Sex frequency and sex planning among men who have sex with men in Bangkok, Thailand: implications for pre- and post-exposure prophylaxis against HIV infection.
BACKGROUND
Daily HIV antiretroviral pre-exposure prophylaxis (PrEP) is being evaluated in clinical trials among men who have sex with men (MSM). However, daily PrEP may not be congruent with sexual exposure profiles of MSM. Here, we investigate sex frequency and sex planning to identify and inform appropriate PrEP strategies for MSM.


METHODS
We evaluated sex frequency and sex planning in a cohort of HIV-negative MSM in Bangkok, Thailand. Chi-squared test was used to compare reports of sex on different weekdays; logistic regression was used to identify predictors of sex frequency and sex planning.


RESULTS
Of 823 MSM (with a mean age of 28.3 years), 86% reported having sex on two days per week or less, and 65% reported their last sex to have been planned. Sex on the weekend (approximately 30%) was more often reported than sex on weekdays (approximately 23%). In multivariate analysis, use of alcohol, erectile dysfunction drugs, group sex, sex with a foreigner, buying and selling sex, and a history of HIV testing were associated with having sex on three days or more per week. Being aged 22 to 29 years, not identifying as homosexual, having receptive anal intercourse, and not engaging in group sex were associated with unplanned sex.


CONCLUSIONS
Intermittently dosed PrEP (as opposed to daily) may be a feasible HIV prevention strategy and should be considered for evaluation in clinical trials. Risk factors for sex frequency and sex planning may help to identify those in need for daily PrEP and those who may not be able to take a timely pre-exposure dose.
van Griensven
Frits
F
Thailand Ministry of Public Health - US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand. fav1@cdc.gov
Thienkrua
Warunee
W
Sukwicha
Wichuda
W
Wimonsate
Wipas
W
Chaikummao
Supaporn
S
Varangrat
Anchalee
A
Mock
Philip A
PA
D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D015658:HIV Infections / Q000517:prevention & control* / Q000523:psychology; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D056990:Post-Exposure Prophylaxis; D011446:Prospective Studies; D021841:Safe Sex; D012725:Sexual Behavior; D013785:Thailand; D055815:Young Adult
AIDS. 2007 Nov 30;21(18):2513-20
18025888
PLoS Med. 2008 Feb;5(2):e28
18254653
Curr Opin HIV AIDS. 2009 Jul;4(4):300-7
19532068
J Infect Dis. 2006 Oct 1;194(7):904-11
16960777
N Engl J Med. 1997 Nov 20;337(21):1485-90
9366579
Sci Transl Med. 2010 Jan 13;2(14):14ra4
20371467
J Int Assoc Physicians AIDS Care (Chic). 2003 Jul-Sep;2(3):102-5
14556428
J Infect Dis. 2006 Oct 1;194(7):874-6
16960773
AIDS. 2003 Apr 11;17(6):937-8
12660549
J Acquir Immune Defic Syndr. 2008 Feb 1;47(2):241-7
18340656
AIDS. 2008 Sep 12;22(14):1829-39
18753932
J Acquir Immune Defic Syndr. 2005 May 1;39(1):82-9
15851918
Clin Infect Dis. 2009 Mar 15;48(6):806-15
19193111
J Acquir Immune Defic Syndr. 2009 Jan 1;50(1):77-83
19295337