HIV This Week

Trends in HIV Prevalence, Estimated HIV Incidence, and Risk Behaviour Among Men Who Have Sex With Men in Bangkok, Thailand, 2003-2007.

van Griensven F, Varangrat A, Wimonsate W, Tanpradech S, Kladsawad K, Chemnasiri T, Suksripanich O, Phanuphak P, Mock P, Kanggarnrua K, McNicholl J, Plipat T. J Acquir Immune Defic Syndr. 2009 No. [Epub ahead of print]

Men who have sex with men (MSM) continue to be at high risk for HIV infection. Here the authors evaluate trends in HIV prevalence, estimated HIV incidence, and risk behaviour among MSM in Bangkok, Thailand. Between 2003 and 2007, 3 biennial cross-sectional HIV prevalence assessments were conducted among men who have sex with men in Bangkok, Thailand, using venue-day-time sampling. Oral fluid was tested for HIV infection; demographic and behavioural data were self-collected using hand-held computers. Estimates of annual HIV incidence in young men who have sex with men were derived as follows: (number of HIV infections/sum of [current age-age at start of anal intercourse]) x 100). Logistic and Poisson regression was used to evaluate trends in HIV prevalence, estimated HIV incidence, and risk behaviour. The overall HIV prevalence increased from 17.3% in 2003 to 28.3% in 2005 to 30.8% in 2007 (P < 0.001 for trend). The estimated HIV incidence among young men who have sex with men increased from 4.1% in 2003 to 6.4% in 2005, to 7.7% in 2007 (P < 0.02 for trend). The increase in HIV prevalence from 2005 to 2007 was not statistically significant. The proportion of men reporting anal sex and casual or steady male sex partners in the past 3 months significantly decreased, whereas the proportion reporting drug use and drug use during sex significantly increased. No increase was observed in the proportion of men reporting consistent condom use. These data suggest that after a strong increase from 2003 to 2005, the HIV prevalence among men who have sex with men in Bangkok may have begun to stabilize. Given the continuing high levels of risk behaviour and the estimated high HIV incidence in young MSM, additional HIV preventive interventions are necessary.

Abstract: 1

Editors’ note: The high HIV prevalence in Bangkok among men who have sex with men is part of the global phenomenon of resurgent or newly described HIV epidemics among men who have sex with men around the world. The encouraging signs of a possible epidemic plateau should not distract from the need to intensify efforts towards universal access to services and prevention interventions for this key population. It is clear that current programmes are inadequate to reverse the epidemic among Thai men who have sex with men, unlike the 100 per cent condom campaign that led to the resounding success of the Royal Thai government in reversing the epidemic of heterosexual transmission in the mid-1990s.