HIV-1 INFECTION IN YOUNG MEN IN NORTHERN THAILAND

Objectives: To determine risk factors for HIV-1 infection in young men in northern Thailand, Methods: At enrollment into a prospective study , data were collected from a self-administered questionnaire and serol ogic testing on a cohort of 1115 young men selected by lottery for con scription. Results: The overall HIV-1 infection rate was 6.9%; however , the rate was 15.3% among the 387 (34.7%) men who had been living in the upper north subregion of Thailand compared with 2.5% for the remai ning 728 men (P < 0.001). A history of sex with female prostitutes was reported by 74.7% of men and increased frequency of this type of sex was highly associated with HIV-1 infection and a history of sexually t ransmitted disease (STD) symptoms (chi2 for trend, P < 0.001). In stra tified and multivariate analyses, however, history of STD symptoms, re ported by 42.5% of the cohort, was most strongly associated with HIV-1 infection. Only 42.8% of men who reported sex with prostitutes had us ed condoms more than half the time. Conclusions: Young men in the gene ral population in northern Thailand are at high risk for HIV-1 infecti on via sex with female prostitutes; STD are highly associated with HIV -1 infection. Increasing condom use and controlling STD should be imme diate goals of HIV control programs.