1018 
Risk factors for HIV-1 Infection among Young Thai Men in 2005 to 2007
Ram Rangsin*1, K Kana2, T Chuenchitra2, A Sunantarod3, P Tengtrakulcharoen1, S Eiamtrakul4, and K Nelson5
1Phramongkutklao Coll of Med, Bangkok, Thailand; 2Armed Forces Inst of Med Sci, Bangkok, Thailand; 3Royal Thai Army Inst of Pathology, Bangkok; 4Phramongkutklao Hosp, Bangkok, Thailand; and 5Johns Hopkins Univ Bloomberg Sch of Publ Hlth, Baltimore, MD, US
Background: The course of
HIV-1 epidemic in Thailand has been decreased dramatically since its peak in
the early 1990s. The recent risk factors of HIV-1 infection should be examined.
Hepatitis C virus (HCV) antibody was believed to be a good surrogate marker for
intravenous drug users (IDU). ~30,000 military conscripts of the Royal Thai
Army aged 21 years old are selected bi-annually by random lottery selection
process. All of them are invited to voluntarily participate in the HIV-1
sero-surveillance.
Methods: We conducted a
case cohort study among military conscripts during 2005 to 2007. Cases were
defined as all military conscripts who were HIV-1 antibody positive from the
HIV-1 sero-surveillance. Cohort sample was selected from the whole conscripts
using systematic random sampling technique. The number of conscripts resulted
into the study of 700 to 1000 men each round of bi-annual induction. Among
HIV-1+ and cohort samples, stored blood samples from the HIV-1
sero-surveillance were tested for HCV antibody (Abbot HCV EIA 3.0). Self-administered
standardized questionnaires were used to obtain the risk behaviors. Data
analysis was performed for each year separately. Prevalence of HCV infection
was analyzed among HIV-1+ and negatives. Odds ratios and 95%CI were
obtained. Multiple logistic regression model was used to estimate the
independent risk factors.
Results: The prevalence
of HIV-1 infection was stable at 0.5% during 2005 to 2007. There were 4808 men
participated in the study in which 386 men were HIV-1+ and 4422 were
HIV–. HCV prevalence in 2005, 2006, and 2007 were 2.4, 3.2, 0.9% in
HIV-1– and they were 14.6, 6.1, and 7.6% in HIV-1+,
respectively. The independent risk factor for HIV-1 infection were sex between
men; adjusted OR 9.40 (95%CI, 3.51 to 25.15), 2.39 (1.20 to 4.74), and 4.88 (2.72
to 8.76) in 2005, 2006, and 2007, respectively. HCV infection was independently
associated with HIV-1 infection in 2005 and 2007; adjusted OR 6.76 (95%CI 2.85
to 16.03) and 4.40 (1.62 to 12.00), respectively. Female sex worker visit was
not significantly associated with HIV-1 infection during the study period.
Conclusions: Sex between
men and HCV infection were independently associated with HIV-1 infection among
young Thai men, recently. Since, HCV antibody was believed to be a good
surrogate marker for IDU, interventions for HIV prevention should focus more on
men who have sex with men and IDU in Thailand.
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