Potential bridges for the HIV epidemic: sexual behaviors, and prevalence of HIV and rectal infections among men who have sex with men (MSM) in Luang Prabang, Lao PDR
O. Rattiphone1, T. Khanti1, G. Morineau2, C. Phimphachanh1
1Center for HIV/AIDS and STI (CHAS), Vientiane, Lao People’s Democratic Republic, 2Family Health International, Asia Pacific Regional Office, Bangkok, Thailand
Background: In Laos, intravenous drug use is seldom reported and HIV is mainly transmitted sexually. In 2007, the prevalence of HIV was still below 1% among female sex workers nationwide, but 5.6% of MSM from the capital Vientiane were found to be infected with HIV, putting an end to the virtual absence of HIV epidemics among high-risk populations in Laos. Against this background, the HIV epidemic among MSM was assessed in 2009, in the most touristic city of the country: Luang Prabang.
Methods: A cross-sectional survey conducted in 2009 gathered information from 300 MSM in Luang Prabang. Those eligible were men who had anal sex in the past 6 months. Participants selected using respondent-driven sampling were ask to self-complete a questionnaire on sexual behaviors using personal digital assistants and to provide blood and self-collected rectal swabs.
Results: The mean age of MSM was 21.8 years, and their mean age at first sex was 17.1 years. In the past 3 months, 58.0% had sex with women, 41.0% had sex with men, and 29.0% had sex with transgenders, and 29.4% had sex with both male and female partners. Only 34.7% reported receptive anal sex in the past 3 months. Depending on the type of partner, condom use at last sex ranged 66%-78% with men, and 52%-59% with women. In the past 3 month, 23% had sold sex and 23% had purchased sex. None of the respondents was infected with HIV, and 9% had rectal chlamydia and/or gonorrhea.
Conclusions: There is no evidence of an HIV epidemic among MSM in Luang Prabang and the prevalence of rectal STI is moderate. Due to their diverse sexual networks and low condom use, MSM are vulnerable to HIV and can bridge HIV epidemics between populations.