HIV Infection Rate, Use of Prostitutes Are Both High Among Young Military Recruits in Northern Thailand

Abstract

Serological and sex behavior data collected in May and November 1991 on 2417 male military recruits aged 19-23 from six provinces in northern Thailand were analyzed. 12% tested positive for HIV 11% in May and 13% in November while 4% tested positive for syphilis. Having had four years or less of formal education; having been employed; cigarette marijuana and alcohol use; having sex with relatively less expensive prostitutes; ever using a condom with a prostitute; and an history of STD were all positively associated with being HIV-positive. All but two of the HIV- positive men reported having sex with a woman making them 13.7 times more likely to be infected with HIV than those who were not similarly experienced. Men reporting twenty or more lifetime sex partners were ten times more likely to be infected with HIV than were men with four or fewer lifetime partners. 97% of HIV-positive men reported having had sexual contact with a female prostitute and they were 7.4 times as likely as those who had not to be infected with HIV. 79% of men who were not HIV-positive however also reported contact with a female prostitute. Sex with female prostitutes is thus the norm among these men. The more contacts a recruit had with a female prostitute in the past year the greater his likelihood of being HIV-positive. Having had sex with a wife or girlfriend was not associated with HIV infection. Sex with a man was reported by 3% of the sample but was not associated with HIV infection. Homosexual orientation and drug use are not grounds for automatic exclusion from the Thai military. The same lack of positive association held for the use of injection drugs and having a tattoo reported by 1% and 8% respectively. A 1991 study of 1034 never married men in Chiang Mai also found that many young unmarried males visit prostitutes and have unprotected intercourse with both prostitutes and other female partners. Sex with female prostitutes is the main risk factor for HIV infection among these men. The level of condom use must be increased and the use of female prostitutes decreased if the AIDS epidemic is to be checked.