17th International AIDS Conference Mexico City, Mexico - August 13 - 18, 2008

SUCCESSFUL START OF A PREPARATORY HIV COHORT STUDY AMONG MEN WHO HAVE SEX WITH MEN (MSM) IN BANGKOK, THAILAND: PRELIMINARY BASELINE, FOLLOW-UP AND HIV INCIDENCE DATA

Int Conf AIDS. 2008 Aug 13-18;17 Abstract No. MOAC0105

W. Wimonsate ¹, S. Chaikummao¹, J. Tongtoyai¹, C. Kittinunvorakoon¹, A. Sriporn¹, A. Varangrat¹, P. Akarasewi¹, P. Sirivongrangson², J. McNicholl³, F. van Griensven^3
1Thailand MOPH - U.S. CDC Collaboration, Behavioral Research, Nonthaburi, Thailand, ²Thailand Ministry of Public Health, Nonthaburi, Thailand, ³Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, United States

BACKGROUND/OBJECTIVES: To assess HIV prevalence and incidence, behavioral characteristics, and follow-up rates among Bangkok MSM and to develop scientific and logistical infrastructure in preparation for HIV prevention trials.

METHODS: A 3-year prospective cohort study of 1,100 HIV-negative men is being conducted. HIV-1 status was determined at baseline and every 4 months by oral fluid testing (OraQuick), confirmed on blood. Baseline prevalences of hepatitis B virus (HBV), herpes simplex virus-2 (HSV-2), and T. pallidum (TP) infection were determined by serology; urethral/rectal C. trachomatis (CT) and urethral N. gonorrhoeae (NG) by PCR. Demographic and behavioral data were collected using audio-computer-assisted self-interview. HIV prevention education, risk reduction counseling, and male condoms and lubricants were provided.

RESULTS: Between April 5, 2006 and January 16, 2008, 1,283 men enrolled (mean age 26; range 18-56 years). At baseline, the prevalence of HIV was 22.6%, HBV (sAg and/or HBc) 47.3%, HSV-2 20.2%, TP 4.3%, urethral CT 4.2%, rectal CT 8.7%, and urethral NG 1.8%. Male sexual intercourse partner(s) during the 4 months preceding enrollment were reported by 1220 (95.1%) participants (mean 12.1, range 1-810), and 42.5% (519/1220) reported consistent condom use with these partners. Among HIV-negatives, 4 and 8 month follow-up rates were 88.0% (709/806) and 84.2% (457/543), respectively, and the HIV incidence density was 5.5 per 100 person-years (31/561). In multivariate analysis, older age (>21 yrs), being employed (versus student or not employed), lower education, practicing receptive anal intercourse and evidence of past HBV, HSV-2 or TP infection were independently and significantly associated with prevalent HIV infection.

CONCLUSIONS: A preparatory HIV cohort study was successfully started among MSM in Bangkok. Baseline prevalence of HIV, high levels of risk behavior, follow-up rates and HIV incidence suggest that MSM in Bangkok are an appropriate population for the evaluation and implementation of HIV prevention interventions.

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2008-08-13
MOAC0105

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