HIV RISK BEHAVIORAL SURVEILLANCE IN BANGKOK, THAILAND - SEXUAL-BEHAVIOR TRENDS AMONG 8 POPULATION GROUPS

Objective: To assess trends in HIV risk behaviors over a 3-year period in eight population groups in Bangkok, Thailand. Design and subjects: Using a repeated cross-sectional survey design with a structured ques tionnaire, we collected five sets of self-reported sexual behavior dat a related to HIV risk from the following subject groups at the same sa mpling sites during 1993-1996: direct and indirect female sex workers, male attenders of sexually transmitted disease (STD) clinics, female attenders of antenatal care clinics, male and female vocational studen ts, and male and female factory workers. Results: Reported patronage o f commercial sex by the three male groups declined by an overall avera ge of 48% over the 3-year period. Other non-regular sexual partnership s declined among male STD clinic attenders and vocational students. Co ndom use during most recent sexual intercourse between sex workers and clients peaked at high levels (>90%) in the early data waves, while a mong indirect sex workers and their clients, consistent condom usage i ncreased from 56% to 89%. Low condom use persisted among sex workers a nd their non-paying sex partners. Single women reported low levels of sexual activity and condom use with no signs of an increase. Similarly , married women from antenatal clinics reported low condom use with th eir husbands, with no change throughout the period of the study. Concl usions: HIV risk behavioral surveillance is a useful way of determinin g whether behavior change has occurred in specific population groups. The results here confirm and add to a growing set of evidence of risk behavior reduction in Thailand. The behavioral changes did not occur u niformly but varied depending on the sexual dyad and the population gr oup under study. Behavioral surveillance should be promoted and its me thodologies strengthened in attempts to understand the local dynamics of HIV epidemics.