919
HIV Surveillance among Men who have Sex with Men (MSM) Populations in Thailand: Evidence for High Prevalence and Incidence
Frits Van Griensven*1,2, A Varangrat1, S Naorat1, C Sinthuwattanawibool1, J McNicholl1,2, P Mock1, T Siraprapasiri3, R Jommaroeng4,5, P Phanuphak4, J Tappero1,2, and the Thailand MSM Study Group
1Thailand Ministry of Publ Hlth-US CDC Collaboration, Nonthaburi; 2CDC, Atlanta, GA, US; 3Thailand Ministry of Publ Hlth, Bangkok; 4Thai Red Cross Society, Bangkok; and 5Rainbow Sky Assn, Bangkok, Thailand
Background:
In 2003, we conducted the first surveillance of HIV prevalence among MSM in
Bangkok (BKK). In 2005, surveillance was conducted in BKK, Chiang Mai (CM) and
Phuket (PKT) in MSM, male sex workers (MSW) and male transgenders
(TG). Here, we present the 2003 and 2005 HIV prevalence data.
Methods:
Cross-sectional surveys, using time-location sampling, were conducted from April
to May 2003 and from March to Oct 2005. Participants were Thai, 15 years or older
and had oral/anal sex with a man in the past 6 months. Palm-assisted
self-interviews gathered demographic and behavioral data. Oral fluid samples
were collected using Orasure and tested at a 1:2
dilution in single wells by Vironostika HIV-1 microelisa system. Positive samples were retested in duplicate
and those with 2/3 or 3/3 positive wells were reported as positive. HIV test
results were available to participants, and if positive they were referred for confirmatory
testing and treatment according to the Thai national guidelines.
Results: 1,121 MSM (mean age 29.5 yrs) were enrolled
in BKK in 2003; and 822 MSM (mean age 25.6 yrs), 754 MSW (mean age 24.4 yrs), and
274 TG (mean age 23.9 yrs) in
BKK, CM, and PKT in 2005. In BKK the
HIV prevalence among MSM increased from 17.3% in 2003 to 28.3% in 2005. In
2005, the HIV prevalence among MSM in CM was 15.3% and in PKT 5.5%. Among MSW, the
HIV prevalence was 18.9% in BKK, 11.4% in CM and 14.4% in PKT. HIV prevalence
in TG was 17.6% in CM and 11.2% in PKT. Data-collection among TG in BKK is ongoing.
|
HIV prevalence
|
|
2003
|
BKK
n/N
(%) 95% CI
|
CM
n/N
(%) 95% CI
|
PKT
n/N
(%) 95% CI
|
|
MSM
|
194/1,121 (17.3) 15.2-19.7
|
Not done
|
Not done
|
2005
|
|
|
|
MSM
|
113/400 (28.3) 23.9-33.0
|
34/222 (15.3) 11.0-20.9
|
11/200 (5.5) 2.9-9.9
|
|
MSW
|
66/350 (18.9) 14.0-23.4
|
23/202 (11.4) 7.5-16.8
|
29/202 (14.4) 10.0-20.1
|
|
TG
|
In progress
|
26/148 (17.6) 12.0-24.9
|
14/126 (11.1) 6.4-18.3
|
Conclusion: HIV prevalence data show that by 2005,
HIV was widespread in MSM, MSW and TG in BKK, CM and PKT. Between 2003 and 2005,
observed HIV prevalence among MSM in BKK increased by more than 50%, suggesting
a high underlying HIV incidence. Given this high HIV prevalence and incidence, MSM
in Thailand
should be considered for the implementation and evaluation of interventions to
prevent HIV transmission.
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