May 4, 2009
The importance of including HIV-positive people in prevention programs is underscored by the fact that "almost half of all new HIV infections in Thailand occur among low-risk partners of people infected with HIV," the authors noted in introducing the current study.
Among HIV patients accessing routine care at the National Infectious Disease Institute in Thailand, the risk of HIV transmission was evaluated. The factors assessed were sexual risk behavior, prevalence of STI (syphilis, gonorrhea, chlamydia, trichomoniasis, and genital ulcers), and HIV disclosure status. STI care, risk reduction and HIV disclosure counseling were provided to the patients.
From July 2005 to September 2006, baseline data were assessed among 894 consecutive HIV patients (395 men, 499 women). Among participants, 33.2 percent reported unprotected last sex with a partner of unknown or negative HIV status. This was more likely with casual, commercial or male-to-male sex partners than with steady heterosexual partners (p=0.03). Patients receiving antiretroviral therapy were less likely to report unsafe sex (p<0.001). In all, 10.7 percent of men and 7.2 percent of women had an STI (p=0.08). HIV status disclosure to steady partners was reported by more women than men (82.5 percent vs. 65.9 percent; p=0.05).
"Indicators for HIV transmission risk were common among people attending HIV care in Bangkok," the authors concluded. "Efforts need to be strengthened to reduce unsafe casual and commercial sex and to increase HIV disclosure from men to their partners. A strategy for STI screening and treatment for people with HIV in Thailand should be developed."