HIV risk behaviour among men who have sex with men (MSM) who attended the sexually transmitted diseases (STD) clinic, Ragama

Introduction Sri Lanka remains a low HIV prevalent country with an estimated sero-prevalence of less than 0.1% in the general population. The seroprevalence among key populations such as female sex workers (FSW), men who have sex with men (MSM), people who inject drugs (PWID) and beach boys is also <1%.(1) MSM were identified as one of the priority target groups for interventions because of their risky sexual behaviors and the increasing sero-prevalance observed among the group in the recent years.

Objective To ascertain the level of HIV risk behaviours among MSM who attended the STD clinic, Ragama and develop necessary interventions to reduce the potential for HIV infection among them.

Method A descriptive cross sectional study was carried out among the MSM’s attending Ragama STD clinic over a period of three and a half years. MSM register and the patients records maintained at the STD clinic were used to extract the data for this study. There were 160 newly registered MSMs from January 2009 to July 2012 and all consecutive newly registered MSM were included in the sample. Data were analyzed by using the statistical package for the social sciences version 16 (SPSS v16).

Results Majority of MSM were in their twenties (58%). Their level of education was relatively high and about 81% had Ordinary Level or higher qualifications. About 73% of them were engaged in some occupation while 4.4% admitted to commercial sex work as their occupation. With regard to the behavioural factors, half of them were bisexuals, and rate of insertive and receptive anal sex were 60% and 42% respectively at their most recent sex. Majority of them had sex with casual or non-regular partners (62.4%). Level of condom use was not satisfactory. The condom use at last sex was 13% and consistent use with regular partners was 6.3%. Consistent condom use during anal sex was as low as 5.7%. Risk of HIV was further aggravated by the presence of STIs and use of recreational drugs. Half (50%) were found to be positive for STIs and out of which 20% had multiple diagnoses. Fortunately, there were no injecting drug users in this sample but they had used alcohol (30%) and smoked heroin (12%).

Conclusions MSM who attended the STD clinic, Ragama during the four years under study were a fairly literate community and about 68% of them were less than 30 years of age. Half of the MSM were bisexuals. Rate of insertive anal sex and receptive anal sex at last sex were 60% and 42% respectively while consistent condom use was 5.7% which constitutes a considerable risk and this risk was further aggravated by the prevalence of STIs (50%), alcohol use (30%) and heroin use (12%). Therefore, risk factors for HIV transmission should be explored among MSM while maintaining good rapport and encouraging high rate of clinic attendance in order to promote protective behaviours through STI consultation and counselling.

DOI: http://dx.doi.org/10.4038/sljv.v4i1.6701

Sri Lanka Journal of Venereology, 2013; Vol.4(1):p.13-18