DYNAMICS OF RISK BEHAVIOR FOR HIV-INFECTION AMONG YOUNG THAI MEN

The objective of this investigation was to analyze the dynamics of ris k for HIV-1 infection among young men in Thailand. We conducted a pros pective study in a cohort (n = 1,236) of young men, aged 19-23 years a t conscription into the Royal Thai Army and Air Force from six provinc es in northern Thailand in May 1991 who were followed until their disc harge in April 1993. The outcome measure was change since conscription in the frequency of self-reported sex with female commercial sex work ers (CSW) during military service. Although 42% of conscripts reported no visit to a female CSW in the year prior to conscription, most had a visit during military service. Men who visited female CSWs infrequen tly at baseline increased their visits somewhat over time, whereas tho se with high initial rates of CSW visits decreased. Based on an assume d stable distribution over time, change from baseline was not statisti cally significant. Only marital status and high baseline CSW visit rat es were associated with diminished visit frequency in multivariate ana lysis. No differences were seen in patterns of change in CSW visits by HIV-1 serostatus. More aggressive preventive interventions are needed to reduce the frequency of CSW visits in northern Thailand, a setting where 40-80% of all female CSWs working in brothels are now HIV serop ositive.