Factors associated with testing for HIV and other sexually transmitted infections in men who have sex with men and transgender women in Bangkok, Thailand

Abstract

Background Routine screening for HIV and other sexually transmitted infections (STIs) facilitates early diagnosis and treatment, thereby preventing morbidity and onward transmission. We estimated the prevalence of prior HIV/STI testing among men who have sex with men (MSM) and transgender women (TGW) in Bangkok, Thailand, and identified factors associated with prior testing. Methods Cross-sectional analyses were performed using data collected at enrollment into an HIV incidence cohort. From April to October 2017, MSM and TGW were enrolled if they were aged 18–35 years, reported anal intercourse with a male or TGW partner, and reported behavioral vulnerability to HIV. Participants answered questions about demographics, sexual behaviors, and lifetime HIV/STI testing history. Multivariable robust Poisson regression was used to estimate risk ratios (RRs) and 95% confidence intervals (CIs) for factors potentially associated with prior testing. Results Among 1,014 participants, 348 (34.3%) were TGW and the median age was 21.6 (interquartile range 20.0-24.8) years. Prior testing for HIV was reported by 421 (41.5%) and for other STIs by 268 (26.4%). HIV testing was more common among participants aged ≥ 22 years (RR 1.37 [95% CI 1.13–1.67]), with college education as compared to secondary or less (RR 1.37 [95% CI 1.08–1.72]), and who met male sexual partners online (RR 1.52 [95% CI 1.24–1.85]), but lower among participants attracted to both men and women as compared to men only (RR 0.64 [95% CI 0.51–0.81]) and who met male sexual partners in bars (RR 0.83 [95% CI 0.72–0.97]). Similar associations were observed with prior testing for other STIs, including increased testing among participants with college education (RR 1.52 [95% CI 1.11–2.09]) and who met male sexual partners online (RR 1.73 [95% CI 1.30–2.31]), but lower among participants attracted to both men and women (RR 0.70 [95% CI 0.51–0.96]) and who met male sexual partners in bars (RR 0.67 [95% CI 0.54–0.83]). Conclusions Despite behavioral vulnerability, prior testing for HIV and other STIs was uncommon. Online engagement strategies may be effectively reaching Thai MSM and TGW who meet sexual partners online, but new interventions are needed to encourage testing among younger, less educated, and bisexual MSM and TGW.

HIV infections in youth: prevalence and associated factors

“…Entretanto, é oportuno destacar que o diálogo entre programas, profissionais e grupos mais afetados por este agravo é uma condição fundamental para a construção de respostas para o enfrentamento à epidemia. Superar barreiras organizacionais com olhar atento aos jovens com maior vulnerabilidade por exposição à infecção, reorganizar fluxos de atendimentos de modo a conhecer aqueles que continuamente procuram o serviço para retestagem, bem como capacitar profissionais a fim de que não tenham constrangimento na abordagem sobre práticas sexuais, constituem-se elementos essenciais para uma testagem ativa na rotina dos serviços (27) .…”

“…A limitação do acesso aos testes, a redução de busca por indivíduos mais jovens, bem como a procura tardia pela testagem podem se apresentar como fatores diagnósticos para HIV mais tardios nesta faixa etária. Cabe ainda, reflexão quanto à ênfase dada a estratégias de testagem entre jovens de 15 a 19 anos, para proporcionar oportunidades de diagnóstico e tratamento adequadas (24,(27)(28)(29)(30) .…”

Partying in Thailand: Never Testing Among Men Who Have Sex With Men Who Attend Sexualized (Drug) Parties

“…4 However, only 52.8% of Thai MSM had ever been tested for HIV and knew their current HIV status, especially among younger MSM. 5,6 Delayed linkage to care due to undiagnosed HIV status continues to fuel the HIV epidemics, as it leads to increased transmission. 3,7,8 The lack of HIV testing uptake by MSM may be attributable to unique challenges that are specific to the Thai context.…”

“…Modeling data show that Thailand can attain the UNAIDS goal to end AIDS by 2030 if HIV testing coverage among key populations is increased to 90% 4 . However, only 52.8% of Thai MSM had ever been tested for HIV and knew their current HIV status, especially among younger MSM 5,6 . Delayed linkage to care due to undiagnosed HIV status continues to fuel the HIV epidemics, as it leads to increased transmission 3,7,8 …”