title: HIV-Related Stigma and HIV Prevention Uptake Among Young Men Who Have Sex with Men and Transgender Women in Thailand.
abstract: HIV-related stigma is a pervasive structural driver of HIV. With an HIV epidemic among young men who have sex with men (MSM) and transgender women (TG) in Thailand characterized as explosive, we conducted a cross-sectional survey among MSM and TG aged 18-30 years. From April-August 2013, participants recruited using venue-based sampling from gay entertainment sites and community-based organizations completed a tablet-assisted survey interview in Thai language. We conducted multiple logistic regression to assess correlations between HIV-related stigma (felt-normative, vicarious domains) and socio-demographic variables, HIV vulnerabilities (gay entertainment employment, sex work, forced sex history), and HIV prevention uptake (condom use, HIV testing, rectal microbicide acceptability). Among participants (n = 408), 54% identified as gay, 25% transgender, and 21% heterosexual. Two-thirds (65.7%) were employed at gay entertainment venues, 67.0% had more than three male partners (past month), 55.6% had been paid for sex, and 4.5% were HIV-positive. One-fifth (21.3%) reported forced sex. Most participants reported experiencing felt-normative and vicarious HIV-related stigma. Adjusting for socio-demographics, participants with higher total HIV-related stigma scores had significantly lower odds of HIV testing and rectal microbicide acceptability, and higher odds of having experienced forced sex. Both vicarious and felt-normative dimensions of HIV-related stigma were inversely associated with HIV testing and rectal microbicide acceptability. Our findings suggest that HIV-related stigma harms the health of HIV-negative MSM and TG at high risk for HIV infection. HIV-related interventions and research among young MSM and TG in Thailand should address multiple dimensions of HIV-related stigma as a correlate of risk and a barrier to accessing prevention.
authors.affiliation: 1 Factor-Inwentash Faculty of Social Work, University of Toronto , Toronto, Ontario, Canada .
authors.forename: Carmen H
authors.initials: CH
authors.lastname: Logie
authors.affiliation: 1 Factor-Inwentash Faculty of Social Work, University of Toronto , Toronto, Ontario, Canada .
authors.forename: Peter A
authors.initials: PA
authors.lastname: Newman
authors.affiliation: 1 Factor-Inwentash Faculty of Social Work, University of Toronto , Toronto, Ontario, Canada .
authors.forename: James
authors.initials: J
authors.lastname: Weaver
authors.affiliation: 2 Faculty of Science and Technology, Rajamangala University of Technology Phra Nakhon , Bangkok, Thailand .
authors.forename: Surachet
authors.initials: S
authors.lastname: Roungkraphon
authors.affiliation: 1 Factor-Inwentash Faculty of Social Work, University of Toronto , Toronto, Ontario, Canada .
authors.forename: Suchon
authors.initials: S
authors.lastname: Tepjan
mesh_terms: D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D004192:Discrimination, Psychological; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D020010:Heterosexuality; D018451:Homosexuality, Male / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D021841:Safe Sex; D012747:Sexual Partners; D057545:Social Stigma; D013785:Thailand / Q000453:epidemiology; D063106:Transgender Persons / Q000523:psychology* / Q000706:statistics & numerical data; D014189:Transsexualism; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents