Background: Almost half of all new HIV infections in Thailand occur among low-risk partners of HIV-infected persons, so it is important to include HIV-infected persons in prevention efforts.
Methods: Risk for HIV transmission was assessed among HIV-infected persons attending routine care at the National Infectious Disease Institute in Thailand. Sexual risk behavior, sexually transmitted infection (STI; syphilis, gonorrhea, chlamydia, trichomoniasis, and genital ulcers) prevalence, and HIV disclosure status were assessed. Patients were provided with STI care, risk-reduction and HIV disclosure counseling.
Results: Baseline data were assessed among 894 consecutive HIV-infected persons (395 men and 499 women) from July 2005 through 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). Persons receiving antiretroviral treatment were less likely to report unsafe sex (p<0.001). Overall, 10.7% of men and 7.2% of women had an 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 persons 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 HIV-infected persons in Thailand should be developed.
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