Widely varying HIV prevalence and risk behaviours among the ethnic minority peoples of northern Thailand

Abstract

We compared HIV prevalence, risk behaviours, and social and sexual norms among nine ethnic minority (Hilltribe) groups in northern Thailand. Communities were selected on the basis of size, ethnicity, development level and geography. Subjects (15-45 years) were stratified by gender and selected by household using two-stage randomization. Forty volunteers were identified in each of 27 villages. Participation was voluntary and informed consent was obtained. HIV infection status was determined using ELISA and Western Blot on saliva samples. Risks for HIV were measured with structured interviews using local languages. Overall HIV prevalence was 23/1080 (2.13%) with an equal male-female ratio. HIV prevalence rates were: Shan 8.75%, Akha 5.0%, Yao 5.0%, Thin 1.25%, Hmong 0.63%, Lahu 0.63%, Lisu 0.63%, Karen 0, and Pa-Long 0. Sex worker use was an HIV risk for men (p=0.0001), but injecting drug use was not; for women, having been a sex worker was a significant HIV risk (p< 0.0001). HIV rates, social norms and sexual behaviour varied considerably among ethnic groups, as did attitudes toward commercial sex work and use. HIV prevention needs to target the Shan, Akha, and Yao communities, and to focus on reduction of brothel work and use.