Opinions about accessibility and barriers to hiv testing and sexual health services among men who have sex with men university students in Northern Thailand

Abstract

Men who have sex with men (MSM) university students are at risk of contracting human immunodeficiency virus (HIV) infection. In this study we aimed to determine the opinions of MSM university students about access and barriers to HIV testing and sexual health services in northern Thailand in order to improve existing services. Study subjects were recruited through peers and the internet. The calculated minimum number of study subjects required for this study was 169. Each study subject was asked to complete a self-administered questionnaire on basic demographics, sexual behavior, history of getting tested for HIV and using sexual health services, as well as opinions about access and barriers to HIV testing and sexual health services. Data were analyzed with descriptive statistics and logistic regression analysis. A total of 176 subjects were included in the study. The mean age of study subjects was 20 years. The most common field of study (72.6% of subjects) was sciences/applied sciences. Among study subjects, 40.9% had previously been tested for HIV infection or used sexual health services. Eighty-five-point six percent of subjects who were sexually active engaged in high-risk sexual behavior, defined as having multiple sex partners within the previous year. Study subjects mentioned the following barriers to accessing sexual health services: poor service quality (71.6%), anticipated stigma (68.8%), low perception of HIV risk (68.2%), inconvenient location (65.3%) and high cost for service (52.3%). On multivariate analysis, having a history of HIV testing or using sexual health services previously were significantly associated with: having a history of sexual intercourse (adjusted odds ratio (adjusted OR) = 3.12; 95% confidence interval (CI): 1.16-8.39; p = 0.024) and having a positive opinion about the quality of the health service system (adjusted OR = 2.74; 95%CI: 1.28-5.91; p = 0.010). In summary, a large proportion of our study subjects had a negative opinion about existing HIV testing and sexual health services, particularly regarding location and cost. We conclude there is a perceived problem with HIV testing and sexual health services among MSM university students in northern Thailand. Studies are needed to determine the quality of current sexual health services and to determine why the subject population held these opinions. There is also a need to raise awareness of sexual risk behavior in the study population.