HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION AND SELF-TREATMENT FOR SEXUALLY-TRANSMITTED DISEASES AMONG NORTHERN THAI MEN

Background and Objectives: Self-treatment for sexually transmitted dis eases (STD) is common, but little studied, in Thailand, and its influe nce on human immunodeficiency virus (HIV) infection is unknown. Goals: To assess STD self-treatment and self-prophylaxis behaviors as well a s HIV risks and serostatus among northern Thai men. Study Design: Cros s-sectional report from a cohort of military conscripts (N=869). HIV a nd STD seroprevalence and reported risk behaviors, including STD histo ry and antibiotic self-treatment, were obtained. Associations between STDs and self-treatment or prophylaxis and HIV infection were analyzed using t-tests, odds ratios, and logistic regression. Results: The pre valence rate for HIV was 12.3%, and for syphilis it was 2.2%. Men who were seropositive for HIV were more likely to report having sex with c ommercial sex workers (OR 9.1), to have had an STD (OR 5.96), and to r eport inconsistent condom use with commercial sex workers (OR 3.13). O f 282 men reporting any STD, 65.2% treated themselves with antibiotics , and 8.5% used them before commercial sex. Among those who frequented commercial sex workers, 98.7% took preventive steps after sex by incr easing urine output (69.2%), washing the genital area (28.9%), and usi ng antibiotics (0.9%). Men reporting STD self-treatment were less like ly to be HIV infected (OR 0.53; 95% CI 0.31, 0.93). Conclusions: These men are attempting to prevent HIV and STDs. Self-treatment with antib iotics may lower HIV risks associated with bacterial STD in a high-pre valence population.