All MSM are not the same: adapting behavior change communication to the needs of MSM subpopulations in Myanmar

Published: July 21, 2010

H. Rahman, C. Wolf, N. Lwin, M. Theuss

Population Services International (Myanmar), Yangon, Myanmar

Background: While HIV prevalence among the male general population in Myanmar is 2.5%, among men who have sex with men (MSM) it reaches 28%. This contrast highlights the need for effective HIV prevention programming with MSM. To inform PSI/Myanmar’s activities addressing MSM, this study investigated the differences in HIV and STI prevalence among MSM engaging in receptive versus insertive anal sex.
Methods: In the context of a transversal descriptive study, a convenience sample of 650 consenting MSM was recruited from PSI-run drop-in centers. Individuals were interviewed and biological samples were collected for syphilis and HIV (blood) and gonorrhea (urethral swabs) testing. Pre- and post-test counseling was provided to participants. Based on self report, 310 participants practiced receptive anal intercourse (RAI) and 340 practiced insertive anal intercourse (IAI). Sexual roles were described as somewhat fluid, with a small proportion of all MSM (12%) reporting both insertive and receptive practices.
Results: Descriptive statistics were generated and disaggregated by sexual practice: 41% of MSM engaging in RAI and 23% practicing IAI were HIV positive (p< 0.05). Urethral gonorrhea was found in 7% of MSM reporting RAI and 12% in those reporting IAI (p< 0.05). Syphilis was found in 11% of MSM practicing RAI and 4% practicing IAI (p< 0.05). Finally, MSM engaging in RAI reported an average of 3.1 male sexual partners per week versus those engaging in IAI who reported 1.6 male partners per week (p< 0.05).
Conclusions: There was significant difference in HIV and STI incidence among MSM engaging in receptive versus insertive anal intercourse. MSM engaging in RAI have more male partners and are thus at greater risk of HIV and STI infection. In response, PSI/Myanmar developed a communication strategy targeting MSM with unique messages tailored to their specific sexual behaviors.

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