Indicators for sexual HIV transmission risk among people in Thailand attending HIV care: the importance of positive prevention
- P Tunthanathip1,
- R Lolekha2,
- L J M Bollen2,
- A Chaovavanich1,
- U Siangphoe2,
- C Nandavisai2,
- O Suksripanich2,
- P Sirivongrangson3,
- A Wiratchai1,
- Y Inthong1,
- B Eampokalap1,
- J Ausavapipit1,
- P Akarasewi2,
- K K Fox2,4
- 1Bamrasnaradura Institute, Thailand Ministry of Public Health (MOPH), Nonthaburi, Thailand
- 2Thailand MOPH—US Centers for Disease Control and Prevention (CDC) Collaboration, Nonthaburi, Thailand
- 3STI Division, Bureau of AIDS, TB and STIs, MOPH, Bangkok, Thailand
- 4Global AIDS Program, CDC, Atlanta, Georgia, USA
- Rangsima Lolekha, Thailand MOPH—US CDC Collaboration, PO Box 139, Nonthaburi 11000, Thailand;
- Accepted 24 September 2008
- Published Online First 16 October 2008
Background: Almost half of all new HIV infections in Thailand occur among low-risk partners of people infected with HIV, so it is important to include people infected with HIV in prevention efforts.
Methods: Risk for HIV transmission was assessed among people with HIV attending routine care at the National Infectious Disease Institute in Thailand. Sexual risk behaviour, sexually transmitted infection (STI—syphilis, gonorrhoea, chlamydia, trichomoniasis and genital ulcers) prevalence and HIV disclosure status were assessed. Patients were provided with STI care, risk-reduction and HIV disclosure counselling.
Results: Baseline data were assessed among 894 consecutive people with HIV (395 men and 499 women) from July 2005 to September 2006. Unprotected last sex with a partner of unknown or negative HIV status (unsafe sex) was common (33.2%) and more likely with casual, commercial or male-to-male sex partners than with steady heterosexual partners (p = 0.03). People receiving antiretroviral treatment were less likely to report unsafe sex (p<0.001). Overall, 10.7% of men and 7.2% of women had a STI (p = 0.08). More women than men had disclosed HIV status to their steady partners (82.5% vs 65.9%; p = 0.05).
Conclusion: Indicators for HIV transmission risk were common among people attending HIV care in Bangkok. Efforts need to be strengthened to reduce unsafe casual and commercial sex and to increase HIV disclosure from men to their partners. A strategy for STI screening and treatment for people with HIV in Thailand should be developed.
Presented in part at the 14th International Union against Sexually Transmitted Infections (IUSTI) Asia Pacific Conference, 27–30 July 2006; Kuala Lumpur, Malaysia. Abstract FP2.
Competing interests: None.
Ethics approval: This project was approved by the Thai MOPH and the US CDC as a programme activity and did not require review by an institutional review board.
Contributors: PT participated in project design, project implementation and interpretation of data. RL and LB participated in project design, project implementation, statistical analysis, interpretation of data and preparation of the manuscript. AC participated in project design and interpretation of data. US performed statistical analysis and interpretation of data. PS participated in project design and project implementation. CN, OS, AW, YI, BE, JA participated in project implementation and data collection. PA participated in project implementation. KF participated in project design, statistical analysis, interpretation of data and preparation of the manuscript. All authors approved the final version of the manuscript.
The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the US Centers for Disease Control and Prevention.