Determinants of condom use among subgroups of men who have sex with men in Myanmar: need for adapted health messages
E.E. Akom1, M. Theuss2, T. Aung2
1PSI, Research and Metrics, Washington DC, United States, 2Population 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%. PSI/Myanmar is implementing a program addressing MSM needs and in 2008 conducted a baseline survey among MSM, to measure condom use and its determinants.
Methods: A cross-sectional study was conducted among 18-49 year-old MSM from 29 cities across Myanmar who reported having anal sex within the last week. Participants were selected using Respondent Driven Sampling and a structured questionnaire was used for data collection. “Correct and consistent” condom use was defined as the systematic use of a condom through the whole duration of the intercourse
Results: A total of 1,179 MSM were interviewed. MSM were categorized, based on self reported sexual practices. .Correct and consistent condom use was reported by 44.0% of MSM practicing insertive anal sex versus 40.5% of MSM practicing receptive anal sex.In multivariate analysis, MSM that practiced receptive anal sex and reported correct and consistent condom use were significantly more likely to think that it is important to know one’s HIV status (p< 0.05), to consider condom use important regardless of physical characteristics or trust (p< 0.01), and to feel confident about buying and using condoms (p< 0.01)MSM that practiced insertive anal sex and reported correct and consistent condom use were significantly more likely to remember to use condoms before having sex (p< 0.001), believe that their life would be shattered if they got HIV (p< 0.001), and perceive condoms as easily available (p< 0.05).
Conclusions: Study results informed health behavior communications and provide baseline data for program evaluation. Communications for MSM practicing insertive anal sex were designed to target improving perceptions of condom availability. Among MSM practicing receptive anal sex, communications encourage condom use regardless of physical characteristics or trust in a partner.