Prevalence and Correlates of HIV Testing among Young People Enrolled in Non-Formal Education Centers in Urban Chiang Mai, Thailand: A Cross-Sectional Study

PLOS ONE, Dec 2019

Background HIV testing is the gateway to HIV prevention, treatment, and care. Despite the established vulnerability of young Thai people to HIV infection, studies examining the prevalence and correlates of HIV testing among the general population of Thai youth are still very limited. This study investigates socio-demographic, behavioral, and psychosocial factors associated with HIV testing among young Thai people enrolled in Non-formal Education Centers (NFEC) in urban Chiang Mai, Northern Thailand. Methods This was a cross-sectional quantitative study conducted among young unmarried Thai youth—between the ages of 15 and 24—who were enrolled in NFEC in urban Chiang Mai. Multiple logistic regressions were used to identify correlates of “ever tested for HIV” among the sexually active participants. Findings Of the 295 sexually active participants, 27.3% reported “ever tested for HIV;” 65.4% “did not consistently use condom;” and 61.7% “had at least 2 lifetime partners.” We found that “self-efficacy” (AOR, 4.92; CI, 1.22–19.73); “perception that it is easy to find a location nearby to test for HIV” (AOR, 4.67; CI, 1.21–18.06); “having at least 2 lifetime sexual partners” (AOR, 2.05; CI, 1.09–3.85); and “ever been pregnant or made someone pregnant” (AOR, 4.06; CI, 2.69–9.15); were associated with increased odds of having ever been tested. On the other hand, “fear of HIV test results” (AOR, 0.21; CI, 0.08–0.57) was associated with lower odds of ever having been tested for HIV. Conclusion The main finding is that a substantially high proportion of Thai youth is engaged in risky sexual behaviors—yet reports low rates of ever having been tested for HIV. This highlights an urgent need to develop appropriate interventions—based on the identified correlates of HIV testing. There is also an urgent need to enhance HIV testing and to promote safer sexual behaviors among young Thai people—particularly those who are out-of-school.

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Prevalence and Correlates of HIV Testing among Young People Enrolled in Non-Formal Education Centers in Urban Chiang Mai, Thailand: A Cross-Sectional Study

April Prevalence and Correlates of HIV Testing among Young People Enrolled in Non-Formal Education Centers in Urban Chiang Mai, Thailand: A Cross-Sectional Study Patou Masika Musumari 0 1 Arunrat Tangmunkongvorakul 1 Kriengkrai Srithanaviboonchai 1 Sawang Yungyuankul 1 Teeranee Techasrivichien 0 1 S. Pilar Suguimoto 0 1 Masako Ono-Kihara 0 1 Masahiro Kihara 0 1 Suwat Chariyalertsak 1 0 Department of Global Health and Socio-epidemiology, Kyoto University School of Public Health, Kyoto, Japan, 2 Research Institute for Health Sciences, Chiang Mai University , Chiang Mai , Thailand , 3 Faculty of Medicine, Chiang Mai University , Chiang Mai , Thailand , 4 Center of Medical Education, Graduate School of Medicine, Kyoto University , Kyoto , Japan 1 Editor: Peter A Newman, University of Toronto , CANADA HIV testing is the gateway to HIV prevention, treatment, and care. Despite the established vulnerability of young Thai people to HIV infection, studies examining the prevalence and correlates of HIV testing among the general population of Thai youth are still very limited. This study investigates socio-demographic, behavioral, and psychosocial factors associated with HIV testing among young Thai people enrolled in Non-formal Education Centers (NFEC) in urban Chiang Mai, Northern Thailand. - OPEN ACCESS Data Availability Statement: All relevant data are within the paper and its Supporting Information files. Funding: This study was part of the HIV/AIDS Prevention Program among out-of-school young people in Chiang Mai. It was supported by the Chiang Mai University Center of Excellence in HIV/AIDS Research, and by the National Research University Project under Thailand's Office of the Higher Education Commission. The funders had no role in Background Methods Findings This was a cross-sectional quantitative study conducted among young unmarried Thai youth—between the ages of 15 and 24—who were enrolled in NFEC in urban Chiang Mai. Multiple logistic regressions were used to identify correlates of “ever tested for HIV” among the sexually active participants. Of the 295 sexually active participants, 27.3% reported “ever tested for HIV;” 65.4% “did not consistently use condom;” and 61.7% “had at least 2 lifetime partners.” We found that “selfefficacy” (AOR, 4.92; CI, 1.22–19.73); “perception that it is easy to find a location nearby to test for HIV” (AOR, 4.67; CI, 1.21–18.06); “having at least 2 lifetime sexual partners” (AOR, 2.05; CI, 1.09–3.85); and “ever been pregnant or made someone pregnant” (AOR, 4.06; CI, 2.69–9.15); were associated with increased odds of having ever been tested. On the other hand, “fear of HIV test results” (AOR, 0.21; CI, 0.08–0.57) was associated with lower odds of ever having been tested for HIV. study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing Interests: The authors have declared that no competing interests exist. Conclusion The main finding is that a substantially high proportion of Thai youth is engaged in risky sex ual behaviors—yet reports low rates of ever having been tested for HIV. This highlights an urgent need to develop appropriate interventions—based on the identified correlates of HIV testing. There is also an urgent need to enhance HIV testing and to promote safer sexual behaviors among young Thai people—particularly those who are out-of-school. Introduction The prospect of ending the HIV/AIDS epidemic has crystalized over time. Increasing evidence today shows the potential for antiretroviral therapy (ART). It has a strong therapeutic effect, and it also has the ability to dramatically reduce both the transmission and acquisition of HIV infection [ 1 ]. HIV testing—as the gateway to effective HIV prevention, treatment, and care— must absolutely be optimized, before this enthusiastic hope to end the HIV/AIDS epidemic could translate to palpable reality. There is extensive literature in support of the finding that individuals substantially reduce risky sexual behaviors after they become aware of their HIV status [ 2, 3 ]. Moreover—for infected individuals—HIV testing prompts early initiation of ART, which, in turn, is associated with significantly reduced risk of HIV transmission [1]. However, today, the proportion of individuals who know their HIV status still remains unacceptably low. At the global level, as of the end of 2012, only 50% of people were aware of their HIV status, with great variation within and between countries and regions [ 4 ]. This sobering fact indicates that—despite the current expansion of HIV prevention, treatment and care programs worldwide—tremendous efforts are still necessary to improve HIV testing behavior, in order to achieve the optimum possible level of prevention and treatment of HIV infection. In Thailand, the first anonymous HIV testing and counseling (HTC) clinic was established by the Thai Red Cross Society in mid-1991. The Ministry of Public Health (MoPH) (...truncated)


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Patou Masika Musumari, Arunrat Tangmunkongvorakul, Kriengkrai Srithanaviboonchai, Sawang Yungyuankul, Teeranee Techasrivichien, S. Pilar Suguimoto, Masako Ono-Kihara, Masahiro Kihara, Suwat Chariyalertsak. Prevalence and Correlates of HIV Testing among Young People Enrolled in Non-Formal Education Centers in Urban Chiang Mai, Thailand: A Cross-Sectional Study, PLOS ONE, 2016, Volume 11, Issue 4, DOI: 10.1371/journal.pone.0153452