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

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.

Characteristics of a Sexual Network of Behaviorally Bisexual Men in Vientiane, Lao PDR, 2010

“…While behaviorally homosexual and bisexual men had the lowest levels of CCU, the overall level of CCU was low across the sample-and lower than has been reported for similar populations in Thailand (Chemnasiri et al, 2010;Li et al, 2009a). The comparison of levels of CCU between Lao PDR and Thailand is important given cultural similarities between the two countries.…”

“…Chow, Wilson, & Zhang, 2012), have also highlighted the potential for behaviorally bisexual men to act as a bridge of HIV transmission, although there are no current studies supporting this as a major source of HIV transmission. In some settings, HIV prevalence among men who have sex with men and women is lower than among men who have sex with men only (Li et al, 2009b) and the number of sex acts between behaviorally bisexual men and their female partners low (Chow et al, 2012), which may help reduce the risk of bridging. Nonetheless, our study demonstrates clear links between behaviorally homosexual and bisexual men, and reports on high numbers of both male and female partners.…”

“…While there is a growing field of research surrounding the behaviors of men who have sex with men in Southeast Asian countries such as Thailand, Vietnam and Lao People's Democratic Republic (Lao PDR) (Bengtsson, Thorson, Thanh, Allebeck, & Popenoe, 2013;Beyrer et al, 1995;Kontula & Haavio-Mannila, 1995;Laumann, Gagnon, Michael, & Michaels, 1994;Sheridan et al, 2009;Smith, Rissel, Richters, Grulich, & de Visser, 2003;Toole et al, 2006;Wellings, Field, Johnson, & Wadsworth, 1994;World Health Organization, 2010), there has been only a narrow scope of exploration into the context and behaviors of men that have sex with both men and women in the region, with Thailand being the primary focus (Li et al, 2009a;van Griensven et al, 2004). Further, there has been limited epidemiological consideration of the role of transgendered (male to female) individuals (commonly known as "kathoey teng ying" or "kathoey phom yao" in Lao PDR and herein referred to as "kathoey") as sexual partners.…”

Drugs, sex, and the geographies of sexual health in Thailand, Southeast Asia

“…The 2010 report by the National AIDS Prevention and Alleviation Committee notes, for example, that HIV rates have risen since 2003 among MSM, with rates in Bangkok increasing from 17.3 per cent to 30.7 per cent among self-identified MSM. While studies immediately following the 'war on drugs' reported very low levels of drug use (Mansergh et al 2006;Vongchak et al 2005), more recent studies suggest that 'lifetime drug use was a risk factor for HIV infection' among MSM in Thailand (Li et al 2009). In comparison, the National AIDS Prevention and Alleviation Committee (2010: 26) also reported that 'In addition to the risk from needle sharing, the survey found that many IDU have unsafe sex: only 35 per cent reported using a condom at last sex.'…”

Preventing Mother-to-Child Transmission of HIV — Protecting This Generation and the Next

“…Recently, a number of studies have focused on epidemiological and behavioural differences between men who have sex only with other men and those who have sex with both men and women. In Bangkok, men who have sex only with other men are more than 2.5 times more likely to be HIV-infected than men who have sex with both men and women (Li et al, 2009). While one study in Jinan, China, found that unmarried men who have sex only with other men were more than six times more likely to be HIV-infected than married men with both male and female partners (Ruan et al, 2009), another survey in Chongqing, China, determined that married men who have sex with men were more than twice as likely to be infected as their non-married counterparts (Feng et al, 2009 Ma et al, 2007;Mansergh et al, 2006).…”