HIV Prevention Service Delivery and PrEP in Urban Thai MSM/Transgender Women in Bangkok Restricted; Files Only
Bhamidipati, Divya (Summer 2022)
Abstract
The prevalence of HIV infection in Thailand is high among men who have sex with men (MSM) and transgender women (TGW) at 28-31% over the last few years. HIV pre-exposure prophylaxis (PrEP) with daily oral tenofovir/emtricitabine is >90% effective at preventing HIV infection. Uptake of PrEP is still suboptimal among MSM and TGW both in Thailand and around the world. The needs of TGW have been noted to be different compared to other cohorts on PrEP and more research is needed to see how to better serve this population. Currently in Bangkok, the Silom Community Clinic (SCC) operates an HIV and sexually transmitted infection (STI) testing and treatment center geared toward sexual and gender minorities where all clients are offered PrEP as standard of HIV prevention care. This study looked to understand the needs and behaviors of the gender non-conforming individuals (including TGW) and cis-gender MSM utilizing SCC services from 2017 to 2019. Additionally, this study also aimed to study the factors associated with PrEP persistence in the overall clinic cohort from 2016-2019. We found significant differences between gender non-conforming (GNC) and cis-gender MSM with GNC more likely to engage in sex work, more likely to utilize personal networks in learning about clinic services, and more likely to engage in unprotected anal sex when compared to cisgender MSM. Interestingly, there was an increase in the proportion of patients engaging in sex work over time in both groups. Age and having sex with women was seen to be the most significant covariate for PrEP persistence in clinic with younger patients more likely to stay on PrEP at the clinic through the study period. These findings represent interesting changes in the demographics of those utilizing SCC in the last few years and point to areas where more education and counseling is needed at the clinic to engage people in PrEP and then ensure they are able to stay on PrEP.
Table of Contents
1. Introduction ………………………………………………………......................................2 2. Background …………………………………………………………………………………………….5 3. Methods ……………………………………………………………………………………………….11 4. Results ……………………………………………………………........................................15 5. Discussion …………………………………………………………………………………………….21 6. References ……………………………………………………………………………………………28 Tables/Figures ………………………………………………………………………………………34
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File download under embargo until 19 August 2026 | 2022-07-20 00:27:53 -0400 | File download under embargo until 19 August 2026 |
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