THAC0202 - Oral Abstract Session
Incidence and risk factors of HIV-infection among young men who have sex with men in Bangkok, Thailand
Presented by Sarika Pattanasin (Thailand).
W. Thienkrua1, S. Pattanasin1, N. Promda1, S. Winaitham1, W. Sukwicha1, T. Chemnasiri1, S. Chaikummao1, A. Varangrat1, P. Sirivongrangson2, T.H. Holtz1,3
1Thailand Ministry of Public Health - U.S. CDC Collaboration, Nonthaburi, Thailand, 2Ministry of Public Health, Department of Disease Control, Nonthaburi, Thailand, 3U.S. Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, United States
Background: Formative research by our program among young (18-24 years old) men who have sex with men (YMSM) in Bangkok revealed misconceptions that likely influence HIV risk perception among YMSM, and subsequent safe sex practices. These findings led us to estimate incidence density, and examine risk factors for HIV infection among YMSM enrolled in the Bangkok MSM Cohort Study.
Methods: Between 2006-2010, Thai MSM, age 18 years and older from the Bangkok metropolitan area, were enrolled into a cohort study and followed every four months for 60 months. HIV testing was routinely performed at every visit on oral fluid, with serologic confirmation of all reactive specimens and all non-reactive specimens obtained after February 2010. At each visit, respondents were asked about sexual and drug use behaviors in the preceding four months using audio computer-assisted self-interview. We calculated incidence per 100 Person Years (PY) by survival analysis, and determined risk factors for HIV infection using Cox regression analyses.
Results: Of 1,744 participants enrolled, 712 (41%) were YMSM with a baseline HIV-prevalence of 21% (n=151). Of the remaining 561 participants, 67 were excluded due to missing data. Of the 494 YMSM for whom data were available for analyses, median age was 22 years (IQR: 20-23 years), 295 (60%) reported unprotected anal intercourse at baseline, and 214 (43%) had basic HIV knowledge. Respondents identified themselves as being at relatively moderate risk for infection with HIV/STI in the future. Overall incidence density was 7.5 per 100 PY. Multivariate risk factors for HIV-incidence were reported in the last four months: unprotected receptive anal intercourse (Adjusted Hazard Ratio, AHR, 2.8: 95% Confidence Interval, CI: 1.8-4.1), being paid for sex (AHR 2.2; 95% CI: 1.4-3.4), having a casual sexual encounter at a sauna (AHR 1.9; 95% CI: 1.3-2.9), or at home (AHR 1.6; 95% CI: 1.06-2.3), and living alone or with a roommate (AHR 1.5; 95% CI: 1.02-2.3).
Conclusions: Estimated HIV prevalence and incidence density among YMSM in Bangkok are high. Combination HIV prevention interventions that reduce HIV transmission during unprotected receptive anal intercourse, and education programs for skill-based training, are urgently needed for YMSM in Bangkok.
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