HIV risk, risk perception and uptake of HIV testing and counseling among youth men who have sex with men attending a gay sauna

Abstract

Background Men who have sex with men (MSM) are amongst populations at-risk for HIV acquisition in Thailand. In youth MSM (aged 15–24 years), the incidence of HIV infection has substantially increased. However, data on HIV risk, risk perception and HIV testing and counseling (HTC) uptake among youth MSM in hotspots are limited. Methods A subanalysis of a prospective study among Thai MSM attending a gay sauna was conducted. HIV risk and risk perception were assessed by an anonymous survey. The MSM were categorized as having actual “low-risk”, “moderate-risk” and “high-risk” for HIV acquisition based on the validated study risk categorization tool. HTC was provided on-site with result notification within 1 h. HIV care establishment appointment was arranged by the counselors for HIV-infected participants. Care engagement within 1 year of diagnosis was subsequently assessed. Results There were 358 MSM participants; 87 (24%) were youth MSM. Comparing to other MSM, youth MSM had significantly higher median number of lifetime sexual partners [2 (IQR 1–9) vs. 1 (IQR 0–1); P < 0.001), were more-likely to ever exchange sex for money (44% vs. 9%; P < 0.001) and have sexual partner who exchanged sex for money (8% vs. 1%; P < 0.001). Rates of consistent condom use in the past 3 months for anal, oral and vaginal sexes were low and not significantly different between youth and other MSM (51% vs. 61%, 26% vs. 35% and 72% vs. 61%, respectively). By using the study risk categorization tool, there were 68 youth MSM with moderate or high-risk for HIV acquisition, of which 43 (63%) had false perception of low HIV risk. Youth MSM were more likely than other MSM to accept HTC [68% vs. 33%, P < 0.001)] and to be first-time testers (42% vs. 28%, P = 0.07). By HTC, the rates of HIV infection tended to be higher among youth MSM comparing to other MSM [14/59 (24%) vs. 11/89 (12%); P = 0.07]. Among the 14 youth MSM newly-diagnosed with HIV infection, only 6 (43%) showed-up for continuity care after 1-year follow-up. Conclusions Youth MSM had substantial high HIV risk, false perception of low HIV risk and low rate of care engagement but demonstrated considerable rate of HTC uptake. Strategies to improve access to HTC, risk perception and linkage to care are needed for HIV prevention and management among the youth MSM.

How heterogeneous are MSM from Brazilian cities? An analysis of sexual behavior and perceived risk and a description of trends in awareness and willingness to use pre-exposure prophylaxis

“…This finding is of great concern and might help explain the recent rise in HIV incidence among MSM aged 16-24 years in Brazil [7]. A recent Thai study reported similar results among MSM attending a gay sauna, where young MSM were at higher-risk compared to older MSM due to their higher risk behaviors and false perception of low HIV risk [43]. One explanation of this finding might be that younger individuals may be more fearless of HIV and/or optimistic of HIV treatment and prevention strategies [44][45][46].…”

How heterogeneous are MSM from Brazilian cities? An analysis of sexual behavior and perceived risk and a description of trends in awareness and willingness to use PrEP

“…This could also indicate a gap in the framing of health messages which might be inadvertently excluding non-gay MSM 37 (9). A recent Thai study reported similar results among MSM attending a gay sauna, where young MSM were at higher-risk compared to older MSM due to their higher risk behaviors and false perception of low HIV risk (43). One explanation of this finding might be that younger individuals may be more fearless of HIV and/or optimistic of HIV treatment and prevention strategies (44)(45)(46).…”

Factors Associated with Having Multiple Sexual Partners among Men Who Have Sex with Men University Students in Northern Thailand

“…MSM tended to have a higher number of sexual partners than heterosexual men and women [4,10,11]. In Thailand, young MSM who attended a gay sauna reported 2 different sexual partners for the last 1 month on average [12]. MSM who had multiple sexual partners were 2 times more likely to get infected from HIV, as reported by a Chinese study [13].…”