Thailand Ministry of Public Health—US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand.
J Acquir Immune Defic Syndr. 2010 Feb;53(2):234-9. doi: 10.1097/QAI.0b013e3181c2fc86.
Men who have sex with men (MSM) continue to be at high risk for HIV infection. Here we evaluate trends in HIV prevalence, estimated HIV incidence, and risk behavior among MSM in Bangkok, Thailand.
Between 2003 and 2007, 3 biennial cross-sectional HIV prevalence assessments were conducted among MSM in Bangkok,Thailand, using venue-day-time sampling. Oral fluid was tested for HIV infection; demographic and behavioral data were self-collected using hand-held computers. Estimates of annual HIV incidence in young MSM were derived as follows: (number of HIV infections/sum of [current age–age at start of anal intercourse]) 3 100). Logistic and Poisson regression was used to evaluate trends in HIV prevalence,estimated HIV incidence, and risk behavior.
The overall HIV prevalence increased from 17.3% in 2003 to 28.3% in 2005 to 30.8% in 2007 (P , 0.001 for trend). The estimated HIV incidence among young MSM increased from 4.1%in 2003 to 6.4% in 2005, to 7.7% in 2007 (P , 0.02 for trend). The increase in HIV prevalence from 2005 to 2007 was not statistically significant. The proportion of men reporting anal sex and casual or steady male sex partners in the past 3 months significantly decreased,whereas the proportion reporting drug use and drug use during sex significantly increased. No increase was observed in the proportion of men reporting consistent condom use.
Our data suggest that after a strong increase from 2003 to 2005, the HIV prevalence among MSM in Bangkok may have begun to stabilize. Given the continuing high levels of risk behavior and the estimated high HIV incidence in young MSM,additional HIV preventive interventions are necessary.
男男性行为者（MSM）仍然面临着很高的 HIV 感染风险。在此，我们评估了泰国曼谷 MSM 中的 HIV 流行率、估计的 HIV 发病率和风险行为的趋势。
2003 年至 2007 年期间，在泰国曼谷，采用场所-时间-日期抽样方法，对 MSM 进行了三次两年一次的 HIV 流行率横断面评估。使用唾液样本检测 HIV 感染情况；使用手持电脑收集人口统计学和行为数据。通过以下方式计算年轻 MSM 的年 HIV 发病率估计值：（HIV 感染人数/[开始肛交时的年龄-当前年龄]之和）3 100）。使用逻辑和泊松回归来评估 HIV 流行率、估计的 HIV 发病率和风险行为的趋势。
HIV 总流行率从 2003 年的 17.3%上升至 2005 年的 28.3%，再上升至 2007 年的 30.8%（P, 0.001 趋势）。年轻 MSM 的估计 HIV 发病率从 2003 年的 4.1%上升至 2005 年的 6.4%，再上升至 2007 年的 7.7%（P, 0.02 趋势）。2005 年至 2007 年 HIV 流行率的增加没有统计学意义。报告过去 3 个月发生过肛交和偶然或固定男性性伴的男性比例显著下降，而报告使用毒品和性伴中使用毒品的男性比例显著增加。报告坚持使用安全套的男性比例没有增加。
我们的数据表明，曼谷 MSM 的 HIV 流行率在 2003 年至 2005 年大幅上升后，可能已经开始趋于稳定。鉴于高危行为持续存在以及年轻 MSM 中估计的高 HIV 发病率，需要采取更多的 HIV 预防干预措施。
