Journal Article

HIV prevalence and incidence among men who have sex with men and transgender women in Bangkok, 2014–2018: Outcomes of a consensus development initiative

Guadamuz, Thomas E., Colby, Donn J., Dunne, Eileen F., Benjamaneepairoj, Kanya, Phanuphak, Nittaya, Chaiphosri, Pannee, Mock, Philip A., Na Nakorn, Panus, Rangsin, Ram, Mills, Stephen, Avery, Matthew, Manopaiboon, Chomnad, Vannakit, Ravipa, van Griensven, Frits, Ramautarsing, Reshmie, de Lind van Wijngaarden, Jan Willem

2022

Overview

To reach its goal of ending AIDS by 2030, Thailand has adopted antiretroviral treatment as prevention and HIV pre-exposure prophylaxis for men who have sex with men (MSM) and transgender women (TGW) as its core HIV control strategy. However, in the absence of reliable epidemiologic indicators, the impact of these policies on the course of the HIV epidemic in these groups remains unknown. To help answer this question, we formulated an HIV epidemic consensus initiative for Bangkok, Thailand, to analyze epidemiologic and program data and reach agreement between experts and stakeholders on the evolving state of the HIV epidemic among MSM and TGW. A customized Delphi process was used to consult and consolidate viewpoints of experts and stakeholders. Experts presented and discussed HIV prevalence and incidence data from recent and ongoing studies among MSM and TGW in Bangkok (2014 to 2018) during a meeting with stakeholders representing government, donors, and civil society. Agreement about the course of the HIV epidemic among MSM and TGW was attained by voting consensus. Based on presented data, meeting participants agreed that HIV prevalence and incidence had decreased among Bangkok MSM from 2014 to 2018. Despite these declines, HIV prevalence and incidence were found to remain high. This was particularly the case among younger MSM. Participants agreed that there was no evidence for a decrease in HIV prevalence and incidence among Bangkok TGW. Introduction of antiretroviral treatment as prevention and HIV pre-exposure prophylaxis may have contributed to these declines. However, HIV prevalence and incidence remained high, and no signs of a decrease were reported among Bangkok TGW. At the current rate of new HIV infections in MSM and TGW, Thailand will not reach its goal of ending AIDS by 2030. This HIV consensus initiative may serve as a model for building agreement and advocacy on epidemiologic and program data and their implications for a large metropolitan city.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Acquired immune deficiency syndrome / Adolescent / Adult / Age Factors / AIDS / Antiretroviral agents / Antiretroviral drugs / Biology and Life Sciences / Cities - epidemiology / Collaboration / Consensus Statements as Topic / Delphi method / Delphi Technique / Demographic aspects / Diagnosis / Disease control / Disease prevention / Disease transmission / Epidemics / Epidemiology / FDA approval / Female / Gays & lesbians / Health surveillance / HIV / HIV infection / HIV Infections - epidemiology / HIV Infections - etiology / Homosexuality, Male / Human immunodeficiency virus / Humans / Incidence / Male / Marginalized groups / Medical examination / Medical tests / Medicine and health sciences / Men / Mens health / MSM (Men who have sex with men) / People and Places / Prevalence / Prevention / Prophylaxis / Public health / Risk Factors / Sexually transmitted diseases / STD / Thailand - epidemiology / Transgender people / Transgender persons / Transgender Persons - statistics & numerical data / Women / Womens health / Young Adult