Willingness to participate in a rectal microbicide trial among men who have sex with men (MSM) in Bangkok

Published: July 18, 2010

Willingness to participate in a rectal microbicide trial among men who have sex with men (MSM) in Bangkok

W. Thienkrua1, S. Chaikummao1, W. Sukwicha1, S. Yafant1, N. Tippanont1, A. Varangrat1, P. Khlaimanee1, F. van Griensven1,2

1Thailand Ministry of Public Health – U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand, 2Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, United States

Background: In Thailand, high HIV prevalence has been documented among MSM. Rectal microbicides have been proposed for evaluation in clinical studies to determine their safety, acceptability and efficacy for HIV prevention. This study evaluates willingness of MSM in Bangkok to participate in rectal microbicide trials.

Methods: A cross-sectional sub-study of willingness to participate in rectal microbicide trials was conducted among participants in the Bangkok MSM Cohort Study, using an audio-computer-assisted self-interview. Variables with p values < 0.1 in univariate analysis were further evaluated in multivariate logistic regression to identify independent predictors of willingness to participate.

Results: During follow-up visits between February 2008 and May 2009, 1,063 MSM, (mean age, 28 years; range 19-57 years) completed the interview. Of these men, 233 (21.9%) were HIV-infected at baseline and 45 (4.2%) became HIVinfected during follow-up. Overall, 93.2% said they had ever used lubricants for anal sex, including 13.6% vaseline, 4.9% baby oil and 1.0% saliva. Of all men, 56.0% said they were definitely willing to join the microbicide trial, 22.8% were probably willing, 13.9% were not sure, 5.4% were probably not willing, and 1.9% were definitely not willing. Reasons for not willing to join included not wanting a rectal exam, not wanting to have specimens collected, and not wanting to receive a placebo. In multivariate analysis, club drug use, ever sold sex, concern about HIV risk and awareness that AIDS is common among MSM were associated with willingness to participate; concern about receiving placebo was associated with unwillingness to participate.

Conclusions: Most men where definitely or probably willing to participate in rectal microbicide trials. Those with higher HIV risk and increased HIV awareness were more willing, while those with concerns about receiving a placebo were less willing. Education about HIV risk and trial concepts may help to increase trial participation.

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