ABSTRACT
Men who have sex with men are a priority population for HIV control in Laos, but encompass men diverse in sexual orientation, gender identification, and behavior. Behaviorally bisexual men and their sexual partners were recruited in Vientiane, Laos, in 2010 using modified snowball sampling. Heterosexual-identifying bisexual men identified as exclusively/predominantly heterosexual and other bisexual men identified as bisexual or predominantly/exclusively homosexual. Sixty (68%) heterosexual-identifying and 38 (32%) other bisexual men were recruited; the median number of sex partners in the past year was eight and seven, respectively. Consistent condom use was low with regular (7%) and casual (35%) partners and did not differ by identity. More heterosexual-identifying (53%) than other bisexual (29%) men reported weekly alcohol consumption. Twelve (20%) heterosexual-identifying and 15 (54%) other bisexual men correctly answered all HIV-knowledge questions. High-risk behaviors for STI and HIV transmission were common. Targeted HIV prevention initiatives are needed, particularly to reach heterosexual-identifying bisexual men.
Subject(s)
Bisexuality/statistics & numerical data , Condoms/statistics & numerical data , HIV Infections/transmission , Heterosexuality , Sexual Partners , Bisexuality/psychology , Cross-Sectional Studies , HIV Infections/epidemiology , Health Knowledge, Attitudes, Practice , Homosexuality, Male , Humans , Laos/epidemiology , Male , Retrospective Studies , Risk Assessment , Risk Factors , Risk-Taking , Socioeconomic Factors , Surveys and Questionnaires , Young AdultABSTRACT
A partnership was formed between a mass youth organization, a national HIV coordinating committee, and an international agency, to implement an HIV capacity building project in the youth sector of Lao PDR. Involving the local community in situation analysis, planning and skills-building was a key focus of the project. District project working teams were trained in situation analysis, strategic planning, proposal development, and the implementation of HIV prevention activities. Young village volunteers were trained in participatory research, analysis, and behaviour change communication to promote HIV prevention. After 6 years, the partnership used qualitative methods to evaluate the local outcomes of the project. We found that district project working teams and young volunteers had improved skills in the areas in which they had been trained. Communities and local government workers had developed greater understanding of the HIV situation in their districts, and expressed a strong sense of ownership over their activity plans. Young people more readily acknowledged personal risk of HIV infection and were more comfortable talking about sexually transmitted infections. Although there were challenges to sustaining project activities in some areas, we found that our approach helped to engage youth and build their resilience to HIV in this country of low prevalence.
Subject(s)
Community Participation , Cooperative Behavior , HIV Infections/prevention & control , Program Development , Adolescent , Adult , Female , Focus Groups , HIV Infections/ethnology , Humans , International Agencies , Laos , Male , Program Evaluation , Young AdultABSTRACT
METHODS: Focus group discussions were conducted with a range of young men in Vientiane, Laos; interviews were conducted with male sex workers. A questionnaire survey was conducted with a purposive sample of 800 young men. RESULTS: Most young men initiate sex at an early age and have multiple sex partners. Married men are more likely to pay for sex and most sex for money is negotiated in non-brothel settings. Despite high reported condom use for last intercourse with a casual partner, decisions on condom use are subjective. Many men have extramarital sex when their partner is pregnant and post partum. 18.5% of men report having had sex with another man; most of these men also report having sex with women. Moreover, more men report having had anal sex with a woman than with a man. CONCLUSIONS: Although not a probability sample survey, this study of a broad range of young men in Vientiane reveals sexual behaviours that could lead to accelerated HIV transmission. Education should emphasise the need to use condoms in all sexual encounters outside the primary relationship. This needs special emphasis when the partner is pregnant or post partum. Advice on safe sex with other men needs to be integrated into all sexual health education for young men.
