The effectiveness of national HIV prevention education program on behavioral changes for men who have sex with men and transgender women in Thailand

Abstract

Purpose The purpose of this paper is to investigate the effectiveness of the national HIV prevention outreach program for men who have sex with men (MSM) and transgender women (TGW). Design/methodology/approach It examined changes in condom use, lubricant use, HIV testing and counseling (HTC) uptake and sexually transmitted infection (STI) screening uptake, as well as how and why changes did or did not occur. The study applied mixed methods of both quantitative and qualitative approaches. Findings There were 16,539 MSM, and TGW reached at least three times in the program during October 2011‒September 2012. The program was found to affect changes in condom use with steady partners (p<0.000), condom use with casual partners (p<0.000), water-based lubricant use (p<0.000), HTC uptake (p<0.000) and STIs screening uptake (p<0.000). Age and province of outreach are associated with HTC uptake and STI screening (p<0.000), slightly as well as gender identity (p<0.1). Gender identity and province of outreach are associated with condom use with steady partners (p<0.000). Gender identity (p<0.000) and sex work (p<0.05) are associated with the use of lubricant. The qualitative results showed that the program had an immediate effect on HTC and STIs screening due to successful bond between the outreach workers and their clients, leading to trust and influencing behavior change. Originality/value HIV prevention by peer educators continues to be proved the most effective method, assuming its program consistency. TGW are more vulnerable to MSM to protect themselves, and they have steady partners. Future program for MSM can be replicated and scaled up, but more empowerment component and self-esteem building should be integrated to target TGW.