Sexual behaviors, STIs and HIV Among Men Who Have Sex with Men in Phnom Penh, Cambodia: Part 2

Contents
				Page
ABBREVIATIONS				ii
EXECUTIVE SUMMARY				iii
I.	BACKGROUND			1
II.	OBJECTIVES			2
III.	METHODS			2
IV.	RESULTS			6
	IV-1		SAMPLE DESCRIPTION / DEMOGRAPHIC PROFILE6
	IV-2		BEHAVIORAL AND CLINICAL FINDINGS	8
V.	DISCUSSION			23
VI.	RECOMMENDATIONS			25
REFERENCES					26

APPENDIX I: QUESTIONNAIRE

APPENDIX II: CLINICAL PROTOCOL

TPHA Treponema pallidum Hemaggultination Assay USAID United States Agency for International Development USD United States Dollars

VCT Voluntary Counseling and Testing WHO World Health Organization

Executive Summary

Background

Cambodia has the highest national HIV prevalence in Asia. In 1999, the Cambodian national surveillance system suggested that 3.8% ¹ of the population was infected with HIV. In Cambodia HIV is largely transmitted sexually, and most interventions and resources have been focused on reducing heterosexual transmission. The epidemic is fuelled by a large sex industry, poorly developed health and education infrastructures, and the increasing mobility of the population as the country resumes normal economic activity after decades of war.

In June 2000, FHI undertook a cross-sectional survey of men who have sex with other men. The objectives of this study were to assess the prevalence of HIV, syphilis and other sexually transmitted infections (STIs), and risk behaviors among men who have sex with men (MSM) in Phnom Penh (PNP), Cambodia. The survey was conducted at selected locations, as defined by an extensive mapping exercise.

Methodology

Using a two-stage time-location cluster sampling technique, a probability sample of two hundred and six (206) MSM aged 18 years and older from 16 sites in Phnom Penh, were selected. Inclusion criteria for recruitment into the study included self-reported male-to-male sex behavior, inclusive of non-penetrative sex, during the previous 12 months and being age 18 years or older. Potential participants were approached at the sites by trained interviewers and then accompanied back to one of the two drop-in centers, which were established for the purpose of the study.

At the centers, those who agreed to participate were interviewed and their sera, urethral and anal swabs were collected. Laboratory testing was conducted using ELISA for HIV, quantitative RPR for syphilis, PCR for Chlamydia trachomatis and modified Thayer-Martin medium for Neisseria gonorrhoeae.

The data were analyzed using cluster and weighted univariate and bivariate analyses with STATA. Confidence intervals (CI) were calculated with adjustment for design effect. The chi-square for independence (c²) was used to assess differences.

¹ NCHADS 1999, BSS