HIV Risk Perception, Sexual Behavior, and HIV Prevalence among Men-Who-Have-Sex-with-Men at a Community-Based Voluntary Counseling and Testing Center in Kuala Lumpur, Malaysia.

Kwee Choy Koh,Lit Sin Yong

doi:10.1155/2014/236240

Abstract

We describe the HIV risk perception, sexual behavior, and HIV prevalence among 423 men-who-have-sex-with-men (MSM) clients who received voluntary counseling and testing (VCT) services at a community-based center in Kuala Lumpur, Malaysia. The mean age was 29 years old. One hundred one (23.9%) clients rated themselves as low risk, 118 (27.9%) as medium risk, 36 (8.5%) as high risk, and 168 (39.7%) were unsure of their risk. Twenty-four (9.4%) clients tested HIV positive (4 (4%) low risk, 9 (7.6%) medium risk, 11 (30.6%) high risk, and 13 (7.7%) unsure risk). We found a positive correlation between risk perception and HIV infection in this study. Clients with high HIV risk perception have 17x the odds of testing HIV positive compared to low risk clients. High HIV risk perception was significantly associated with multiple sex partners, multiple types of sex partners, alcohol use before intercourse, unprotected sex beyond 6 months, and inconsistent condom use during anal sex compared to low risk clients. There were no statistically significant differences between medium risk and unsure risk clients compared to low risk clients. Strategies should be targeted towards change in sexual practices among those who are perceived to be at high risk.

Highlights

HIV risk perception studies among men-who-have-sex-withmen (MSM) have often reported similar findings, namely: inaccurate or misperception of HIV risk being common among MSM [1, 2], perception of low risk being associated with no previous HIV testing and considerable high risk behavior [3,4,5], and moderate/high risk being associated with unrecognized HIV infection [4]
We present the findings of a study where we explored the relationship between HIV risk perception in a cohort of MSM who sought voluntary counseling and testing (VCT) services at a nongovernmental organizations (NGO)-run center in Kuala Lumpur, Malaysia, and their sexual behavior and risk factors
From a total of 423 clients, 101 (23.9%) clients perceived themselves to be at low risk (75%), while the remaining 168 (39.7%) clients were unsure regarding their risk

Summary

Introduction

HIV risk perception studies among men-who-have-sex-withmen (MSM) have often reported similar findings, namely: inaccurate or misperception of HIV risk being common among MSM [1, 2], perception of low risk being associated with no previous HIV testing and considerable high risk behavior [3,4,5], and moderate/high risk being associated with unrecognized HIV infection [4].Compared to the general adult population, MSM in Asia have 18.7 times the odds of being HIV infected [6]. Across Asia, HIV prevention expenditures targeting MSM have been reported to range between 0% in China to only 4% in Thailand [7]. The lack of funding for these programs is lamentable as prevention and harm reduction strategies targeting MSM are successful in reducing high-risk behaviors [8, 9]. MSM in Malaysia are part of the marginalized most-at-risk populations (MARP) that include commercial sex workers, migrant workers, and transgender people. HIV prevention programs including HIV testing among the MARP in Malaysia are mainly spearheaded by several nongovernmental organizations (NGO) with very limited resources. We present the findings of a study where we explored the relationship between HIV risk perception in a cohort of MSM who sought VCT services at a NGO-run center in Kuala Lumpur, Malaysia, and their sexual behavior and risk factors.

Methods

Results

Conclusion