Mills S, Benjarattanaporn P, Bennett A, Pattalung R N, Sundhagul D, Trongsawad P, Gregorich S E, Hearst N, Mandel J S
AIDS Control and Prevention Project, Family Health International, Bangkok, Thailand.
AIDS. 1997 Sep;11 Suppl 1:S43-51.
To assess trends in HIV risk behaviors over a 3-year period in eight population groups in Bangkok, Thailand.
Using a repeated cross-sectional survey design with a structured questionnaire, we collected five sets of self-reported sexual behavior data related to HIV risk from the following subject groups at the same sampling sites during 1993-1996: direct and indirect female sex workers, male attenders of sexually transmitted disease (STD) clinics, female attenders of antenatal care clinics, male and female vocational students, and male and female factory workers.
Reported patronage of commercial sex by the three male groups declined by an overall average of 48% over the 3-year period. Other non-regular sexual partnerships declined among male STD clinic attenders and vocational students. Condom use during most recent sexual intercourse between sex workers and clients peaked at high levels (>90%) in the early data waves, while among indirect sex workers and their clients, consistent condom usage increased from 56% to 89%. Low condom use persisted among sex workers and their non-paying sex partners. Single women reported low levels of sexual activity and condom use with no signs of an increase. Similarly, married women from antenatal clinics reported low condom use with their husbands, with no change throughout the period of the study.
HIV risk behavioral surveillance is a useful way of determining whether behavior change has occurred in specific population groups. The results here confirm and add to a growing set of evidence of risk behavior reduction in Thailand. The behavioral changes did not occur uniformly but varied depending on the sexual dyad and the population group under study. Behavioral surveillance should be promoted and its methodologies strengthened in attempts to understand the local dynamics of HIV epidemics.
评估泰国曼谷八个群体在三年期间的艾滋病毒风险行为趋势。
采用重复横断面调查设计并使用结构化问卷，1993 - 1996年期间，我们在相同抽样地点从以下研究对象群体收集了五组与艾滋病毒风险相关的自我报告性行为数据：直接和间接女性性工作者、性病门诊男性就诊者、产前护理门诊女性就诊者、男女职业学生以及男女工厂工人。
在这三年期间，三个男性群体报告的光顾商业性行为总体平均下降了48%。男性性病门诊就诊者和职业学生中其他非固定性伴侣关系有所减少。性工作者与嫖客最近一次性交时的避孕套使用在早期数据波中达到高水平峰值（>90%），而在间接性工作者及其嫖客中，持续使用避孕套的比例从56%增至89%。性工作者及其非付费性伴侣的避孕套使用率仍然较低。单身女性报告的性活动水平和避孕套使用率较低，且无上升迹象。同样，产前护理门诊的已婚女性报告与丈夫的避孕套使用率较低，在研究期间没有变化。
艾滋病毒风险行为监测是确定特定人群行为是否发生变化的有用方法。此处结果证实并补充了泰国风险行为减少的越来越多的证据。行为变化并非均匀发生，而是因性对偶关系和所研究的人群群体而异。应推广行为监测并加强其方法，以了解艾滋病毒流行的当地动态。
