• HIV
• sexual dysphoria
• screening
• sex change

The health and behavioural issues of homosexual men and women have recently become a focus of research and interest. A well conceived framework within which to consider the uniqueness of problems faced by homosexual youths and the role of healthcare providers is needed.¹ Significant physical morbidity occurs among homosexual men and women because healthcare providers are often unaware of their actual or potential health concerns. Physical health concerns mainly include HIV disease, hepatitis, and other sexually transmitted diseases. Healthcare professionals, who are clinically competent in the care of homosexual men and women, should have the opportunity to reduce the risk of disease, while providing unbiased, quality care which recognises the unique problems of this population.² In this study, we report the prevalence of HIV infection among the homosexual men and women who visited the pre-admission clinic, King Chulalongkorn Memorial Hospital, Bangkok, for further sex change surgery.

A prospective study on the data concerning anti-HIV test for 35 cases (33 homosexual men and two lesbian women) with sexual dysphoria who attended the pre-admission clinic, King Chulalongkorn Memorial Hospital, Bangkok for further sex change surgery, during years 1999 and 2000 was performed. The demographic data about occupation, injecting drug use, previous plastic surgery, hormone injection, and abnormal sexual intercourse (as oral and anal sex) were also reviewed for each case.

For all 35 cases of sexual dysphoria, only two cases of anti-HIV seropositivity were detected. The prevalence was equal to 5.71%. These two cases were homosexual. The demographic data of HIV seronegative and HIV seropositive cases are shown in table1.

Currently, the two major routes of transmission of HIV are blood borne and sexual propagation. Sexual propagation also includes the abnormal sexual behaviour such as oral and anal sex found in the “gay” population.³ Unique aspects of Thai culture have shaped the response of homosexual men and women to HIV infection in Thailand. Thailand is a relatively homogeneous society that has, by and large, felt invulnerable to AIDS, viewing it primarily as a Western phenomenon. This attitude has also been common in the gay community and has resulted in some homosexual men and women engaging in high risk behaviour.

In Thailand it has been argued that HIV infection is still a major health problem among homosexual men and women. The current HIV epidemic among young homosexual men and women is a major public health concern. Nevertheless, hardly any specific HIV education interventions have been designed for this population. In this study, the rather high rate of HIV infection among the homosexual men and women attending the hospital for further sex change surgery was detected. Compared with the rate in the general population in Thailand,⁴ this rate is five times higher. Therefore, this population is still a target group for HIV infection, and thus, proper control for this population is necessary.