Sexual behaviors during antiretroviral therapy among HIV-infected patients, Thailand.

An increasing trend in sexual risk behavior has occurred in the era of antiretroviral therapy (ART) in Thailand. This study was conducted to identify sexual risk behavior and examine relationships between unprotected sex and CD4 levels among HIV-infected patients receiving ART in the National Antiretroviral Program. A cross-sectional survey was conducted in 460 HIV-infected patients age 18-49 years who visited the out-patient clinic of Bamrasnaradura Infectious Diseases Institute in February 2006 by using a standardized self-administered questionnaire. The results show that 60.4% of participants were men. The median most recent CD4 cell count during the prior 6 months was 261 cells/mm3. Twenty-three percent of the participants who had no sexual activity after they knew their HIV positive status started having sex again after receiving ART with a 12-week median duration period from starting ART to having first sex. There was a significant difference between the number of those having sexual activity before and after starting ART (p-value=0.013). Fifty-six percent of participants had sex during the previous 6 months. Of these, 26.5% had sex with commercial partners and 28.4% with non-regular partners. Inconsistent condom use, with commercial partners or non-regular partners, in females (35.3-36.8%) was higher than in males (7.8-11.1%). Participants with a known HIV-negative regular partner were 0.25 times more likely to have unprotected sex than those with a known HIV-positive regular partner (adjusted OR, 0.25; 95%CI, 0.09-0.73). No association between unprotected sex and CD4 levels was found. The findings support the need for reinforcing risk reduction programs among HIV-infected persons, particularly couple counseling, and promoting awareness of risk of acquirring sexually transmitted infections and drug-resistant strains of HIV.

Development of screening indicators for ranking areas at risk of vitamin A deficiency in Thailand.

The objective of this study was to develop community based screening indicators for identifying areas at risk of vitamin A deficiency. Three hundred children aged 24-71 months in 12 villages of 3 provinces who were previously identified to have various degrees of vitamin A deficiency were randomly selected to participate in the study. These villages were located in Songkhla, Yala and Narathiwat provinces. Data collection included anthropometric measurements, serum retinol analysis, data on dietary intake, illness, and socioeconomic status. Subsamples of 120 children were taken for Modified Relative Dose Response. Statistics used for data analysis were factor analysis, discriminant analysis and Receiver Operating Characteristic curves. Sensitivity and specificity of the screening indicators were calculated and compared with the rate of vitamin A deficiency at > or = 15 per cent of children with serum retinol < 0.70 micromol/l. Findings revealed that the screening indicators could identify areas at risk of vitamin A deficiency with 83.3 per cent efficiency. Data to be used for identifying areas at risk of vitamin A deficiency included home and land ownership for agriculture, dietary intake of vitamin A, access to social services (maternal education and antenatal care), vaccination, infectious diseases (diarrhoea and upper respiratory tract infection with fever) and nutritional status.

A longitudinal causal relationship among cardiovascular risk factors in the employees of the government savings bank.

A longitudinal structural causal model was generated to examine the causal relationship among determinants which were composed of four personal factors, stress, four health behaviors, and BMI on five physiological risks for cardiovascular disease: SBP, DBP, FBS, TC and HDL-C in 1,019 bank employees, within a five-year interval. A fourteen-item food frequency questionnaire for assessing eating habits and the Health Opinion Survey for the stress test were included in the self-administered questionnaires. Weight, height and blood pressure were measured and blood samples were collected for blood chemical analysis. Data analysis by LISREL showed that the determinants in the proposed model explained as much as 96 per cent variation in physiological risks for CVD (R2 = 0.96, relative chi-square = 1.92, RMSEA = 0.03, GFI = 0.96 and AGFI = 0.95). The findings also indicated that current physiological status was affected by their status of age, education, health behaviors, BMI and physiological status 5 years ago.