HIV — your REAL risk, Part II
HIV prevalence amongst Batam Sex Workers : ~1 in 6
% Condom use amongst Sg men in Batam : ~ 3 in 10 (7 in 10 at risk!!!!)
% Condom use amongst Sg men abroad with sex workers in general : ~ 1 in 2
% Condom use amongst Sg men with local sex workers in general: ~8-9 in 10
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HIV prevalence amongst Bangkok MSM : 1 in 3
% Condom use amongst S’porean MSM with casual partners : 4 in 5
(http://www.msmsexsurvey.com 2009 Fridae.com MSM survey, see the results there)
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This ongoing Anonymous Asia Internet MSM Sex Survey will help improve our understanding of MSM behaviors http://www.2010aimss.com/
Please help. Please ask your friends to help
“The results will give us critical information in understanding why HIV and other sexually transmitted infection rates are rising so quickly in our community, and help us design better programs for you.”
– 2010 AIMSS
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THis is a follow up from the previous article which gives more explanations . Please take a look. http://mathialee.wordpress.com/2010/01/19/hiv-knowing-your-real-risk/
See comments for Abstracts & Citations for the above info.
(I was doing some research as part of my routine work, and came across these figures. I nearly shit in my pants. It’s unethical to not tell. I just HAD to. Underestimation of risk perception is a huge reason why people still engage in risky sex —- they think it doesn’t happen to them. Condoms are 99% safe. Russian roulette is 5 in 6 safe….. )
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J Acquir Immune Defic Syndr. 2009 Nov 5. [Epub ahead of print]
Trends in HIV Prevalence, Estimated HIV Incidence, and Risk Behavior Among Men Who Have Sex With Men in Bangkok, Thailand, 2003-2007.
van Griensven F, Varangrat A, Wimonsate W, Tanpradech S, Kladsawad K, Chemnasiri T, Suksripanich O, Phanuphak P, Mock P, Kanggarnrua K, McNicholl J, Plipat T.
From the *Thailand Ministry of Public Health-US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand; daggerDivision of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA; double daggerBureau of Epidemiology, Ministry of Public Health, Nonthaburi, Thailand; section signThai Red Cross Society, AIDS Research Centre, Bangkok, Thailand; and parallelRainbow Sky Association of Thailand, Bangkok, Thailand.
BACKGROUND:: Men who have sex with men (MSM) continue to be at high risk for HIV infection. Here we evaluate trends in HIV prevalence, estimated HIV incidence, and risk behavior among MSM in Bangkok, Thailand. METHODS:: Between 2003 and 2007, 3 biennial cross-sectional HIV prevalence assessments were conducted among MSM in Bangkok, Thailand, using venue-day-time sampling. Oral fluid was tested for HIV infection; demographic and behavioral data were self-collected using hand-held computers. Estimates of annual HIV incidence in young MSM were derived as follows: (number of HIV infections/sum of [current age-age at start of anal intercourse]) x 100). Logistic and Poisson regression was used to evaluate trends in HIV prevalence, estimated HIV incidence, and risk behavior. FINDINGS:: The overall HIV prevalence increased from 17.3% in 2003 to 28.3% in 2005 to 30.8% in 2007 (P < 0.001 for trend). The estimated HIV incidence among young (15-22yrs) MSM increased from 4.1% in 2003 to 6.4% in 2005, to 7.7% in 2007 (P < 0.02 for trend). The increase in HIV prevalence from 2005 to 2007 was not statistically significant. The proportion of men reporting anal sex and casual or steady male sex partners in the past 3 months significantly decreased, whereas the proportion reporting drug use and drug use during sex significantly increased. No increase was observed in the proportion of men reporting consistent condom use. INTERPRETATION:: Our data suggest that after a strong increase from 2003 to 2005, the HIV prevalence among MSM in Bangkok may have begun to stabilize. Given the continuing high levels of risk behavior and the estimated high HIV incidence in young MSM, additional HIV preventive interventions are necessary.
Singapore Med J. 2008 May;49(5):376-9.
Building partnerships to address the HIV epidemic.
Chua AC, Leo YS, Lee CC.
Department of Medicine, Division of Infectious Diseases, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074. arlene_chua@nuhs.edu.sg
INTRODUCTION: Batam is one of the islands comprising the Riau Province in Indonesia, and is closest to Singapore. It is a popular destination of many Singaporeans. Surveillance reports among commercial sex workers conducted in Batam showed the prevalence rate of human immunodeficiency virus (HIV) is 16.2 percent. At the end of 2006, the total number of HIV-infected Singaporeans was 3,060, the majority being infected via heterosexual transmission. The aim of the Indonesian government is to rapidly scale up HIV treatment to those needing it. One of the factors critical to the rapid scale-up is healthcare worker training. METHODS: An intersectoral collaboration addressing the issue of HIV care and treatment with a hospital in Batam was created. The first activity of the collaboration was a two-day HIV training course conducted in February 2007. The aim of the course was to provide a basic understanding of HIV, as well as knowledge on common opportunistic infections that may present to a general hospital or clinical setting. RESULTS: 34 doctors from 23 institutions in Batam and three doctors from two hospitals in the Riau Islands attended the two-day HIV training course. The participants found the training very useful and highly relevant. CONCLUSION: This first HIV training provided a foundation to build on further HIV education. It is our belief that through the HIV training programme, there will be more awareness of HIV among the various medical institutions in Batam. As the HIV epidemic knows no borders, working with neighbouring countries is one strategy that deserves attention.
Sex Transm Dis. 2007 Apr;34(4):237-44.
HIV prevention among travelers: why do men not use condoms when they engage in commercial sex overseas?
Wong ML, Chan RK, Koh D.
Department of Community, Occupational and Family Medicine, Yong Loo Lin School of Medicine, Faculty of Medicine, National University of Singapore. cofwml@nus.edu.sg
OBJECTIVES: We investigated factors associated with condom use among men patronizing female sex workers abroad and locally. STUDY DESIGN: We conducted a survey on 372 local men attending the only public sexually transmitted infections clinic in Singapore between 2001 and 2003. RESULTS: Condom use was higher among clients patronizing sex workers in Singapore than those patronizing sex workers abroad (87.5% vs. 54.4%, P<0.001). Condom use in both groups was associated with initiation of condom use by the sex workers (adjusted prevalence ratios: 1.67, 95% confidence interval: 1.11-2.49; 1.87, 1.21-2.90) but was not associated with clients' knowledge of disease, self-perceived risk, confidence in condom use, and dislike of condoms. Less sex workers abroad than in Singapore (32.7% vs. 75.6%, P<0.001) initiated condom use. CONCLUSION: Lower condom use among Singaporean travelers abroad was determined by extrinsic factors, whereby sex workers abroad were less likely to initiate condom use rather than by clients' factors.
I honestly think we need a big sign at the ferry terminal to Batam giving the statistics & a caution to be protected
And we should tell our father brother mother sister cousin aunty uncle friends etc this coming CNY
4 of 5 MSM use condoms with casual partners against 3 in 10 men who patronise Batam sex workers. Who was it again who said that gay men engaged in riskier sex? Am so proud of you!! ; )
( Ok the above statement is an extremely unprofessional, biased , personal statement, probably ‘cos some of my loveliest friends are gay/bi & I think men who patronise Batam sex workers are the drivers of the super exploitative human trafficking trade.)
In your letter
“Porn may not be factor in teen pre-marital sex” to my paper.
Right at the bottom it says:
The writer is a clinical sexologist and holds a doctorate in human sexuality.
Wow! I didn’t know…and can never guess. BTW what does a clinical sexologist do? After one become an expert at it..does it all become very clinical?..hmmm.
Anyway, sad to say I agree with your letter from my personal experience. For boys, there is life before porn and life after porn. You suggested that boys who are more sexually curious will seek out porn and more likely to engage in pre-marital activities so porn may not be the cause. This is not true from my own experience. Porn does something to a boy’s mind that cause them to engage in more pleasure seeking activities. Its like after you watch it, something goes into you head to make you want to do it…it triggers the desire to do it.
Hi Joe Lee
Just to clarify, that’s Dr Martha Lee in that article, not me. She’s a sexologist & founder of Eros Coaching. Her speciality is in Public Policy n Management(Masters) and Human Sexuality(DHS). Her training is more from the humanities/communications/psychology side.
I’m Mathia Lee, yet to graduate still, my speciality is in Developmental Biology (PhD) and I’m moving into a Public Health (research & strategic planning) focus currently, both of which are very hardcore biomedical sciences. My training was more from the basic research lab-based science, at the molecular, cell & genetic level. At present I’m applying the research skills & methodology to the public health sector (which covers everything from HIV to H1N1 to mental health to obesity and cancer), while involving myself in NGO work to understand the sociopolitical aspects which one can only learn from the ground, and not texts. =)
Oops so sorry!!! I didn’t notice it was Martha and not Marthia. So paiseh leh. Given your postings on various related topics, I instantly mis-associated.
Yeah it is scary how HIV is spreading among Singaporeans. They should give out free condoms at the jetty before they board those boats to Batam.
There is one reason one of my friends told me why men going to Batam don’t use condoms while those who do it locally do. The men going to batam are older typically late 40s or in their 50s or 60s. When you’re that old, you are more ready to die and also the instrument becomes less sensitive so wearing a condom takes all the pleasure away. Some one really has to invent a thinner condom so thin that it is as if it is not there. I don’t think men going to Batam are actually that ignorant – they are taking a risk and it is all for pleasure.
No prob Joe Lee, it happens all the time =D (about the mix-up)
oh dear, i wonder how common that thinking is? Frankly , I know very few people in that demographics —- my info here is based very much on research. Hmmmm maybe Dr Martha Lee, as a sexologist would be able to give a better view = ) Most studies (from the public health perspective) agree that the biggest (and in some studies, the ONLY) determiner of condom use amongst men of that demographics is the sex worker’s ability to negotiate for condom use.
One area that Singapore does well in, is that it equips the brothel-based workers here with the skills and resources to negotiate for condom use. They also regularly get health checks and treatment, and condom use is very high. STI/HIV rates are very low and mostly detected early before it spreads.
Amongst the street-based (not in the brothels), a study found that the condom use was much lower. The biggest determiner of a sex-worker’s insistence on condom use , was whether she had dependants. The local study found that female sex workers with child dependants tended to insist on condom use most of the time, while those without, insisted less often.
In Batam, very sadly, most of the sex workers are aged between 13 to 18 yrs. A lot of these were cheated into the industry after they came for jobs from more rural parts of Indonesia. A lot of them feel hopeless and in despair because they feel they can no longer go back to their homes, and will never have a chance to have a normal family because nobody wants them anymore. They also don’t have access to medical care, their pay is controlled/taken by the pimps. They have little knowlege of condom use, or even if they do, lack the skills to negotiate for condom use. Their pimps might not provide condoms and if the clients don’t have one, they have no choice. Most of their clients are Singapore and Malaysian men.
As Singapore is the country with more financial and educational and health resources than Batam, I feel it is our moral duty to do something about the situation. I understand that the Singapore-based UNICEF has some programmes.
Sometimes, I don’t know what to do beyond making the info known………. i mean, what motivates these men? how can these men be motivated and persuaded? i honestly don’t know.
:::The biggest determiner of a sex-worker’s insistence on condom use , was whether she had dependants:::
I guess if they are educated enough to refuse all unsafet customers then that solves it. But they can’t do it for economic reasons because they need a certain level revenue to survive and perhaps they can’t get enough ‘safe customers’. That is why giving some welfare helps e.g running a small center where they have to show up for health talks after which condoms and money is given out. The risk for men (clients) is actually worse but men being men will do it for pleasure because for older folks sex with condoms is not worth having.
Have you read Super-Freakonomics? There is a chapter on prostitution and the authors summarised decades worth of research on the topic – % of prostitutes who get beaten up, why they don’t see alternatiive employment and so on…fascinating.
Really? I must get around to reading Super-Freakonomics then, Thanks for the recommendation!
(I read Freakonomics and it was great; am looking fwd to Super-freakonomics)