KNOWLEDGE, ATTITUDES AND BEHAVIOR AMONG HIV-POSITIVE AND HIV-NEGATIVECLIENTS OF A CONFIDENTIAL HIV COUNSELING AND TESTING CENTER IN THAILAND

Objective: To describe the clients, operation and impact of an Asian p ublic HIV counselling and testing centre. Design and setting: Analysis of samples from clients attending the Thai Red Cross Anonymous Clinic (TRC-AC) in Bangkok, Thailand in 1993. Subjects: HIV-positive and HIV -negative consecutive clients (250 of each). Main outcome measures: HI V seroprevalence rates, knowledge, attitudes and behaviour. Results: O verall HIV-1 prevalence was 16%; 13% in men and 24% in women. Reasons for requesting an HIV test were high-risk behaviour (21%), feeling unw ell (20%), checking a previous HIV test result (18%), a planned marria ge or new relationship (10%), and planning a baby (5%). Heterosexual r isk behaviour was reported by 85% of clients, while in each case only 1% reported male homosexual or intravenous drug use risk behaviour. Fa ctors associated with HIV infection on univariate analysis included a history of sexually transmitted disease, not using condoms, a low leve l of education and salary, and being female. Knowledge about HIV trans mission risks and AIDS prevention measures was good, and most clients expressed a caring attitude towards people with HIV and AIDS. A former negative HIV test result was associated with higher levels of condom use, and most clients expressed the intention to reduce their HIV risk behaviour in response to a positive or negative HIV test result (more so if positive). Conclusions: Our study demonstrates the demand for a nd the feasibility of confidential HIV counselling and testing service s in Thailand and illustrates the value of these services in achieving behaviour changes. Such services should be considered as an additiona l approach for reducing HIV transmission in Asia, especially in areas with high HIV seroprevalence rates.