Abstract
HIV prevalence and associated risk behaviors were examined among Thai bisexually active men (MSMW, n = 450) and men who have sex with men only (MSM-only, n = 1,125). Cross sectional venue-day-time sampling was used to collect data. Chi-square and logistic regression were used to identify HIV risk factors. HIV prevalence was 8.2% among MSMW and 21.2% among MSM-only. Consistent condom use with male partners was higher among MSMW (77.6%) than MSM-only (62.9%), and lower with female partners (44.4%). Lack of family confidant, migration, concern about acquiring HIV infection, and self-reported STD were associated with HIV prevalence among MSMW. Older age, lower educational level, residing in Bangkok or Chiang Mai, living away from family, recruitment from a sauna, increased frequency of visiting the surveyed venue, practicing receptive or both receptive and insertive anal intercourse, inconsistent condom use with male paying partners, and a history of drug use were associated with HIV prevalence in MSM-only.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Adimora, A. A., & Fullilove, R. E. (2006). Men who have sex with men and women: Pieces of the U.S. HIV epidemic puzzle. Sexually Transmitted Diseases, 10, 596–598. doi:10.1097/01.olq.0000233666.67788.fc.
Anonymous. (1988). Leads from the MMWR. Number of sex partners and potential risk of sexual exposure to human immunodeficiency virus. Journal of the American Medical Association, 260(14), 2020–2021. doi:10.1001/jama.260.14.2020
Bankole, A., Darroch, J. E., & Singh, S. (1999). Determinants of trends in condom use in the United States, 1988–1995. Family Planning Perspectives, 31(6), 264–271. doi:10.2307/2991536.
Beesey, A. (2000). HIV vulnerability and mobile populations: Thailand and its borders. Development Bulletin (Canberra), June(52), 38–41.
Beyrer, C., Eiumtrakul, S., Celentano, D. D., Nelson, K. E., Ruckphaopunt, S., & Khamboonruang, C. (1995). Same-sex behavior, sexually transmitted diseases and HIV risks among young northern Thai men. AIDS (London, England), 9(2), 171–176.
Beyrer, C., Razak, M. H., Jittiwutikarn, J., Suriyanon, V., Vongchak, T., Srirak, N., et al. (2004). Methamphetamine users in northern Thailand: Changing demographics and risks for HIV and STD among treatment-seeking substance abusers. International Journal of STD & AIDS, 15(10), 697–704. doi:10.1258/0956462041944376.
Boulton, M., Hart, G., & Fitzpatrick, R. (1992). The sexual behaviour of bisexual men in relation to HIV transmission. AIDS Care, 4(2), 165–175. doi:10.1080/09540129208253088.
Caceres, C. F., & van Griensven, G. J. (1994). Male homosexual transmission of HIV-1. AIDS (London, England), 8(8), 1051–1061. doi:10.1097/00002030-199408000-00004.
Centers for Disease Control and Prevention. (2006). HIV prevalence among populations of men who have sex with men—Thailand, 2003 and 2005. Morbidity and Mortality Weekly Report, 55(31), 844–848.
Central Intelligence Agency. (2007). The World Factbook Thailand. Retrieved on September 17, 2007 from https://www.cia.gov/library/publications/the-world-factbook/geos/th.html#People.
Colby, D. J. (2003). HIV knowledge and risk factors among men who have sex with men in Ho Chi Minh City, Vietnam. Journal of Acquired Immune Deficiency Syndromes, 32(1), 80–85.
Colfax, G. N., Mansergh, G., Guzman, R., Vittinghoff, E., Marks, G., Rader, M., et al. (2001). Drug use and sexual risk behavior among gay and bisexual men who attend circuit parties: A venue-based comparison. Journal of Acquired Immune Deficiency Syndromes, 28(4), 373–379.
Ekstrand, M. L., Coates, T. J., Guydish, J. R., Hauck, W. W., Collette, L., & Hulley, S. B. (1994). Are bisexually identified men in San Francisco a common vector for spreading HIV infection to women? American Journal of Public Health, 84(6), 915–919.
Girault, P., Saidel, T., Song, N., de Lind Van Wijngaarden, J. W., Dallabetta, G., Stuer, F., et al. (2004). HIV, STIs, and sexual behaviors among men who have sex with men in Phnom Penh, Cambodia. AIDS Education and Prevention, 16(1), 31–44. doi:10.1521/aeap.16.1.31.27727.
Hanenberg, R. W., Kunasol, P., & Sokal, D. C. (1994). Impact of Thailand’s HIV-control programme as indicated by the decline of sexually transmitted diseases. Lancet, 344, 243–245. doi:10.1016/S0140-6736(94)93004-X.
Hightow, L. B., Leone, P. A., Macdonald, P. D., McCoy, S. I., Sampson, L. A., & Kaplan, A. H. (2006). Men who have sex with men and women: A unique risk group for HIV transmission on North Carolina College campuses. Sexually Transmitted Diseases, 33(10), 585–593. doi:10.1097/01.olq.0000216031.93089.68.
Izazola-Licea, J. A., Gortmaker, S. L., de Gruttola, V., Tolbert, K., & Mann, J. (2003). Sexual behavior patterns and HIV risks in bisexual men compared to exclusively heterosexual and homosexual men. Salud p’Ublica de M’Exico., 45(Supp 5), S662–S671. doi:10.1590/S0036-36342003001100012.
Jackson, P. (1997). Kathoey><Gay><Man: The historical emergence of gay male identity in Thailand. In L. Manderson & M. Jolly (Eds.), Sites of desire, economies of pleasure (pp. 166–190). Chicago: University of Chicago Press.
Kunawararak, P., Beyrer, C., Natpratan, C., Feng, W., Celentano, D. D., de Boer, M., et al. (1995). The epidemiology of HIV and syphilis among male commercial sex workers in northern Thailand. AIDS (London, England), 9(5), 517–521.
Mansergh, G., Colfax, G. N., Marks, G., Rader, M., Guzman, R., & Buchbinder, S. (2001). The circuit party men’s health survey: Findings and implications for gay and bisexual men. American Journal of Public Health, 91(6), 953–958.
Mansergh, G., Naorat, S., Jommaroeng, R., Jenkins, R. A., Jeeyapant, S., Kanggarnrua, K., et al. (2006). Adaptation of venue-day-time sampling in Southeast Asia to access men who have sex with men for HIV assessment in Bangkok. Field Methods, 18(2), 135–152. doi:10.1177/1525822X05282267.
Maticka-Tyndale, E., Elkins, D., Haswell-Elkins, M., Rujkarakorn, D., Kuyyakanond, T., & Stam, K. (1997). Contexts and patterns of men’s commercial sexual partnerships in northeastern Thailand: Implications for AIDS prevention. Social Science and Medicine, 44(2), 199–213. doi:10.1016/S0277-9536(96)00146-3.
Montgomery, J. P., Mokotoff, E. D., Gentry, A. C., & Blair, J. M. (2003). The extent of bisexual behaviour in HIV-infected men and implications for transmission to their female sex partners. AIDS Care, 15(6), 829–837. doi:10.1080/09540120310001618676.
Nagachinta, T., Duerr, A., Suriyanon, V., Nantachit, N., Rugpao, S., Wanapirak, C., et al. (1997). Risk factors for HIV-1 transmission from HIV-seropositive male blood donors to their regular female partners in northern Thailand. AIDS (London, England), 11(14), 1765–1772. doi:10.1097/00002030-199714000-00014.
Nelson, K. E., Eiumtrakul, S., Celentano, D. D., Beyrer, C., Galai, N., Kawichai, S., et al. (2002). HIV infection in young men in northern Thailand, 1991–1998: Increasing role of injection drug use. Journal of Acquired Immune Deficiency Syndromes, 29(1), 62–68.
Phanuphak, P., Muller, O., Sarangbin, S., & Sittitrai, W. (1994a). Knowledge, attitudes and behaviour among HIV-positive and HIV-negative clients of a confidential HIV counselling and testing centre in Thailand. AIDS (London, England), 8(9), 1315–1319.
Phanuphak, P., Muller, O., Sarangbin, S., & Sittitrai, W. (1994b). Knowledge, attitudes and behaviour among HIV-positive and HIV-negative clients of a confidential HIV counselling and testing centre in Thailand. AIDS (London, England), 8(9), 1315–1319.
Podhisita, C., Wawer, M. J., Pramualratana, A., Kanungsukkasem, U., & McNamara, R. (1996). Multiple sexual partners and condom use among long-distance truck drivers in Thailand. AIDS Education and Prevention, 8(6), 490–498.
Sittitrai, W., Phanuphak, P., Barry, J., & Brown, T. (1992). Thai sexual behavior and risk of HIV infection. Bangkok: Thai Red Cross Society.
Skeldon, R. (2000). Population mobility and HIV vulnerability in Southeast Asia: An assessment and analysis. Bangkok: United Nations Development Programme.
Stokes, J., McKirnan, D. J., Doll, L., & Burzette, R. G. (1996). Bisexual men, sexual behavior, and HIV/AIDS. In B. Firestein (Ed.), Bisexuality: The psychology and politics of an invisible minority. Newbury Park, CA: Sage.
Thai Working Group on HIV/AIDS Projection. (2001). HIV/AIDS projections for Thailand 2000–2020. Thailand Ministry of Public Health.
Thailand Ministry of Public Health. (2003). Reported AIDS cases by transmission category, 1984–2003. Nonthaburi, Thailand: Department of Epidemiology, Thailand Ministry of Public Health.
Thailand Ministry of Public Health. (2004). Guidelines for the care and treatment of HIV/AIDS in children and adults in Thailand (8th ed.). Nonthaburi, Thailand: Division of AIDS, Department of Disease Control, Thailand Ministry of Public Health.
Thailand Ministry of Public Health. (2006). HIV sero-surveillance in Thailand: Result of the 23rd round, June 2005. Nonthaburi, Thailand: Thailand Ministry of Public Health.
van Griensven, F., Kilmarx, P. H., Jeeyapant, S., Manopaiboon, C., Korattana, S., Jenkins, R. A., et al. (2004). The prevalence of bisexual and homosexual orientation and related health risks among adolescents in northern Thailand. Archives of Sexual Behavior, 33(2), 137–147. doi:10.1023/B:ASEB.0000014328.49070.8c.
van Griensven, F., Naorat, S., Kilmarx, P. H., Jeeyapant, S., Manopaiboon, C., Chaikummao, S., et al. (2006). Palmtop-assisted self-interviewing for the collection of sensitive behavioral data: Randomized trial with drug use urine testing. American Journal of Epidemiology, 163(3), 271–278. doi:10.1093/aje/kwj038.
van Griensven, F., Thanprasertsuk, S., Jommaroeng, R., Mansergh, G., Naorat, S., Jenkins, R. A., et al. (2005). Evidence of a previously undocumented epidemic of HIV infection among men who have sex with men in Bangkok, Thailand. AIDS (London, England), 19(5), 521–526. doi:10.1097/01.aids.0000162341.50933.e8.
Wangroongsarb, Y., Weniger, B. G., Wasi, C., Traisupa, A., Kunasol, P., Rojanapithayakorn, W., et al. (1985). Prevalence of HTLV-III/LAV antibody in selected populations in Thailand. The Southeast Asian Journal of Tropical Medicine and Public Health., 16(4), 517–520.
Weinhardt, L. S., Carey, M. P., Johnson, B. T., & Bickham, N. L. (1999). Effects of HIV counseling and testing on sexual risk behavior: A meta-analytic review of published research, 1985–1997. American Journal of Public Health, 89(9), 1397–1405.
Wold, C., Seage, G. R., III, Lenderking, W. R., Mayer, K. H., Cai, B., Heeren, T., et al. (1998). Unsafe sex in men who have sex with both men and women. Journal of Acquired Immune Deficiency Syndromes, 17(4), 361–367.
Acknowledgments
Andrea Li is a medical student III at Vanderbilt University, Nashville, TN, and participated in this project as an intern with the Thailand Ministry of Public Health—U.S. Centers for Disease Control and Prevention Collaboration (TUC). The authors thank the personnel of TUC, the Rainbow Sky Association of Thailand and the Thai Red Cross Society for their contributions to this work. This study was supported by TUC. Disclaimer: the findings and conclusions in this paper are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Li, A., Varangrat, A., Wimonsate, W. et al. Sexual Behavior and Risk Factors for HIV Infection Among Homosexual and Bisexual Men in Thailand. AIDS Behav 13, 318–327 (2009). https://doi.org/10.1007/s10461-008-9448-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10461-008-9448-3