HIV Incidence, Risk Factors, and Motivation for Biomedical Intervention among Gay, Bisexual Men, and Transgender Persons in Northern Thailand

Suwat Chariyalertsak,Chris Beyrer,Pongpun Saokhieo,Radchanok Songsupa,Natthapol Kosachunhanan,Surasing Visarutratana,Chonlisa Chariyalertsak,Antika Wongthanee,Zhiwei Chen

doi:10.1371/journal.pone.0024295

Suwat Chariyalertsak, Chris Beyrer + Show 7 more

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https://doi.org/10.1371/journal.pone.0024295

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Abstract

BackgroundHIV prevalence among men who have sex with men (MSM) and transgender (TG) persons is high and increasing in Chiang Mai, northern Thailand.ObjectivesTo describe demographic, socioeconomic, sexual behavior and interest in future HIV prevention trials among gay and bisexual MSM and TG presenting for HIV testing (VCT) and pre-screening for the iPrEx pre-exposure chemoprophylaxis trail.MethodsIn 2008–09, MSM/TG participants attending VCT were interviewed and tested for HIV and STI. Univariate and multivariate regression analyses were done to assess associations with HIV infection.ResultsA total of 551 MSM clients (56.1% gay, 25.4% TG, and 18.5% bisexual (BS)) were enrolled. The mean age was 23.9 years. HIV prevalence among MSM overall was 12.9% (71/551); 16.5% among gay men, 9.3% among TG, and 6.9% among BS. Consistent use of condom was low, 33.3% in insertive anal sex and 31.9% in receptive anal sex. Interest in participation was high, 86.3% for PrEP, 69.7% for HIV vaccine trials, but 29.9% for circumcision. HIV was independently associated with being gay identified, aOR 2.8, p = 0.037 and with being aged 25–29, aOR 2.7, p = 0.027. Among repeat testers, HIV incidence was 8.2/100 PY, 95% CI, 3.7/100PY to 18.3/100PY.ConclusionHIV risks and rates varied by self-reported sexual orientation and gender identity. HIV was associated with sexual practices, age, and being gay-identified. These are populations are in need of novel prevention strategies and willing to participate in prevention research.

Highlights

HIV infection rates are high and rising among men who have sex with men (MSM) in Thailand [1,2,3]
These are populations are in need of novel prevention strategies and willing to participate in prevention research
The aim of this study was to assess the HIV prevalence among populations of MSM who self-identified as gay/homosexual, TG or bisexual; to describe their socio-demographics and sexual risk behavior patterns; and to assess willingness to participate in biomedical intervention trials for HIV prevention

Summary

Introduction

HIV infection rates are high and rising among men who have sex with men (MSM) in Thailand [1,2,3]. IPrEx reported an overall 44% reduction in HIV incidence (95% CI, 15–63; P = 0.0005) among 2499 seronegative men and transgender women receiving oral daily Truvada vs placebo [5]. This landmark result has raised an array of new questions about the likely target populations for oral pre-exposure prophylaxis (PrEP,) and interest in communities at risk in this and other interventions, including generation ARV-based regimens, HIV vaccines, and rectal microbicides [6]. The PIMAN Center provided HIV testing and counseling (VCT) and STI services to MSM in Chiang Mai as a gateway to contacting MSM and TG populations interested in participating in iPrEx and other HIV prevention trials. HIV prevalence among men who have sex with men (MSM) and transgender (TG) persons is high and increasing in Chiang Mai, northern Thailand

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