Prevalence of HIV infection and sexually transmitted diseases and risk behaviors among men who have sex with men in 3 provinces and Bangkok, Thailand, 2023

Abstract

Introduction: Thailand has been conducting surveillance on the prevalence and risk behaviors related to HIV infection among men who have sex with men since the year 2003. From the surveillance in 2020, the HIV prevalence was found to be 6.19%, and the consistent use of condoms was below 80%, indicating a lack of awareness of self–protection from HIV infection. The spread of the HIV virus among MSM remains a public health concern that requires continuous monitoring to follow epidemiological trends.
Methods: A serial cross–sectional survey was conducted among MSM in the provinces of Phuket, Chonburi, Ubon Ratchathani, and Bangkok from March 1 to May 31, 2023, involving 2,564 participants. The survey utilized the self–administered questionnaire method on mobile devices and collected oral fluid samples from the general MSM and transgender. Additionally, collected blood samples from male sex workers to test for HIV infection, syphilis, hepatitis B, and hepatitis C. Data were analyzed using descriptive statistics and logistic regression analysis to explore the relationships between risk behaviors and HIV infection.
Results: Phuket province had the highest HIV prevalence at 3.74%. When stratified by population groups, the HIV prevalence among male sex workers was 6.09%, in the general MSM group was 4.31%, and the transgender in Bangkok had the highest prevalence at 4.50%. The prevalence of syphilis in Chonburi province was 18.50%, and in Phuket province, it was 5.22%. The prevalence of hepatitis B and C in Chonburi province was 3.00% and 1.00%, respectively. Risky behaviors associated with HIV infection included using dating apps/websites more than once a week, with a 1.5–2 times higher likelihood of HIV infection compared to those who never used them. Furthermore, MSM who were the receptive partner during anal sex had a 5.70 times higher likelihood of HIV infection than those who were the insertive partner. Consistent condom use during anal sex was associated with a 91% reduction in the risk of HIV infection compared to those who never used condoms.
Discussion: Ongoing promotion of condom use remains crucial for preventing HIV and sexually transmitted infections. Emphasizing correct and consistent condom use, along with building positive relationships between healthcare providers and MSM, is essential to improve access to services. This collaborative effort will contribute to long–term HIV prevention and control.