Skip to main content

Advertisement

SpringerLink
Log in

Psychosocial and Behavioral Characteristics of High-Risk Men Who Have Sex with Men (MSM) of Unknown HIV Positive Serostatus in Bangkok, Thailand

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

HIV prevalence remains high in men who have sex with men (MSM) in Bangkok. Even though resources for HIV testing and treatment are available for all, a large proportion of MSM still do not get HIV tested. We studied high risk MSM who are unaware of their HIV status to help maximize effectiveness of our resources. Convenience sampling was conducted among MSM who came for HIV testing at the Thai Red Cross Anonymous Clinic and two popular drop-in centers in Bangkok. Inclusion criteria were MSM aged >18 years, have not been tested positive for HIV, who reported ≥1 of the following in the previous 6 months: condomless sex with a male, being a sex worker, or having a sexual transmitted infection diagnosis. Audio-Computer-Assisted Self-Interview was used to assess psychosocial profile, sexual risks, and HIV testing patterns prior to being informed of their HIV positive status. Among 499 high-risk MSM enrolled, the median age was 24.8 years and 112 (22 %) tested HIV-positive. Among the HIV-positive participants, 92 % self-identified as gay (versus bisexual), 39 % attained a bachelors degree or higher, 65 % had monthly income 10,000-29,999 baht ($280-830 USD), 10 % had vaginal or anal sex with a woman in the past 12 months, 39 % had condomless receptive sex with men and 21 % went to Lat Phrao to find a sexual partner. Compared to HIV negative MSM, HIV-positive MSM had less HIV testing: 31 % had ever been tested for HIV, 12 % had been tested in the past 6 months; but were more likely to guess correctly their positive status (31 %). Regarding psychosocial variables among HIV-positive MSM, 7 % had regular methamphetamine use in the past 3 months, 10 % had >2 sources of discrimination, and 8 % had >2 sources of discrimination due to being MSM. In multivariable model, age<30 year old, self-identified as gay, had monthly income <50,000 baht ($1400 USD), had anal sex with men in past 12 months, had >2 sources of discrimination because of being MSM, did not get HIV test in past 6 months, and guess of positive HIV were significantly associated with HIV positive status. Young MSM with lower socioeconomic status (SES) should be prioritized for innovative approaches to promoting awareness and uptake of HIV testing. Societal stigmatization of MSM should be addressed as a potential barrier to uptake of voluntary HIV testing. Resilience factors among these marginalized MSM who still test frequently and remain HIV-negative despite residing in a context with community viral loads and discrimination should also be studied in order to curb the HIV epidemic in Bangkok.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. The Joint United Nations Programme on HIV/AIDS. 2014 GLOBAL STATISTICS. 2014.

  2. World Health Organization. Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations 2014.

  3. Joint United Nations Programme on HIV/AIDS. HIV in Asia and the Pacific UNAIDS report 2013.

  4. van Griensven F, Varangrat A, Wimonsate W, Tanpradech S, Kladsawad K, Chemnasiri T, et al. Trends in HIV prevalence, estimated HIV incidence, and risk behavior among men who have sex with men in Bangkok, Thailand, 2003–2007. J Acquir Immune Defic Syndr. 2010;53(2):234–9.

    Article  PubMed  Google Scholar 

  5. van Griensven F, Thienkrua W, McNicholl J, Wimonsate W, Chaikummao S, Chonwattana W, et al. Evidence of an explosive epidemic of HIV infection in a cohort of men who have sex with men in Thailand. Aids. 2013;27(5):825–32.

    Article  PubMed  Google Scholar 

  6. Novitsky V, Essex M. Using HIV viral load to guide treatment-for-prevention interventions. Curr Opin HIV AIDS. 2012;7(2):117–24.

    Article  CAS  PubMed  Google Scholar 

  7. McCarthy K WW, Guadamuz T, et al. Syndemic analysis of co-occurring psychosocial health conditions and HIV infeciton in a cohort of men who have sex with men (MSM) in Bangkok, Thailand. International AIDS Conference 2010 July 18–23, 20102010.

  8. Jie W, Ciyong L, Xueqing D, Hui W, Lingyao H. A Syndemic of psychosocial problems places the MSM (men who have sex with men) population at greater risk of HIV infection. PLoS One. 2012;7(3):e32312.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Stall R, Mills TC, Williamson J, Hart T, Greenwood G, Paul J, et al. Association of co-occurring psychosocial health problems and increased vulnerability to HIV/AIDS among urban men who have sex with men. Am J Public Health. 2003;93(6):939–42.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, Kumarasamy N, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Eng J Med. 2011;365(6):493–505.

    Article  CAS  Google Scholar 

  11. Karim SSA, Karim QA. Antiretroviral prophylaxis: a defining moment in HIV control. Lancet. 2011;378(9809):e23–5.

    Article  PubMed  Google Scholar 

  12. WHO National consultation on the strategic use of ARVs-Thailand. 2012 9–10 Aug 2012. Report.

  13. van Griensven F, Phanuphak N, Srithanaviboonchai K. Biomedical HIV prevention research and epidemic control in Thailand: two sides of the same coin. Sexual health. 2014;11(2):180–99.

    PubMed  Google Scholar 

  14. Pankam. T, Saensiriphan. S, Jafari. Y. The optimization and evaluation of HIV screening algorithm used in men who have sex with men in metropolitan Bangkok, Thailand (Poster Board Number: 14). HIV Diagnosis conference 2016, 21–24 March 2016; Atlanta, USA2016.

  15. Rainbow Sky Association of Thailand. Survey on healthcare uptake among MSM in Bangkok. 2011–2012.

  16. Zhang L, Phanuphak N, Henderson K, Nonenoy S, Srikaew S, Shattock AJ, et al. Scaling up of HIV treatment for men who have sex with men in Bangkok: a modelling and costing study. lancet HIV. 2015;2(5):e200–7.

    Article  PubMed  Google Scholar 

  17. Vilai Kuptniratsaikul, Pekuman P. The study of the center for epidemiologic studies-depression Scale (CES-D) in Thai people. Siriraj Med J. 1997;49((5):442–8.

    Google Scholar 

  18. Zhang W, O’Brien N, Forrest JI, Salters KA, Patterson TL, Montaner JS, et al. Validating a shortened depression scale (10 item CES-D) among HIV-positive people in British Columbia, Canada. PLoS One. 2012;7(7):e40793.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Ewing JA. Detecting alcoholism. CAGE questionnaire. Jama. 1984;252(14):1905–7.

    CAS  PubMed  Google Scholar 

  20. Using CAGE to screen alcoholism in the hospital http://www.dmh.go.th/abstract/details.asp?id=2407. Accessed 20 Apr 2016.

  21. van Griensven F, van Wijngaarden JW. A review of the epidemiology of HIV infection and prevention responses among MSM in Asia. Aids. 2010;1(24):S30–40.

    Article  Google Scholar 

  22. Buchbinder SP, Vittinghoff E, Heagerty PJ, Celum CL, Seage GR III, Judson FN 3rd, McKirnan D, Mayer KH, Koblin BA. Sexual risk, nitrite inhalant use, and lack of circumcision associated with HIV seroconversion in men who have sex with men in the United States. J Acquir Imm Defic Syndr. 2005;39(1):82–9.

    Article  Google Scholar 

  23. Wimonsate W, Naorat S, Varangrat A, Phanuphak P, Kanggarnrua K, McNicholl J, et al. Factors associated with HIV testing history and returning for HIV test results among men who have sex with men in Thailand. AIDS Behav. 2011;15(4):693–701.

    Article  PubMed  Google Scholar 

  24. Phanuphak N, Teeratakulpisarn N, van Griensven F, Chomchey N, Pinyakorn S, Fletcher JL, et al. Anogenital HIV RNA in Thai men who have sex with men in Bangkok during acute HIV infection and after randomization to standard vs. intensified antiretroviral regimensAIDS. J Int AIDS Soc. 2015;18:19470.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Tangmunkongvorakul A, Chariyalertsak S, Amico KR, Saokhieo P, Wannalak V, Sangangamsakun T, et al. Facilitators and barriers to medication adherence in an HIV prevention study among men who have sex with men in the iPrEx study in Chiang Mai, Thailand. AIDS care. 2013;25(8):961–7.

    Article  PubMed  Google Scholar 

  26. Busza JR. Promoting the positive: responses to stigma and discrimination in Southeast Asia. AIDS care. 2001;13(4):441–56.

    Article  CAS  PubMed  Google Scholar 

  27. Gribble JN, Miller HG, Rogers SM, Turner CF. Interview mode and measurement of sexual behaviors: methodological issues. J sex Res. 1999;36(1):16–24.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Anand TNC, Ananworanich J, Pakam C, Nonenoy S, Jantarapakde J, et al. Innovative strategies using communications technologies to engage gay men and other men who have sex with men into early HIV testing and treatment in Thailand. J Virus Erad. 2015;1:111–5.

    PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

This study was funded by amfAR, The Foundation for AIDS. The protocol was developed with great help from colleagues at the Center for LGBT Health Research at the University of Pittsburgh’s Graduate School of Public Health. The study team also wants to thank all helpful staffs at all three research sites, including Thai Red Cross Anonymous Clinic (TRCAC), Rainbow Sky Association of Thailand (RSAT), and The Service Workers in Group Foundation (SWING). Finally, this study could not have been conducted without the participation of the men who presented for HIV testing and agreed to contribute to this study.

Funding

This study was funded by amfAR.

Author information

Authors and Affiliations

  1. HIV-NAT, Thai Red Cross AIDS Research Center, 104 Ratchadamri Road, Pathumwan, Bangkok, 10330, Thailand

    Vorapot Sapsirisavat, Nittaya Phanuphak, Siriwan Keadpudsa, Kanitta Pussadee, Preeyarach Klaytong & Frits van Griensven

  2. Department of Behavioral and Community Health Sciences Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA

    James E. Egan & Ron Stall

  3. Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA

    M. Reuel Friedman

  4. Center for LGBT Health Research, University of Pittsburgh Graduate School of Public Health, 130 DeSoto Street, Pittsburgh, PA, 15261, USA

    James E. Egan, M. Reuel Friedman & Ron Stall

Authors
  1. Vorapot Sapsirisavat
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nittaya Phanuphak
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Siriwan Keadpudsa
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. James E. Egan
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kanitta Pussadee
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Preeyarach Klaytong
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. M. Reuel Friedman
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Frits van Griensven
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Ron Stall
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

The FAITH Study Team

Corresponding author

Correspondence to Vorapot Sapsirisavat.

Ethics declarations

Conflict of Interest

Authors Sapsirisavat, Phanuphak, Egan, Pussadee, Klaytong, Friedman, van Griensven, and Stall declares that they have no conflict of interest.

Ethical Approval

This study involve human participants (MSM). Informed consent was obtained from all participants in the study using an electronic informed consent procedure. All procedures were approved by both University of Pittsburgh IRB and Faculty of Medicine Chulalongkorn University IRB along with those ethical standards (already stated in the method section).

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sapsirisavat, V., Phanuphak, N., Keadpudsa, S. et al. Psychosocial and Behavioral Characteristics of High-Risk Men Who Have Sex with Men (MSM) of Unknown HIV Positive Serostatus in Bangkok, Thailand. AIDS Behav 20 (Suppl 3), 386–397 (2016). https://doi.org/10.1007/s10461-016-1519-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-016-1519-2

Keywords

Search

Navigation