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Weir BW, Wirtz AL, Chemnasiri T, Baral SD, Decker M, Dun C, Hnin Mon SH, Ungsedhapand C, Dunne EF, Woodring J, Pattanasin S, Sukwicha W, Thigpen MC, Varangrat A, Warapornmongkholkul A, O'Connor S, Ngo JP, Qaragholi N, Sisel HI, Truong JM, Janyam S, Linjongrat D, Sriplienchan S, Sirivongrangson P, Rooney JF, Sullivan P, Chua-Intra B, Hickey AC, Beyrer C. High PrEP uptake, adherence, persistence and effectiveness outcomes among young Thai men and transgender women who sell sex in Bangkok and Pattaya, Thailand: findings from the open-label combination HIV prevention effectiveness (COPE) study. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2023; 15:100217. [PMID: 37614346 PMCID: PMC10442968 DOI: 10.1016/j.lansea.2023.100217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 04/06/2023] [Accepted: 05/02/2023] [Indexed: 08/25/2023]
Abstract
Background Daily oral pre-exposure prophylaxis (PrEP) is effective in preventing HIV infection, but no study has evaluated combination prevention interventions with PrEP for transgender women (TGW) and men who have sex with men (MSM) who sell sex. Methods The Combination Prevention Effectiveness (COPE) study was a community-based, non-randomized implementation study in Bangkok and Pattaya, Thailand. Participants were HIV-negative MSM and TGW aged 18-26 years who reported exchanging sex with men in the prior 12 months and who met 2014 U.S. Public Health Service PrEP eligibility criteria. The intervention included quarterly HIV testing, semiannual testing for sexually transmitted infections, provision of condoms with lubricant, and the opportunity to initiate or end daily oral PrEP use at any time during study participation. Participants taking PrEP received monthly adherence counseling and short message service reminders. The primary outcome was HIV incidence rate ratio (IRR) on PrEP vs. not on PrEP. Secondary outcomes were PrEP initiation, PrEP use at 12 months, and PrEP adherence. Findings From October 2017 to August 2019, 846 participants were enrolled: 531 (62.8%) immediately initiated PrEP; 104 (12.3%) subsequently initiated PrEP, and 211 (24.9%) never initiated PrEP. Among those initiating PrEP within 30 days of enrollment; 85.9% were on PrEP at the 12-months. When taking PrEP, participants reported adherent PrEP use at 94.2% of quarterly assessments. Ten HIV seroconversions occurred without PrEP use (incidence rate [IR] = 3.42 per 100 person-years [PY]; 95% CI = 1.64-6.30), while zero cases occurred with PrEP use (IR = 0.0 per 100PY; 95% CI = 0.0-0.62), with IRR = 0.0 (95% CI = 0.0-0.22; p < 0.001). Interpretation Young Thai MSM and TGW who exchange sex can have high PrEP uptake, persistence and adherence, and low HIV incidence when offered in supportive community-based settings. Funding U.S. National Institute of Allergy and Infectious Diseases; Centers for Disease Control and Prevention.
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Affiliation(s)
- Brian W. Weir
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Andrea L. Wirtz
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Tareerat Chemnasiri
- Division of HIV Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
- Division of HIV Prevention, Thailand Ministry of Public Health-U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Stefan D. Baral
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Michele Decker
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Population, Family & Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Chen Dun
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sandra Hsu Hnin Mon
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Chaiwat Ungsedhapand
- Division of HIV Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
- Division of HIV Prevention, Thailand Ministry of Public Health-U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Eileen F. Dunne
- Division of HIV Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
- Division of HIV Prevention, Thailand Ministry of Public Health-U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Joseph Woodring
- Division of HIV Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
- Division of HIV Prevention, Thailand Ministry of Public Health-U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Sarika Pattanasin
- Division of HIV Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
- Division of HIV Prevention, Thailand Ministry of Public Health-U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Wichuda Sukwicha
- Division of HIV Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
- Division of HIV Prevention, Thailand Ministry of Public Health-U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Michael C. Thigpen
- Division of HIV Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
- Division of HIV Prevention, Thailand Ministry of Public Health-U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Anchalee Varangrat
- Division of HIV Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
- Division of HIV Prevention, Thailand Ministry of Public Health-U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Anchalee Warapornmongkholkul
- Division of HIV Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
- Division of HIV Prevention, Thailand Ministry of Public Health-U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Siobhan O'Connor
- Division of HIV Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Julie P. Ngo
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Noor Qaragholi
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Haley I. Sisel
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jasmine M. Truong
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Surang Janyam
- Service Workers in Group Foundation (SWING), Bangkok and Pattaya, Thailand
| | | | | | - Pachara Sirivongrangson
- Division of HIV Prevention, Thailand Ministry of Public Health-U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | | | - Patrick Sullivan
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Boosbun Chua-Intra
- Division of HIV Prevention, Thailand Ministry of Public Health-U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Andrew C. Hickey
- Division of HIV Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
- Division of HIV Prevention, Thailand Ministry of Public Health-U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Chris Beyrer
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Duke Global Health Institute, Duke University, Durham, NC, USA
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2
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Pascua BN, Dyne PL. Emergency Medicine Considerations in the Transgender Patient. Emerg Med Clin North Am 2023; 41:381-393. [PMID: 37024171 DOI: 10.1016/j.emc.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Abstract
Transgender patients are at high risk for poor health outcomes and many harbor fear of healthcare settings secondary to prior discrimination, perceived sensationalism, clinician unfamiliarity, and unwanted exams. It is essential to approach transgender patients without judgement and with empathy. Asking open ended questions with explanation as to why your questions are pertinent to their specific care will help create rapport and trust. Through a basic working knowledge of terminology, types of hormone therapy, non-surgical techniques, garments, and surgical procedures typically encountered by such patients, and their respective potential side effects and complications, clinicians can provide quality care to transgender patients.
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Hu T, Jin F, Deng H. Association between gender nonconformity and victimization: a meta-analysis. CURRENT PSYCHOLOGY 2023. [DOI: 10.1007/s12144-023-04269-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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4
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Kummaraka U, Oonarom A, Manojai N, Maneeton B, Maneeton N, Chiawkhun P, Kawilapat S, Traisathit P. Effects of Gender Affirming Surgery on the Quality of Life of Transgender Women in Chiang Mai Province, Thailand. JOURNAL OF SEX & MARITAL THERAPY 2022:1-12. [PMID: 36398380 DOI: 10.1080/0092623x.2022.2146026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Gender affirming surgery (GAS) helps individuals to achieve a physical presence consistent with their gender identity. In this study, we explored the decision, expectation, experience, satisfaction, and quality of life (QOL) of transgender women (TGWs) who have undergone GAS and compared their QOL with transfeminine individuals (TFs) who have not and are seeking to do so in Thailand. The median overall QOL score of the TGWs who have undergone GAS was slightly higher than that of the TFs who have not (95 (92-103) vs. 92 (86-98); p = 0.003), which was also reflected in the specific domains of psychological health, social relationships, and environmental health, the exception being physical health. Not being financially prepared was the most relevant reason for delaying undergoing GAS among the TFs who have not undergone it and want to do so. In addition, more than half of the TGWs who have undergone GAS regretted not being socially accepted after surgery. Although the difference between the QOLs of the two groups is statistically significant, the clinical significance should be further investigated to provide more insight. In addition, the higher QOL of TGWs might not solely be due to having undergone GAS.
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Affiliation(s)
- Unyamanee Kummaraka
- Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand
- Data Science Research Center, Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand
| | - Awirut Oonarom
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | | | - Benchalak Maneeton
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Narong Maneeton
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Phisanu Chiawkhun
- Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand
| | - Suttipong Kawilapat
- Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Patrinee Traisathit
- Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand
- Data Science Research Center, Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand
- Research Center in Bioresources for Agriculture, Industry and Medicine, Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand
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5
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BW W, C D, AL W, SHH M, N Q, T C, S P, W S, A V, EF D, TH H, S J, H J, D L, PA M, MC T, JF R, PS S, AC H, P S, C B, M P. Transactional sex, HIV and health among young cisgender men and transgender women who have sex with men in Thailand. Ann Epidemiol 2022; 72:1-8. [PMID: 35405344 PMCID: PMC9553034 DOI: 10.1016/j.annepidem.2022.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 02/18/2022] [Accepted: 03/28/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE To examine how recent sex work is identified and the HIV risk factors and service needs among Thai cisgender men who have sex with men (MSM) and transgender women (TGW) who exchange sex. METHODS MSM and TGW in Bangkok and Pattaya who exchanged sex in the last year (n = 890) were recruited through social media, outreach, and word-of-mouth. Recent sex exchange was based on the primary question, "In the last 30 days, have you sold or traded sex"; secondary questions (regarding income source and client encounters) were also investigated. RESULTS Overall, 436 (48%) participants engaged in sex work in the last 30 days; among those, 270 (62%) reported exchanging sex by the primary question, and 160 (37%) based on secondary questions only. Recent sex exchange was associated with gonorrhea, syphilis, discussing PrEP with others, and using condoms, alcohol, methamphetamine, amyl nitrate, and Viagra. Exchanging sex based on secondary questions only was associated with being in a relationship, social media recruitment, less recent anal intercourse, and not discussing PrEP. CONCLUSIONS Thai MSM and TGW who exchange sex need regular access to HIV/STI prevention, testing, and treatment services, and multiple approaches to assessing sex work will help identify and serve this diverse and dynamic population.
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6
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Wang Y, Qian M, Nabbijohn AN, Wen F, Fu G, Zuo B, VanderLaan DP. Culture influences the development of children's gender-related peer preferences: Evidence from China and Thailand. Dev Sci 2021; 25:e13221. [PMID: 34942036 DOI: 10.1111/desc.13221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 12/09/2021] [Accepted: 12/13/2021] [Indexed: 11/30/2022]
Abstract
Current understanding of how culture relates to the development of children's gender-related peer preferences is limited. To investigate the role of societal acceptance of gender nonconformity, this study compared children from China and Thailand. Unlike China and other cultures where the conceptualization of gender as binary is broadly accepted, individuals who identify as a nonbinary "third" sex/gender have been highly visible and tolerated in Thai society for at least several decades. Chinese and Thai 4- to 9-year-olds (N = 458) viewed vignettes of four hypothetical peers who varied on gender (i.e., boy vs. girl) and gender-typed toy play behavior (i.e., masculine vs. feminine), and were asked to give a friendship preference rating for each peer. Chinese, compared with Thai, children evidenced gender-related peer preferences that emerged earlier, remained more stable across age groups, and were relatively more biased against gender-nonconforming behavior. The only cultural similarity was in children's preference for peers who were of the same gender and/or displayed same-gender-typed behavior. Thus, while preference for peers who are of the same gender and/or display same-gender-typed behavior is common among children across cultures, the developmental onset and course of these preferences vary by culture. Moreover, societal acceptance of gender nonconformity might be key to limiting children's bias against gender-nonconforming peers.
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Affiliation(s)
- Yang Wang
- Central China Normal University, Wuhan, Hubei, China
| | - Miao Qian
- Department of Psychology, University of Detroit Mercy, Michigan, USA
| | - A Natisha Nabbijohn
- Department of Psychology, University of Toronto Mississauga, Mississauga, Ontario, Canada.,Department of Psychology, University of Guelph, Guelph, Ontario, Canada
| | - Fangfang Wen
- Central China Normal University, Wuhan, Hubei, China
| | - Genyue Fu
- School of Education, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Bin Zuo
- Central China Normal University, Wuhan, Hubei, China
| | - Doug P VanderLaan
- Department of Psychology, University of Toronto Mississauga, Mississauga, Ontario, Canada.,Child and Youth Psychiatry, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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7
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Wirtz AL, Weir BW, Mon SHH, Sirivongrangson P, Chemnasiri T, Dunne EF, Varangrat A, Hickey AC, Decker MR, Baral S, Okanurak K, Sullivan P, Valencia R, Thigpen MC, Holtz TH, Mock PA, Cadwell B, Adeyeye A, Rooney JF, Beyrer C. Testing the Effectiveness and Cost-Effectiveness of a Combination HIV Prevention Intervention Among Young Cisgender Men Who Have Sex With Men and Transgender Women Who Sell or Exchange Sex in Thailand: Protocol for the Combination Prevention Effectiveness Study. JMIR Res Protoc 2020; 9:e15354. [PMID: 32012113 PMCID: PMC7011123 DOI: 10.2196/15354] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 10/17/2019] [Accepted: 10/20/2019] [Indexed: 12/11/2022] Open
Abstract
Background Pre-exposure prophylaxis (PrEP) is highly effective in the prevention of HIV acquisition, particularly for men who have sex with men (MSM). Questions remain on the benefits of PrEP and implementation strategies for those at occupational risk of HIV acquisition in sex work, as well as on methods to support adherence among young people who initiate PrEP. Objective The Combination Prevention Effectiveness study for young cisgender MSM and transgender women (TGW) aims to assess the effectiveness and cost-effectiveness of a combination intervention among HIV-uninfected young MSM and TGW engaged in sex work in Thailand. Methods This open-label, nonrandomized assessment compares the relative effectiveness of a combination prevention intervention with and without daily oral emtricitabine and tenofovir disoproxil fumarate (Truvada) PrEP with SMS-based adherence support. HIV-uninfected young MSM and TGW aged 18 to 26 years in Bangkok and Pattaya who self-report selling/exchanging sex at least once in the previous 12 months are recruited by convenience sampling and peer referral and are eligible regardless of their intent to initiate PrEP. At baseline, participants complete a standard assessment for PrEP eligibility and may initiate PrEP then or at any time during study participation. All participants complete a survey and HIV testing at baseline and every 3 months. Participants who initiate PrEP complete monthly pill pickups and may opt-in to SMS reminders. All participants are sent brief weekly SMS surveys to assess behavior with additional adherence questions for those who initiated PrEP. Adherence is defined as use of 4 or more pills within the last 7 days. The analytic plan uses a person-time approach to assess HIV incidence, comparing participant time on oral PrEP to participant time off oral PrEP for 12 to 24 months of follow-up, using a propensity score to control for confounders. Enrollment is based on the goal of observing 620 person-years (PY) on PrEP and 620 PY off PrEP. Results As of February 2019, 445 participants (417 MSM and 28 TGW) have contributed approximately 168 PY with 95% (73/77) retention at 12 months. 74.2% (330/445) of enrolled participants initiated PrEP at baseline, contributing to 134 PY of PrEP adherence, 1 PY nonadherence, and 33 PY PrEP nonuse/noninitiation. Some social harms, predominantly related to unintentional participant disclosure of PrEP use and peer stigmatization of PrEP and HIV, have been identified. Conclusions The majority of cisgender MSM and TGW who exchange sex and participate in this study are interested in PrEP, report taking sufficient PrEP, and stay on PrEP, though additional efforts are needed to address community misinformation and stigma. This novel multilevel, open-label study design and person-time approach will allow evaluation of the effectiveness and cost-effectiveness of combination prevention intervention in the contexts of both organized sex work and exchanged sex. International Registered Report Identifier (IRRID) RR1-10.2196/15354
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Affiliation(s)
- Andrea L Wirtz
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Brian Wilson Weir
- Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Sandra Hsu Hnin Mon
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | | | - Tareerat Chemnasiri
- HIV/STD Research Program, Thailand MOPH-US CDC Collaboration, Nonthaburi, Thailand
| | - Eileen F Dunne
- HIV/STD Research Program, Thailand MOPH-US CDC Collaboration, Nonthaburi, Thailand.,Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Anchalee Varangrat
- HIV/STD Research Program, Thailand MOPH-US CDC Collaboration, Nonthaburi, Thailand
| | - Andrew C Hickey
- HIV/STD Research Program, Thailand MOPH-US CDC Collaboration, Nonthaburi, Thailand.,Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Michele R Decker
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.,Department of Population, Family & Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Stefan Baral
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | | | - Patrick Sullivan
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, United States
| | - Rachel Valencia
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, United States
| | - Michael C Thigpen
- HIV/STD Research Program, Thailand MOPH-US CDC Collaboration, Nonthaburi, Thailand.,Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Timothy H Holtz
- HIV/STD Research Program, Thailand MOPH-US CDC Collaboration, Nonthaburi, Thailand.,Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Philip A Mock
- HIV/STD Research Program, Thailand MOPH-US CDC Collaboration, Nonthaburi, Thailand
| | - Betsy Cadwell
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Adeola Adeyeye
- Prevention Science Program, Division of AIDS, National Institute of Allergy and Infectious Disease, National Institute of Health, Bethesda, MD, United States
| | - James F Rooney
- Medical Affairs, Gilead Sciences, Foster City, CA, United States
| | - Chris Beyrer
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
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- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
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Eroding gains in safe sex behavior, HIV/AIDS knowledge, and risk perceptions among royal Thai Navy conscripts after 28 years of the AIDS epidemic in Thailand. AIDS Behav 2014; 18 Suppl 1:S42-9. [PMID: 23700222 DOI: 10.1007/s10461-013-0522-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Despite extensive early prevention efforts, recent surveys suggest that sexual risk taking may again be on the rise in Thailand. The present cross-sectional study surveyed 3,299 recruits in the Thai Navy in 2010, to examine their rates and correlates of consistent condom use. Most participants were aged 21-22 years, unmarried, and had a secondary education. Almost half were employed in labor/agriculture. Only 17 % of sexually experienced recruits were consistent condom users, and 53 % reported multiple sex partners in the past 3 months. In multiple logistic regression, residence in the Northeast (AOR 1.47), age (AOR 1.43), being single (AOR 2.13), non-MSM status (AOR 1.41), voluntary testing (AOR 1.24), and condom use at first sex (AOR 4.29) were significantly associated with consistent condom use. These findings suggest gaps in Thailand's condom campaign targeting both sexually experienced and inexperienced youth. Interventions targeting naval recruits may benefit from including sex education in the training curriculum, building drillmasters' capacities to facilitate sex education/counseling, and creating a supportive environment with better access to condoms.
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Reducing HIV risk among transgender women in Thailand: a quasi-experimental evaluation of the sisters program. PLoS One 2013; 8:e77113. [PMID: 24204750 PMCID: PMC3812213 DOI: 10.1371/journal.pone.0077113] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Accepted: 08/29/2013] [Indexed: 11/19/2022] Open
Abstract
Transgender women are particularly at risk of HIV infection, but little evidence exists on effective HIV prevention strategies with this population. We evaluated whether Sisters, a peer-led program for transgender women, could reduce HIV risks in Pattaya, Thailand. The study used time-location sampling to recruit 308 transgender women in Pattaya into a behavioral survey in 2011. Coarsened exact matching was used to create statistically equivalent groups of program participants and non-participants, based on factors influencing likelihood of program participation. Using multivariable logistic regression, we estimated effects of any program participation and participation by delivery channel on: condom use at last sex; consistent condom and condom/water-based lubricant use in the past 3 months with commercial, casual, and regular partners; and receipt of HIV testing in the past 6 months. Program coverage reached 75% of the population. In a matched sub-sample (n = 238), participation in outreach was associated with consistent condom/water-based lubricant use with commercial partners (AOR 3.22, 95% CI 1.64-6.31). Attendance at the Sisters drop-in center was associated with receiving an HIV test (AOR 2.58, 95% CI 1.47-4.52). Dedicated transgender-friendly programs are effective at reducing HIV risks and require expansion to better serve this key population and improve HIV prevention strategies.
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10
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Yadegarfard M, Ho R, Bahramabadian F. Influences on loneliness, depression, sexual-risk behaviour and suicidal ideation among Thai transgender youth. CULTURE, HEALTH & SEXUALITY 2013; 15:726-737. [PMID: 23659441 DOI: 10.1080/13691058.2013.784362] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
This study examined the influence of age, education level and number of sex partners on levels of loneliness, depression, suicidal ideation and sexual-risk behaviour in Thai male-to-female transgender youth. A total of 190 participants filled in the study's questionnaire, designed to tap the primary variables of age, level of education, number of sex partners, loneliness, depression, suicidal ideation and sexual-risk behaviour. Results reveal that level of education has a significant influence on depression and loneliness, the number of sex partners has a significant influence on sexual-risk behaviour and suicidal ideation and age has a significant influence on sexual-risk behaviour and suicidal ideation. Participants with higher levels of education reported more loneliness than participants who did not graduate from high school. In addition, participants who did not graduate from high school reported more depression than participants with some university credit. Furthermore, participants aged 15 to 19 years, compared with those of 20 to 25 years, reported higher level of sexual-risk behaviour and higher levels of suicidal ideation.
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