Stigma still barrier to uptake of counseling and testing by MSM in Thailand

Published: July 21, 2010

Stigma still barrier to uptake of counseling and testing by MSM in Thailand

K. Spratt1, M.C. Escobar2

1JSI, Arlington, United States, 2BroadReach Health Care, Washington, United States

Issues: The significant strides made in Thailand in HIV prevention and treatment have failed to reach men who have sex with men (MSM). Cross-sectional studies of HIV prevalence among MSM found that HIV increased rapidly in 2005 to 2007 in Bangkok (from 19% to 27%), Chiang Mai (11% to 16%), and Phuket (14% to 19%). This increase has not been matched by increased uptake of counseling and testing (CT) by MSM

Description: AIDSTAR-One, a USAID-funded project, conducted a situational analysis of public and private sector organizations in four provinces implementing HIV programs for MSM to determine their potential for supporting community-based counseling and rapid HIV testing for MSM. The analysis showed that NGOs and government sectors have enormous potential for, and interest in, increasing coverage of CT services for MSM. However, many MSM key informants indicated an overall reluctance by MSM to get HIV testing. This reluctance is associated with the potential threat to employment and relationships if results are positive, misconceptions that someone could feel well and still be infected, lack of information about access to free ART treatment and its benefits, and ongoing association of HIV and AIDS with fear and death

Lessons learned: Even if rapid testing with same-day results is available, uptake of services may remain low unless community norms among MSM regarding HIV testing are changed. Thus, information about ART and access to care must be more widely disseminated among MSM.

Next steps: Extensive communication campaigns targeting MSM on the benefits of CT are urgently needed, as are initiatives to reduce stigma against MSM and to address self-stigma among MSM. Stigma impacts the willingness of MSM to get tested?whether at an NGO or government site?and to seek treatment in a timely manner.

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