MSM face a significantly higher risk of HIV infection than the general population in every region of the world. laws against homosexual activity to arrest and persecute that men who were thought to be HIV positive ,so the MSM need focused attention and strategies to receive adequate prevention and treatment. And in many countries there is stigma and discrimination prevent this population to access the serivces
Thislittle bit describing HIV rate among MSM throughout world and it shows if countries measure these indicators then it will be find out the MSM population is highly vulnerable to HIV
HIV Testing and Counseling ( HTC) in APMajor progress in increasing availability of HTC servicesSignificant increase in total HIV tests performed ( substantial proportion due to PMTCT expansion)HoweverMany people do test late ( proxy indicator late ART initiation Poor linkage to prevention and treatment services <50% of people living with HIV in Asia Pacific know their HIV status KAP and HTC ( graph) Testing uptake still low among KAPs Only 29 % of PWID in VN knew their status in 2011 Low testing rates among MSM in Cambodia ( 32%); Viet Nam( 30 %); and Thailand (29,2%)Scale up of HTC in AP region Address HTC uptake barriers at country level Promote HTC Ensure linkages to prevention and treatment services
Men who have sex with men (MSM) – 7% to 31% are living with HIV in cities in China, India, Indonesia, Myanmar and ThailandPrevalence:>5% HIV nationally in 5 countries: CHN, IDN, MYN, THA, VN and in cities in PHL (Cebu), LAO (Vientiane 4.4%), >10% HIV in regions/cities in 7 countries: CHN (Chengdu), IND (Manipur, Nagaland, Chattisgarh, Andhra Pradesh), IDN (Jakarta, Bandung), MNG (Ulaanbator), MYN (Yangon, Mandalay), THA (Bangkok), VN (Hanoi, HCMC)Rising trend in regions/cities in 7 countries: CHN (Chengdu), IND (chandigarhDelhi, Goa, Maharashtra),IDN (Jakarta), PHL (Cebu & Metro Manila), THA, VNCoverageCondom use improving, regional median now above the 60% required to turn around epidemicPrevention coverage good improvement, but <80% UA target2009Condom use:Regional median58Maximum88 (Thailand)Minimum17 (Singapore)Prevention coverage:Regional median36Maximum77 (Nepal and Mongolia)Minimum8 (Bangladesh)2011Condom use:Regional median66Maximum85 (Thailand)Minimum26 (Bangladesh)Prevention coverage: Regional median57Maximum77 (Nepal)Minimum9 (Bangladesh)
Transcript of "Introduction ppt"
By: Zeenat Supervisor: Asst .prof .Sukhontha Kongsin Co- Supervisor: Asst. Prof .Sukhum Jiamton Research Proposal for the Fulfillment of requirement of MPH at Mahidol University Thailand.
Globally, 34.0 The burden of It is estimated the epidemic million [31.4 that nearly 0.8% million–35.9 of adults aged different in million] people were living with 15-49 years between worldwide areHIV at the end of countries and living with HIV. 2011 regions
Sub-Saharan Africa remains most severely affected, with nearly 1 in every 20 adults (4.9%) living with HIV and accounting for 69% of the peopleAfter sub-Saharan Africa, the regions most heavily affected are the Caribbeanand Eastern Europe and Central Asia, where 1.0% of adults were living with HIV in 2011ple living with HIV worldwide
In 2011, 1.7 million [1.5 million–1.9 million] people died from AIDS-related causes worldwide.sub-Saharan Africa 70% of all the people dying from AIDS in 2011
The HIV prevalence among men who have sex with men in capital cities is consistently higher than in the general population . The prevalence of HIV infection among men who have sex with men in surveys in capital cities is 13 times higher than that in the country’s general population
Country HIV Prevalence National HIV Criminalize MSM among MSM prevalenceKenya 43% 6.1 yesJamaica 25-30% 1.5% yes Benin 25.5% 1.8% yesSenegal 21.5% 0.9% yesGunny 21.3% 2.4% yes
June 2001 the 26th session of United Nation assembly convened according to pass resolution 55/3 of November 2000 as a matter of urgency immediate review to address the problem of HIV/AIDS and grave concern that all people, rich and poor , without distinction as to age ,gender or race , affected by the H I V/A I D epidemic. further it finds out that the people in developing countries are the most affected and that women , young adults and children vulnerable group it was recognized that access to medication in the context of pandemics such as HIV/A I D S
2001: UNGASS Declaration of Commitment Member countries have to measure their progress periodically against a series of specific indicators Twenty three UNGASS indicators were identified, five of which were relevant to MSM. Prevalence of HIV infection ,Knowledge of HIV. Condom use ,rate of HIV testing and access to prevention programme
2001 2000 United Nations General 2006 2011 Millennium Declaration Assembly Special Session on HIV/AIDS Political Declaration Political Declaration MDG Target 6A: Universal Access to HIV New impact targets andHave halted by 2015 and ( UNGASS) Prevention, Care and commitments towards begun to reverse the Declaration of Treatment by 2015 “Getting to Zero” spread of HIV/AIDS Commitment on HIV/AIDS Zero New HIV Infections; Zero Discrimination; Zero AIDS related Deaths
MSM MSM who MSM with MSM who MSM who Infected test for correct had used reached HIV with HIV last knowledge condom prevention HIV year and about HIV last time programme know Transmissi they sex their on resultLatin America 62% 57% 48% 57% 43%Caribbean 58% 33% 25% 58% 25%Eastern 50% 90% 70% 90% 70%EuropeAfrica 19% 19% 6% 21% 12%Asia ,the 47% 57% 53% 63% 40%pacific c ofmiddle east
Most of the countries have no exist data about on HIV/AIDS among MSM. Fewer than one-third reported on more than three of the five UNGASS indicators Due to lack of appropriate data on HIV epidemic among MSM in many countries governments cannot access the need of prevention and treatment programme
HIV in Asia and the Pacific 2011 4.9 million people living with HIV 1.6 million women living with HIV 370,000 new HIV infections 310,000 deaths 21,000 children newly infected
The HIV prevalence among MSM increasing in low and middle economic countries At many countries such as Cambodia, Thailand and Senegal where the HIV prevalence is declining among heterosexual groupBut high prevalence of among MSM and the data shows HIV epidemic in this group
30%25%20%15%10%5%0% Indonesia india Mynmaar Vitnaam
Strategic Testing and Treatment 100% Percentage of key populations (KP) who received an HIV test in the last 12 months and know their results (selected countries) 90% 82 80% 70% 60% 50 50 50% 44 44 41 38 40% 35 34 29 30 29 30% 20% 10% 0% Sex workers PWID MSM Cambodia (2007 and 2010) China (2011) Viet Nam (2011) Thailand (2010)Data Source: UNAIDS Universal Access and GARPR
• Expand HIV testing in key populations wherever prevalence is high.• Treatment as Prevention with access to ARV regardless of CD4 count for: • Sex workers, people who use drugs, men who have sex with men • Sero-discordant couples • Pregnant women• Community led services to promote testing uptake and treatment adherence
100 % 50 HIV prevalence (%)80 40 66 58 5760 3040 36 2020 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 Prevention coverage (Regional median) Condom use at last anal sex (Regional median) China (Chengdu, Sichuan) India (Andhra Pradesh) Indonesia (Jakarta) Philippines (Cebu) Thailand (Bangkok) Vietnam (Hanoi)
In Thailand AIDS is the major problem for males and the death rate is two times more in them than females and AIDS is the 3rd leading cause of death mostly at the age group of 15- 49 yrs .HIV/AIDS is stand the first leading cause of DALYS(Disability Adjusted Life Years lost)for males
in Thailand HIV epidemic originate in homosexual males during 1986-1987 then it spread to injection drug user, female sex workers after 1991 though IDU cases declining but the HIV infection among MSM is high and show no significance decreasing
In adults HIV prevalence is 1.4% and prevalence in most risk population 5.0%( In Thailand HIV epidemic originate in FSW,30-40% IDU In Thailand, the HIV epidemic among MSM has been considered severe Most of MSM continue to have high-risk behaviour.
In provinces not considered to be popular tourist sites, it was found thatIn Bangkok during 2003 to 2009, it HIV prevalence in the MSM populationwas found that reports of consistent is also high, despite being lower than condom use in the previous three in the primary tourist locations. Formonths showed no signs of increase. example, surveys in Patalung and Udorn in 2008 found levels of HIV among MSM as high as 5.5% and 4.7%
In 2007 at Bangkok, Phuket and Chiang Mai in 2007 that proportion of MSM who reported having “always used” condoms in the three months prior to the survey was 66%, 44%, and 36% In 2008, the survey in the rather small provinces of Udorn and Patalung found that “always used” condoms by MSM in the prior three months were also rather low at 56.3% and 57.0%
In 2009, a survey of condom use found that MSM condom use during last episode of anal sex was only 21.7%, which represented a sharp decrease from the level found in the previous year’s survey. The decline in condom use may be due to some modification in questionnaire about use of condom with last partner and not distinguished about type of partner
At 2009, the proportion using condoms with casual partner when compared to data from 2008 increased in some provinces: from 56% to64% in Khon Kaen; and from 71% to 82% in Phuket, but , in Udorn the proportion declined from 68% to 64%
Core Indicator 2004 2006 2008 2010 2011 RemarksPercentage of NA MSM MSM used IBBS,most-at-risk 24.6 20.0 data from 3populations who touristare HIV provinces;infected Bangkok, Chiang Mai and PhuketPercentage of 28.5 24.8 20.0men who havesex with men whoare living with HIVPercentage of 29.2%men who havesex with men thathave received an
At 2010‐11, the government had expanded HIV prevention interventions targeting that population utilizing multiple channels. There have simultaneously been measure Implemented supporting treatment, care and support through collaboration with civil society and the private sector. The CHAMPION Project (HIV prevention among KAPs), with support from the Global Fund, has been implemented in 30 provinces, which has started in late 2010.
There are many literatures available, which shows that the MSM group is the vulnerable for HIV/STIS so by this research we have to find out that unidentified risk factors associated with HIV transmission Especially the risky behavior among in MSM that is responsible for more transmission of HIV in this group in Thailand
Research TitleThe factors related to the sexual risk behavior among MSM living in Thailand Research QuestionWhat are the factors related to the sexual risk behavior among MSM living in Thailand
General Objective1) To determine the knowledge and attitude factors and their association to the risk sexual behavior among MSM2) To determine the association between the Socio- demographic and socioeconomic and social support factors with sexual risk behavior among MSM
Hypothesis 1) There is an association of knowledge and attitude with sexual risk behavior among MSM 2) There is an association between socio- demographic factor with sexual risk behavior among MSM 3) There is an association of socioeconomic and social support factors with sexual risk behavior among MSM
Men who have sex with men (MSM) Denoted all men who have sex with men (oral- genital) regardless of their sexual identity, sexual orientation and wither or not they sex with female
Socio-Demographic Factorsa) Age refers to complete years of respondent’s age at the time of study b) Age at first homosexual intercourse It refers the age of respondent at which he had first homosexual intercourse including oral sex and anal sex.
Habit of Alcohol drinking Number of Partners referred the number of both homosexual and heterosexual partners during last week of study Type of partners It referred partners of respondent including both male and female during last week, each type including regular, commercial and casual Role during sex with men or gays Referred the role of respondent during sexual intercourse with men or gay Habit of Alcohol drinkingIt refer alcohol drinking behavior of respondent during last week
a) Education level it refers the highest attain education level of respondent b) Monthly income refers the monthly average income of respondent in Thai baths at the time of study
Knowledge of HIV/AIDS It refer to understanding of respondent on mode of transmission and prevention of HIV/AIDS and condom use Peer Support, Referred to positive moral and information support from peer of the respondent on consistent condom use
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