BEHAVIORAL AND SOCIODEMOGRAPHIC RISKS FOR FREQUENT VISITS TO COMMERCIAL SEX WORKERS AMONG NORTHERN THAI MEN

Objective: The transmission of HIV-1 in Thailand has recently been attributed to exposure to infected commercial sex workers (CSW). We sought to identify risk factors for patterns of CSW visits among northern Thai men. Design: Retrospective recall of lifetime and recent CSW visits and associated risk factors were obtained by interview. Setting: Two military bases in northern Thailand. Participants: We enrolled two cohorts (n=2417) of young men, aged 19-23 years, who were conscripted into the Royal Thai Army and Air Force from six provinces in northern Thailand in May and November 1991. Main outcome measures: Frequency of self-reported lifetime and recent sex with CSW. Results: Multivariate results showed that lower socioeconomic status, early first intercourse and substance-use factors (alcohol, marijuana, other drugs, and smoking) associated with lifetime and recent sex with CSW. Sexual intercourse with other female partners, lower price paid at last CSW visit and frequency of condom use with CSW did not differentiate frequent from infrequent CSW visitors. Conclusions: Limits in the frequency of sex with CSW, improved condom practices and reduction of drinking prior to CSW visits would all appear to provide substantial protection from exposure to HIV-1 in this setting.