Abstract
Background
Ethical safeguards are critical in HIV research involving minors, especially vulnerable groups such as men who have sex with men (MSM) under 18 years. This systematic review explores how informed assent and consent practices are reported, guided by the 2016 Council for International Organizations of Medical Sciences (CIOMS) guidelines.
Methods
A systematic review was conducted of peer-reviewed studies from 2010 to 2023 involving MSM under 18 years, using PubMed, Embase, and Scopus databases. Key ethical components were extracted and synthesized thematically.
Results
Of 410 articles screened, 65 met inclusion criteria. All included studies reported informed consent, but only 20% (n = 13) included informed assent. Most were conducted in high-income countries (64%), with no representation from low-income settings. Only 7% involved minors living with HIV. Quantitative methods were predominant (82%), and 20% used online platforms. Waivers of parental permission were reported in 27% of studies, while only 3% obtained parental permission. Four studies described tailored consent/assent approaches, such as simplified language, comprehension checks, and involvement of minor advocates.
Conclusion
This review highlights inconsistencies in how informed assent is addressed in HIV research involving MSM minors. Only one in five studies described ethically appropriate, youth-tailored processes. Limited use of waivers and adapted assent procedures points to ongoing gaps in aligning research with ethical standards. Future studies should adopt clearer, age-appropriate consent practices, ensure transparent reporting, and strengthen researcher training in ethics involving vulnerable minors.
DOI:
https://doi.org/10.1186/s12910-026-01378-7
TYPE:
Journal article
JOURNAL:
BMC Medical Ethics
VOLUME:
27: 49 (2026)
PUBLICATION DATE:
2026
KEYWORDS:
HIV research, MSM, Minor, Informed consent, Informed assent
Abstract
Background
Gay, bisexual and other men who have sex with men’s (GBMSM) sexualised drug use, defined as taking psychoactive drugs before or during sex, is the focus of public health concern globally. ‘Hi-fun’ in Thailand (similar to the practice of ‘chemsex’ in Western settings) is a subset of sexualised drug use. Much harm reduction programming relies on Western chemsex definitions, obscuring critical variation related to local cultures, drug markets and legislative contexts. We aimed to develop, informed by transnational queer sociology, a locally grounded definition of hi-fun compared to other sexualised drug use types practiced among GBMSM in Thailand.DOI:
https://doi.org/10.1186/s12910-026-01378-7
TYPE:
Journal article
JOURNAL:
Harm Reduction Journal
VOLUME:
–
PUBLICATION DATE:
26 February 2026
KEYWORDS:
Chemsex, Sexualised drug use, Gay, bisexual and other men who have sex with men, Methamphetamine, Stimulant drugs, Criminalisation, Thailand
Abstract
Background: The heightened HIV vulnerability associated with men who have sex with men (MSM) who find sex online in Western and East Asian countries may pose similar concerns for MSM in Southeast Asia. However, this line of research is underexamined among Southeast Asian MSM, especially in Southeast Asian cities with a high HIV prevalence among young MSM, such as Ho Chi Minh City, Vietnam.
Objective: This study aimed to characterize the sexual behavioral and psychosocial correlates of online sex seeking in a sample of largely gay-identified young MSM in Ho Chi Minh City, Vietnam, and examine the relationships among social support, outness, and last instance of condomless anal sex while not on preexposure prophylaxis (PrEP) for HIV or antiretroviral therapy (ART). The analysis included specific attention paid to the use of different types of online sex platforms, which may contribute to the understanding of online sex seeking.
Methods: Patterns of online sex seeking in a cross-sectional sample of young MSM (N=1005) were identified using latent class analysis. Multinomial logistic regressions and Poisson regressions with robust variance were used to estimate the associations between patterns of online sex seeking and other participant characteristics.
Results: We found four latent classes of MSM with distinct profiles of online platform use for sex seeking: (1) negligible app users, (2) gay app users, (3) poly app users, and (4) low-cost app users. Patterns of online sex seeking moderated the protective effects of social support and outness on last instance of condomless anal sex while not on PrEP or ART. When stratified by level of social support and outness, only gay app users were associated with a protective effect on last instance of condomless anal sex while not on PrEP or ART when social support and outness were high, respectively. Low-cost app users were marginally associated with a higher prevalence of condomless anal sex while not on PrEP or ART when the level of outness was low.
Conclusions: Young Vietnamese MSM who find sex partners online have distinct patterns of app use, with contrasting sexual and psychosocial health burdens that indicate that online sex seeking is a socially patterned behavior. HIV prevention programs and tailored digital interventions should consider the different exposures to social influences associated with patterns of social networking app use as they could moderate the effectiveness of the delivered programs and interventions for reducing HIV vulnerability in young MSM.
DOI:
10.2196/59072
TYPE:
Journal article
JOURNAL:
Journal of Medical Internet Research
VOLUME:
27
PUBLICATION DATE:
20 Aug. 2025
KEYWORDS:
young men who have sex with men, Vietnam, Ho Chi Minh City, HIV, sexually transmitted infection, STI, mental health, gay dating app, geosocial networking app, preexposure prophylaxis, latent class analysis
Abstract:
Visual research methods are increasingly utilised in educational research and scholars have used them to develop accounts of sexuality in schooling contexts. This article advances this work with an analysis of secondary students’ drawings of their experiences with sexuality education. We performed a thematic analysis on 150 drawings created during participatory focus group discussions (FGDs) among students in 30 Thai general secondary and vocational schools. We present summaries of six key themes identified in the visual data (‘emphasis on puberty, anatomy, and reproduction’; ‘emphasis on preventing pregnancy and infection’; ‘emphasis on the negative consequences of sex’; ‘hidden curriculum of heteronormativity’; ‘absence of complexities in the images’; and ‘a traditional classroom environment’). Conducted as a part of a multi-method study that also included teacher and student surveys, the analysis of students’ drawings highlighted the nature of Thai sexuality education from a complementary vantage point. While our previously reported survey findings indicated relatively comprehensive topic coverage, our interpretation of the student drawings suggests that pregnancy prevention may be emphasised over other topic areas. Our analysis of the drawings also supported earlier survey findings pointing at a lecture-heavy approach to teaching and learning rather than more learner-centred pedagogy.
DOI: 10.1080/14681811.2024.2414756
TYPE: Journal article
JOURNAL: Sex Education.
PUBLICATION DATE: October 2024
KEYWORDS: Sexuality education, visual research methods, secondary education, vocational education, Thailand
Abstract:
This study investigated the clustering of psychosocial adversities and their synergistic effect with depression on suicidality in a 12-month prospective cohort (N = 214) of YMSM living with HIV in Bangkok, Thailand. Latent class analysis identified subgroups with distinct combinations of adversities, including bullying, intimate partner violence, substance use, HIV stigma, low social support, histories of sex work, and below-income status. Significant interactive synergism were found as hypothesized, supporting a syndemic effect with qualitatively increasing levels of adversities on suicidality (score range: 3–17) over the 12 months. The interaction between moderate adversity clustering and depression (βow = 2.50, 95% CI: 1.12–3.88) and high adversity clustering and depression (βow = 3.61, 95% CI: 1.12–6.09) indicated that the impact of depression on suicidality was modified by pre-existing adversities. The findings suggest that, while a multi-component intervention addressing psychosocial problems is ideal, effective depression treatment alone could significantly reduce suicidality among YMSM living with HIV.
DOI: 10.1007/s10461-024-04516-7
TYPE: Journal article
JOURNAL: AIDS and Behavior.
VOLUME: 29
PUBLICATION DATE: October 2024
KEYWORDS: HIV/AIDS, Men who have sex with men, Suicide prevention, Thailand, Causal Inference
Abstract:
Sexualized substance use or “chemsex” may contribute to the HIV epidemic among men who have sex with men (MSM) in Thailand. Specific patterns of chemsex use may be associated with different HIV/STI transmission risks. We examined typologies and correlates of sexualized substance use among a sample of high-risk MSM (n = 532) who had attended a private sex party or circuit party in the past three years using latent class analysis. Multinomial regression was used to adjust for variables associated with the 3-class latent class model. We identified a 3-class model as the best fitting model, which included: (1) “negligible sexualized substance users” (36.7%), who had never engaged in chemsex in the past six months; (2) “sexualized substance users” (13.9%), who had a high level of sexualized alcohol use and a wide range of other substances before or during sex in the past six months; and (3) “exclusive chemsex users” (49.4%), who predominantly used crystal methamphetamine, amyl nitrite, and erectile dysfunctional drugs before or during sex in the past six months. Compared to negligible sexualized substance users, exclusive chemsex users were more likely to be HIV-positive, more likely to have six or more sexual partners in the past six months, less likely to have condom use at last anal intercourse, and more likely to have provided sex work. Relative to negligible sexualized substance users, sexualized substance users reported more frequent online sex-seeking behaviors. These subgroups of Thai MSM have unique substance use patterns and HIV-related risk profiles, underscoring the importance of targeted HIV prevention strategies.
DOI: 10.1007/s10508-024-02868-8.
TYPE: Journal article
JOURNAL: Arch Sex Behav
VOLUME: 53
PUBLICATION DATE: Aug 16, 2024
KEYWORDS: HIV risks, Men who have sex with men, Thailand, Substance use, HIV prevention ,Sexual orientation
Abstract:
Amphetamine-type stimulant (ATS) use is increasing globally and poses a growing threat to the effectiveness of biomedical HIV prevention strategies among sexual minority men. This commentary highlights how ATS use undermines engagement across the HIV prevention continuum, including reduced adherence to pre-exposure prophylaxis (PrEP), increased sexual risk-taking, and poorer retention in prevention and care services. The authors argue that current HIV prevention frameworks insufficiently address stimulant use and its structural, social, and mental health drivers. They call for an integrated, multi-level response that combines biomedical HIV prevention with evidence-based substance use interventions, mental health support, and structural reforms. Addressing ATS use is essential for sustaining global HIV prevention gains and ensuring equitable access to prevention for sexual minority men worldwide.
DOI:
10.1016/S2352-3018(24)00086-2
TYPE:
Journal article
JOURNAL:
The Lancet HIV
VOLUME:
Volume 11, Issue 6, pp. e350–e352
PUBLICATION DATE:
2024
KEYWORDS: amphetamine-type stimulants; HIV prevention; PrEP; biomedical HIV prevention; sexual minority men; substance use; global health; syndemics
Abstract:
Background: Human immunodeficiency virus (HIV) testing for Thai men who have sex with men (MSM) is suboptimal, which undermines their linkage to care and subsequent HIV preexposure prophylaxis (PrEP) uptake.
Methods: We analyzed a cross-sectional survey conducted in 2021 among Thai MSM who attended any private sex parties or circuit parties in the past 3 years (“sexualized parties”).
Results: Of the 424 men included in our analysis, 47.6% had been recently tested for HIV in the past 1 year, 30.2% had not recently been tested, and 22.2% had never been tested. In our multivariable analysis, relative to participants who had recently tested for HIV, those who have never tested were more likely to have lower education or to live outside of Bangkok, and to have attended both circuit and private sex parties (vs. private sex party only) but were less likely to report any sexually transmitted infection diagnosis or to have heard of PrEP. Participants who had an HIV test more than a year ago were more likely to have attended both circuit and private sex parties (vs. private sex parties only) but were less likely to have any sexually transmitted infection diagnosis, meet sexual partners online, or have heard of PrEP. Rates of condomless anal sex and willingness to use PrEP were similar across groups.
Conclusions: Despite the high rates of sexual risk-taking, sexualized party attendees reported suboptimal HIV testing uptake. The joint promotion of HIV testing and PrEP is warranted-especially on-premise HIV testing at circuit parties and outreach at online platforms to reach sexualized party attendees.
DOI:
10.1097/OLQ.0000000000001937
TYPE:
Journal article
JOURNAL:
Sexually Transmitted Diseases
VOLUME:
Volume 51, Issue 6, pp. 352–358
PUBLICATION DATE:
2024
KEYWORDS:
MSM; HIV testing; sexualized drug use; party settings; Thailand
This project uses a secondary dataset of Thailand from a larger cross-sectional study distributed in the Greater Mekong Sub-Region. This study utilized web-based answers from 1468 Thai GBM respondents between the ages of 15–24 years.
Prevalence of depression was over 50%. Across the social groups of interest, those who disclosed to everyone had the lowest depression prevalence. This association was statistically significant for all groups (p<0.050) except for “Family members” (p = 0.052). There was a statistically significant association illustrated between full disclosure to social groups and increased social support. Most respondents (43.9%) had low social support, and additionally this group had the highest level of depression, compared to those with high social support. There was a statistically significant association for lowered depression outcomes and increased social support. IPV experiences that occurred within the last six months had a statistically significant relationship with depression (p = 0.002). There was a notable association between those with experiences of being a victim of IPV, alone and in conjunction with experience of being a perpetrator of IPV, which was associated with increased odds of depression. However, the type of IPV experiences an individual had did not differ based on disclosure status.
This study provides strengthened evidence of the impact that differences in supportive networks can have on mental health outcomes. In addition, they provided a wider consideration for how people may have different IPV experiences, either as a perpetrator, victim, or both, and how those shapes health outcomes of depression. GBM communities still face adversity and challenges that affect their long-term health outcomes, even if they do live in what is considered an accepting country.
DOI:
10.1371/journal.pone.0294496
TYPE:
Journal article
JOURNAL:
PLoS One
VOLUME:
Volume 18, Issue 11, e0294496
PUBLICATION DATE:
2023
KEYWORDS:
sexual orientation disclosure; depression; MSM; social support; intimate partner violence; Thailand
Abstract
The use of specific drugs (e.g. methamphetamine, GHB/GBL and other stimulants) to enhance sex among men who have sex with men (MSM), is the focus of global public health concern because of links to social harms, poor mental and sexual health. Often called ‘chemsex’ in Western settings or ‘hi-fun’ in Southeast Asia, this type of sexualised drug use is increasingly visible in Thailand where the unique sociocultural and legislative environments shape sexual cultures and harms. This study aimed to develop an understanding of key informants’ perspectives on hi-fun contexts, harms and current responses in Bangkok. In-depth interviews were conducted with thirteen key informants from clinical, community, policy and development organisations. Four key informants had personal experience of hi-fun. Interviews covered hi-funcontexts, harms and support, were transcribed verbatim, translated to English (where necessary) and analysed using a thematic framework. MSM hi-fun ‘influencers’ shape norms and provide support online, primarily through Twitter. Hi-fun was linked to Westernisation and wealth; complex hierarchies emerged from asymmetries in social/financial capital. Police coercion towards MSM engaged in hi-fun was a concern. Given the nature of their funding, HIV/HCV/STI transmission was the most pressing focus for many organisations, however key informants were concerned especially about drug overdoses and mental health/well-being impacts. The political and economic context means funding for MSM health in Thailand focuses primarily on HIV prevention/treatment; restrictions on development aid constrain holistic hi-funfocused service development. Most hi-fun support was informally developed; successful strategies relied on partnership working and peer developed/delivered services, some of which were adapted from high-income settings. Despite substantial barriers, organisations developed services responding to the needs of MSM engaged in hi-fun. Given that many were informally developed or adapted from high-income settings, establishing a theoretical basis for further interventions that is grounded in this unique context is a priority.
DOI:
10.1371/journal.pgph.0002295
TYPE: Journal article
JOURNAL: JLoS Global Public Health
VOLUME: Volume 3
PUBLICATION DATE: 2023
KEYWORDS: hi-fun; chemsex; MSM; harm reduction; Thailand
Background: Recently, early maladaptive schemas have been increasingly focused as the underlying factor of several psychopathologies. The primary objective is to systematically review and meta-analytically analyse the evidence on the relationship between early maladaptive schemas and types of addictive behaviours. Additionally, the secondary objective was to examine potential moderators of the effect sizes.
Methods: The systematic search was conducted on three databases including ‘Scopus’, ‘Web of Science’ and ‘PubMed’. They were searched for quantitative studies investigating the relationship between early maladaptive schemas and addictive behaviours. The studies that were non-English and had insufficient information to calculate effect sizes were excluded. The random-effect model was utilized to estimate the pool effect sizes, and the meta-regression was used for moderation analysis.
Results: Thirty-three studies with 12,577 participants were included for analyses. Most of included studies were conducted in the United States (k = 12, 36.36%). The mean ages of participants varied from 13.32 to 46.09 years. The findings indicated that all of early maladaptive schemas and schema domains positively correlated with addictive behaviours. The disconnection and rejection, impaired limits and impaired autonomy were the domains with the highest association with substance addictions (pool r = 0.338, 3.26 and 3.16, respectively). Furthermore, disconnection and rejection and impaired autonomy were the schema domains with the highest association with behavioural addictions (0.310 and 0.304, respectively). The moderation analysis demonstrated that study design was the factor affecting the effect sizes between schema domain and addictive behaviours.
Limitation: All included studies were from peer-reviewed journals in English. Moreover, the number of research examining the relationship between early maladaptive schemas and behavioural addictions was limited.
Conclusion: The findings provide evidence supporting the idea that substance addictions and behavioural addictions have shared risk factors, supporting the validity of the schema model, which can be applied for targeting and preventing addictive behaviours.
DOI:10.1002/cpp.2882
TYPE: Journal article
JOURNAL: Clinical Psychology & Psychotherapy
VOLUME: Volume 3
PUBLICATION DATE: 2023
KEYWORDS: Young’s schema model; addictive behaviours; behavioural addiction; early maladaptive schemas; schema therapy; substance use disorder.
Abstract
In Thailand, antiretroviral therapy (ART) programs still have difficulties reaching and promoting adherence among a key population – young men who have sex with men (YMSM) living with HIV. As such, we sought to examine potential psychosocial barriers that may contribute to suboptimal levels of ART adherence for this population. Data were drawn from a study of 214 YMSM living with HIV from Bangkok, Thailand. Linear regression models tested the association between depression and ART adherence, and whether social support and HIV-related stigma moderated that relationship. Multivariable models demonstrated social support was significantly associated with higher levels of ART adherence, and that there was a three-way interaction between depression, social support, and HIV-related stigma on ART adherence. These results further our understanding of the role of depression, stigma, and social support in ART adherence among Thai YMSM living with HIV, and that additional supports for YMSM with depression and HIV-related stigma are needed.
DOI: 10.1007/s10461-023-04018-y
TYPE: Journal article
JOURNAL: AIDS and Behavior
VOLUME: Volume 27, Issue 9, pp. 2959–2968
PUBLICATION DATE:
2023
KEYWORDS:
ART adherence; depression; HIV stigma; social support; MSM; Thailand
Abstract
Addictive behaviors have been increasingly found to have health impacts on youth groups, including gambling addiction, compulsive shopping, binge eating, internet overuse, and exercise addiction (EA), co-occurring with alcohol consumption, and drug use (1,2). Responses to the problems usually involve understanding addictive behaviors through conceptualizing the research and social determinants of addictive behavior and developing appropriate preventions and interventions. The term addictive behavior in the present study was defined as taking any illicit psychoactive substance that included alcohol, cigarettes, and marijuana. In addition, addictive behavior also extends from drug use to behavioral problems such as social network use, eating behavior, binge eating, and sexual risk behavior. In addiction, “Youth” refers to people who are young adults, from the ages of 15 to 25 or Objective: To explore the scope of the published research studies on mHealth digital application interventions for youths with addictive behaviors, considering both the development and evaluation aspects. The main goal was to identify the concepts and theories underlying such applied technologies, detect any gaps, and provide recommendations. A secondary goal was to identify the components of mHealth digital application interventions that led to cognitive, emotional, and behavioral change among youths with addictive behaviors by drawing on Beck’s cognitive model and cognitive behavioral therapy (CBT). Results: There were 16 mHealth digital application interventions being developed to help youth overcome addiction issues. Most of the existing techniques involve dealing with youth’s stimuli, emotions, addictive behaviors, and physiology or physical reactions. These were the components of cross-sectional Beck’s cognitive model and CBT. In addition, most of the cognitive skill components were focused on managing reflective thoughts such as planning to stop addictive behaviors, intention to stop, encouraging more of creating positive thinking, or benefits of stop doing addictive behavior. No application component focused on identifying any implicit thought influenced of specific memories on addiction outcome expectancies such as the substance or self-intermediate belief, substance or self-core belief contained in Beck’s longitudinal cognitive model. Conclusion: Findings from the present scoping review suggest new routes for working with implicit thoughts. Some opportunities exist here for the development of CBT mHealth applications to raise awareness in youth concerning the implicit substance or self-concept appearing in Beck’s longitudinal cognitive model.
DOI:10.35755/jmedassocthai.2023.03.13800
TYPE:
Journal article
JOURNAL:
Journal of the Medical Association of Thailand
VOLUME:
Volume 106, Issue 4, pp. 320–329
PUBLICATION DATE:
2023
KEYWORDS:
mHealth; youth; addiction; CBT; digital interventions
Abstract
Background: The prevalence of chemsex has been reported by multiple systematic reviews among men who have sex with men (MSM) focussing predominantly on the Global North. An Asian perspective with meta-analytical evidence is missing. This meta-analysis summarised the prevalence of substance use associated with chemsex, and chemsex activity among MSM and MSM sub-populations in Asia, as well as the likelihood for chemsex among MSM living with or without HIV.
Methods: We utilized PubMed, Web of Science and medRxiv to search for literature describing chemsex and its associated substance use among MSM and MSM sub-populations in Asia from January 1, 2010 to November 1, 2021 to conduct three meta-analyses with both frequentist and Bayesian approaches.
Results: We identified 219 studies and included 23 in the meta-analysis. Based on the frequentist models, methamphetamine was the default substance associated with chemsex among MSM in Asia (prevalence = 0.16, 95 %CI:0.09-0.22), followed by GHB/GBL (prevalence = 0.15, 95 %CI:0.03-0.27) and ketamine (prevalence = 0.08, 95 %CI:0.04-0.12), but hardly any cocaine (prevalence = 0.01, 95 %CI:0.00-0.03). Compared to a general MSM population (prevalence = 0.19, 95 %CI:0.15-0.23), MSM engaging in transactional sex showed a higher prevalence of chemsex (MSM sex work clients [prevalence = 0.28, 95 %CI:0.11-0.45]; MSM sex worker [prevalence = 0.28, 95 %CI:0.17-0.26]). MSM living with HIV also showed higher odds of chemsex activity (OR = 3.35, 95 %CI:1.57-7.10), compared to MSM living without HIV. Both meta-analytic models converged, indicating robust evidence.
Conclusions: Our meta-analyses showed that chemsex is not uncommon among MSM, and MSM engaging in transactional sex in Asia. We confirmed that MSM living with HIV have a higher likelihood of engaging in chemsex, too. Chemsex prevention and management strategies in Asia should be adjusted accordingly.
DOI:
10.1016/j.drugalcdep.2022.109741
TYPE:
Journal article
JOURNAL:
Drug and Alcohol Dependence
VOLUME:
Volume 243, 109741
PUBLICATION DATE:
2023
KEYWORDS:
chemsex; substance use; MSM; Asia; meta-analysis
Abstract
The purpose of this study was to validate a new conceptual model of Femininity-Related Intermediate Beliefs about Alcohol use (FIBA) among female undergraduate students (n = 418). The research instruments used for data collection included the newly-constructed Femininity-Related Intermediate Beliefs about Alcohol use Questionnaire (FIBA-Q), the Alcohol Use Questionnaire (Sakulsriprasert, 2014), and the Drinking Problems Scale for College Student (DPS-C) (Sakulsriprasert, 2014). The data were analyzed using descriptive statistics, confirmatory factor analysis, and structural equation models. The results supported the validity of the FIBA model, both the structure of the model (χ² = 196.828, df = 108, χ²/df = 1.822, RMSEA = 0.044, CFI = 0.921, SRMR = 0.060) and its predictive value on alcohol use and alcohol-related problems. The FIBA model explained 40.1 percent of the variance in alcohol use and 37.4 percent in alcohol-related problems. The results of the study provide foundational knowledge that can be applied for developing alcohol harm reduction interventions for young women.
DOI:
doi.org/10.34044/j.kjss.2022.43.1.16
TYPE:
Journal article
JOURNAL:
Kasetsart Journal of Social Sciences
VOLUME:
Volume 43, Issue 1, pp. 115–122
PUBLICATION DATE:
2022
KEYWORDS:
alcohol use; femininity; gender norms; university students
Abstract
Background
In Thailand, drug use is widely observed, especially among vocational-school students, who are more inclined to use various types of drugs and to experience pride-based violence (violence based on institutional pride, honor, or on seniority status) than any other groups of students. Drug use contexts differ based on sexual orientation and gender identity (e.g., clubs). This study aims to examine the prevalence and correlates of poly-drug use (the use of at least three types of drugs) among vocational-school students, with a focus on sexual orientation and gender identity.
Methods
In this study, 638 vocational school students living in Bangkok metropolitan area participated in a three-year longitudinal survey of four vocational schools. Experiences of violence, sexual behaviours, and poly-drug use were assessed and analyzed using multivariable logistic regression.
Results
About one tenth of all students (11.3%) reported poly-drug use, a fifth among Lesbian, Gay, Bisexual and Transgender (LGBT) students (20.2%) and almost a tenth of heterosexual students (9.8%). In the multivariable logistic model of LGBT students, GPA, pride-based violence, intoxicated sex, and counseling needs were significantly associated with poly-drug use (AOR = 4.62; 95% CI 1.17–18.29, AOR = 6.01; 95% CI 1.31–27.32, AOR = 5.17; 95% CI 1.10–24.28, AOR = 4.64; 95% CI 1.16–18.54, respectively). Likewise, among heterosexual students, GPA and intoxicated sex were significantly associated with poly-drug use (AOR = 2.02; 95% CI 1.09–3.75, AOR = 5.31; 95% CI 2.81–10.04, respectively).
Conclusions
LGBT vocational-school students have significantly higher prevalence of poly-drug use than their heterosexual peers. Correlates include lower GPA, having experienced pride-based violence and intoxicated sex. School-based intervention programs should also address pride-based violence and intoxicated sex in their harm reduction programs.
DOI: 10.1186/s12888-022-03777-7
TYPE:
Journal article
JOURNAL:
BMC Psychiatry
VOLUME:
Volume 22, Article 148
PUBLICATION DATE:
2022
KEYWORDS:
pride-based violence; LGBT youth; substance use; vocational students; Thailand
Abstract
To reach its goal of ending AIDS by 2030, Thailand has adopted antiretroviral treatment as prevention and HIV pre-exposure prophylaxis for men who have sex with men (MSM) and transgender women (TGW) as its core HIV control strategy. However, in the absence of reliable epidemiologic indicators, the impact of these policies on the course of the HIV epidemic in these groups remains unknown. To help answer this question, we formulated an HIV epidemic consensus initiative for Bangkok, Thailand, to analyze epidemiologic and program data and reach agreement between experts and stakeholders on the evolving state of the HIV epidemic among MSM and TGW. A customized Delphi process was used to consult and consolidate viewpoints of experts and stakeholders. Experts presented and discussed HIV prevalence and incidence data from recent and ongoing studies among MSM and TGW in Bangkok (2014 to 2018) during a meeting with stakeholders representing government, donors, and civil society. Agreement about the course of the HIV epidemic among MSM and TGW was attained by voting consensus. Based on presented data, meeting participants agreed that HIV prevalence and incidence had decreased among Bangkok MSM from 2014 to 2018. Despite these declines, HIV prevalence and incidence were found to remain high. This was particularly the case among younger MSM. Participants agreed that there was no evidence for a decrease in HIV prevalence and incidence among Bangkok TGW. Introduction of antiretroviral treatment as prevention and HIV pre-exposure prophylaxis may have contributed to these declines. However, HIV prevalence and incidence remained high, and no signs of a decrease were reported among Bangkok TGW. At the current rate of new HIV infections in MSM and TGW, Thailand will not reach its goal of ending AIDS by 2030. This HIV consensus initiative may serve as a model for building agreement and advocacy on epidemiologic and program data and their implications for a large metropolitan city.
DOI:
10.1371/journal.pone.0262694
TYPE:
Journal article
JOURNAL:
PLoS One
VOLUME:
17
PUBLICATION DATE:
2022
KEYWORDS:
HIV prevalence; HIV incidence; MSM; transgender women; Bangkok; Thailand
Abstract
The introduction of biomedical HIV prevention methods, such as pre-exposure prophylaxis (PrEP), holds the potential to overcome the serodivide. We investigated the attitudes of PrEP users towards having sex with partners living with HIV. PrEP users in the Netherlands were recruited online and completed three questionnaires over a period of six months. We investigated changes over time in feelings of fear of HIV, comfort, and attitudes towards condom use when having sex with men living with HIV (MLHIV). A majority of PrEP users in our sample (up to 71.6%) had sex with MLHIV. Feeling comfortable to have sex with MLHIV did not change over time, but was already at a high level at T1. Most importantly, feeling safe not to use condoms with HIV-positive partners significantly increased, and did so in a rather short period of time after the onset of PrEP use (3-6 months). Taken together, the findings suggest that that PrEP may contribute to decreasing the serodivide between MSM rather quickly after the onset of PrEP use.
DOI: 10.1080/09540121.2021.1954588
TYPE:
Journal article
JOURNAL:
AIDS Care
VOLUME:
34: 349–352
PUBLICATION DATE:
2022
KEYWORDS:
PrEP; serodivide; HIV stigma; attitudes; sexual partnerships
Abstract
Next to its benefits for HIV prevention, PrEP may have psychosocial benefits relating to improved quality of sex life. The aim of the current study was to investigate the onset of changes in the quality of sex life and sexual pleasure of PrEP users in the first months of commencing PrEP use. Moreover, we investigated what factors were related to the quality of sex life of PrEP users. We recruited 145 participants via the Dutch PrEP-advocacy website PrEPnu.nl, and they received follow-up questionnaires after three and six months. We found that PrEP users reported an increase in the quality of their sex life, which was related to reduced fear of HIV since they started using PrEP but not to decreased condom use. PrEP users were more interested in experimenting with sex practices, but they did not always feel more desirable as a sex partner because of PrEP use. Health-care providers and health promotion campaigns could emphasize the positive effects of PrEP on the quality of sex life, in addition to the HIV-preventive effects of PrEP, to decrease PrEP stigma and increase PrEP uptake.
DOI:
10.1080/00224499.2021.1931653
TYPE:
Journal article
JOURNAL:
Journal of Sex Research
VOLUME:
59: 303–308
PUBLICATION DATE:
2022
KEYWORDS:
PrEP; sexual pleasure; sexual well-being; quality of sex life
