Evidence of a previously undocumented epidemic of HIV infection among men who have sex with men in Bangkok,Thailand

Background: The HIV prevalence and associated risk behaviours in Thai men who have sex with men (MSM) are unknown. This information is crucial to inform and implement targeted preventive interventions for this population. Methods: A cross-sectional assessment, using venue-day-time sampling, was conducted. Participants were 1121 Thai men who were 18 years or older, were residents of Bangkok, and reported anal or oral sex with a man during the past 6 months. Oral fluid specimens were tested for HIV antibody. Demographic and behavioural data were collected using an interviewer-administered Palm based automated questionnaire. Results: HIV prevalence was 17.3% (194 of 1121). Mean age was 26.9 years (median 25 years), and university education was completed by 42.5%. Sex with men and women during the past 6 months was reported by 22.3%; sex with a woman ever, 36%; and unprotected sexual intercourse during the past 3 months, 36.0%. Alcohol use during the past 3 months was common (73.7%); drug use was rare (2.5%). Multivariate logistic regression analyses showed lower education, recruitment from a park, self-identification as homosexual, receptive and insertive anal intercourse, more years since first anal intercourse, and more male sex partners to be significantly and independently associated with HIV prevalence. Conclusions: HIV infection is common among MSM in Bangkok. HIV prevention programs are urgently needed to prevent further spread of HIV in this young and sexually active population. (c) 2005 Lippincott Williams & Wilkins.