Sex frequency and sex planning among men who have sex with men in Bangkok, Thailand

Abstract + full, open access article

Sex frequency and sex planning among men 

who have sex with men in Bangkok, Thailand: 

implications for pre- and post-exposure prophylaxis 

against HIV infection

Journal of the International AIDS Society 2010, 13:13doi:10.1186/1758-2652-13-13

Objective
Daily HIV anti-retroviral pre-exposure prophylaxis (PrEP) is being evaluated in clinical trials among men who have sex with men (MSM). However, daily PrEP may not be congruent with sexual exposure profiles of MSM. Here we investigate sex frequency and sex planning to identify and inform appropriate PrEP strategies for MSM.

Methods
We evaluated sex frequency and sex planning in a cohort HIV-negative MSM in Bangkok, Thailand. chi2 test was used to compare reports of sex on different weekdays; logistic regression was used to identify predictors of sex frequency and sex planning.

Results
Of 823 MSM (mean age 28.3 yrs) 86% reported sex on 2 days per week or less and 65% reported their last sex to have been planned. Sex on the weekend (~30%) was more often reported than sex on weekdays (~23%). In multivariate analysis, use of alcohol, erectile dysfunction drugs, group sex, sex with a foreigner, buying and selling sex and a history of HIV testing were associated with having sex on 3 days per week or more; age 22 to 29 years, not identifying as homosexual, receptive anal intercourse and not engaging in group sex were associated with unplanned sex.

Conclusion
Intermittently dosed PrEP (as opposed to daily) may be a feasible HIV prevention strategy and should be considered for evaluation in clinical trials. Predictors of sex frequency and sex planning may help to identify those in need for daily PrEP and those who may not be able to take a timely pre-exposure dose.

Open Access.