophyletic outbreak of hepatitis A involving HIV-infected men who have sex with men, Rome, Italy 2008–2009. J Clin Virol. 2012;54(1):26–9.

    Article  PubMed  Google Scholar 

  37. Katz MH, Hsu L, Wong E, Liska S, Anderson L, Janssen RS. Seroprevalence of and risk factors for hepatitis A infection among young homosexual and bisexual men. J Infect Dis. 1997;175(5):1225–9.

    Article  CAS  PubMed  Google Scholar 

  38. Cotter SM, Sansom S, Long T, et al. Outbreak of hepatitis A among men who have sex with men: implications for hepatitis A vaccination strategies. J Infect Dis. 2003;187(8):1235–40.

    Article  PubMed  Google Scholar 

  39. Bialek SR, Barry V, Bell BP, et al. Seroprevalence and correlates of hepatitis A among HIV-negative American men who have sex with men. Sexual health. 2011;8(3):343–8.

    Article  PubMed  Google Scholar 

  40. Prejean J, Song R, Hernandez A, et al. Estimated HIV incidence in the United States, 2006–2009. PLoS ONE. 2011;6(8):e17502.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  41. Xiridou M, Geskus R, De Wit J, Coutinho R, Kretzschmar M. The contribution of steady and casual partnerships to the incidence of HIV infection among homosexual men in Amsterdam. AIDS. 2003;17(7):1029–38.

    Article  PubMed  Google Scholar 

  42. Gebhardt WA, Kuyper L, Greunsven G. Need for intimacy in relationships and motives for sex as determinants of adolescent condom use. J Adolesc Health. 2003;33(3):154–64.

    Article  PubMed  Google Scholar 

  43. Darrow WW, Biersteker S, Geiss T, et al. Risky sexual behaviors associated with recreational drug use among men who have sex with men in an international resort area: challenges and opportunities. J Urban Health. 2005;82(4):601–9.

    Article  PubMed Central  PubMed  Google Scholar 

  44. Goltz HH, Coon DW, Catania JA, Latini DM. A pilot study of HIV/STI risk among men having sex with men using erectile dysfunction medications: challenges and opportunities for sexual medicine physicians. J Sex Med. 2012;9(12):3189–97.

    Article  PubMed  Google Scholar 

  45. Daskalopoulou M, Rodger AJ, Phillips AN, et al. Condomless sex in HIV-diagnosed men who have sex with men in the UK: prevalence, correlates, and implications for HIV transmission. Sex Transm Infect. 2017. https://doi.org/10.1136/sextrans-2016-053029.

    PubMed Central  Article  PubMed  Google Scholar 

  46. Daskalopoulou M, Rodger A, Phillips AN, et al. Recreational drug use, polydrug use, and sexual behaviour in HIV-diagnosed men who have sex with men in the UK: results from the cross-sectional ASTRA study. Lancet HIV. 2014;1(1):e22–31.

    Article  PubMed  Google Scholar 

  47. Pattanasin S, Wimonsate W, et al. Loss to follow-up and bias assessment among a cohort of Thai men who have sex with men in Bangkok. Thailand Int J STD AIDS. 2016;27(3):196–206.

    Article  PubMed  Google Scholar 

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Acknowledgements

The authors are grateful to all the participants for their dedication to the study, the Rainbow Sky Association of Thailand and outreach team, and the support of the personnel of the Thailand Ministry of Public Health-US Centers for Disease Control and Prevention Collaboration, and all research nurses and counsellors, laboratory staff, IT staff and research assistants at the Silom Community Clinic.

Disclaimer

The findings and conclusions presented in this paper are those of the authors and do not necessarily represent the views of the U.S. Centers for Disease Control and Prevention.

Funding

This work was supported by the U.S. Centers for Disease Control and Prevention.

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Affiliations

  1. HIV/STD Research Program, Thailand Ministry of Public Health – U.S. Centers for Disease Control and Prevention Collaboration, DDC7 Building, 4th floor, Ministry of Public Health, Nonthaburi, 11000, Thailand

    Warunee Thienkrua, Philip A. Mock, Eileen F. Dunne, Boonyos Raengsakulrach, Wipas Wimonsate, Chaiwat Ungsedhapand & Timothy H. Holtz

  2. Doctor of Public Health Program in Epidemiology (International Program), Faculty of Public Health, Mahidol University, Bangkok, Thailand

    Warunee Thienkrua

  3. Division of Preventive Medicine and Public Health, University of California, San Francisco, CA, USA

    Frits van Griensven

  4. Division of HIV/AIDS Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA

    Eileen F. Dunne & Timothy H. Holtz

  5. Faculty of Public Health, Mahidol University, Bangkok, Thailand

    Nopporn Howteerakul

  6. Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand

    Anupong Chiwarakorn

Authors
  1. Warunee Thienkrua
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  2. Frits van Griensven
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  3. Philip A. Mock
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  8. Chaiwat Ungsedhapand
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  10. Timothy H. Holtz
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Corresponding author

Correspondence to Warunee Thienkrua.

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Conflict of interest

The authors declare that they have no conflicts of interests.

Ethical Approval

The study protocol was approved by the Ethical Review Committee for Research in Human Subjects of the Thailand Ministry of Public Health, and by the Institutional Review Board of the U.S. Centers for Disease Control and Prevention. We obtained written informed consents from all participants.

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Thienkrua, W., van Griensven, F., Mock, P.A. et al. Young Men Who Have Sex with Men at High Risk for HIV, Bangkok MSM Cohort Study, Thailand 2006–2014. AIDS Behav 22, 2137–2146 (2018). https://doi.org/10.1007/s10461-017-1963-7

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  • DOI: https://doi.org/10.1007/s10461-017-1963-7

Keywords

  • HIV incidence
  • Men who have sex with men
  • Thailand
  • Young population
  • Adolescent