Abstract:
OBJECTIVE: The spread of HIV Infection in Thailand is reaching epidemic proportions, most notably among residents of northern provinces. Serosurveys have shown prostitutes and drug users to have high rates, although few studies have empirically documented risk factors. We assessed the risk factors for prevalent HIV among a cohort of Thai men, focusing on sexual behavior, drug use, sociodemographic background, and history of sexually transmitted diseases. METHODS: The baseline assessment (n = 1236) of a longitudinal cohort study of young (mean age = 21 years) males in the northern provinces (Chiang Mai) in May, 1991 included an interview on HIV risks conducted by trained medical students and serology for HIV and syphilis. Risk factors for prevalent HIV were assessed using multiple logistic regression analysis. RESULTS: Serological results showed that 10.9% of recruits had antibody to HIV. Behavioral risk factors for prevalent HIV identified as independent risks included: education limited to primary school (OR = 1.8, 95% Cl = 1.1, 2.8), 20+ lifetime sexual partners (OR = 2.35, 95% Cl = 1.1, 5.05), lifetime STD history (OR = 2.1, 95% Cl = 1.35, 3.00), monthly or more frequent prostitute use (OR = 2.33, 95% Cl = 1.2, 4.5), and most recent prostitute in Chiang Mai. Drug injection was rare (less than 10%) and not related to HIV status. Condom use with prostitutes did not afford significant protection from HIV in the manner used by these young men despite their use 60% of the time with last prostitute contact. CONCLUSIONS: Sex with female prostitutes appears to be the principal risk factor for the heterosexual transmission of HIV among youth in Thailand. Rates of HIV are rapidly increasing, and public health countermeasures are urgently required to decrease this epidemic. Consistent condom use would appear to offer the greatest (and perhaps sole) protection for the acquisition of HIV in this high risk setting.
Keywords: Adult Disease Outbreaks Human HIV Infections/*EPIDEMIOLOGY/*TRANSMISSION Male Prostitution Risk Factors Risk-Taking Sex Behavior Sexual Partners Thailand/EPIDEMIOLOGY ABSTRACT 921230
M92C5213
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