AIDSImpact.com:: - Santa Fe, USA 2011

Abstract #265 - Bao cao su, kondom, ถุงยาง: sexual cultures, condoms and lubricant
Authors: Presenting Author: Dr Stephen McNally - La Trobe University
Additional Authors: Dr. Jeffrey Grierson, Prof. Marian Pitts, Prof. Anthony Smith,
Aim: While MSM in developing countries continue to be over-represented in HIV diagnoses, there still remains a paucity of research that contextualises sexual practice and protective measures taken by MSM in these settings. This study aimed to provide an understanding of sexual practices including condom and lubricant use in three South East Asian countries. This study provides critical analyses that support targeted HIV prevention and sexual health promotion initiatives for MSM.
Method / Issue: Men in Thailand, Indonesia and Vietnam completed an online sexual health and sexual practices questionnaire. The study was promoted on gay and MSM websites and was completed during 2009/ 2010. The sample size achieved was 726 in Thailand, 509 in Indonesia and 608in Vietnam. The survey covers a range of topics, including; socio-demographic information, sexual practice, and sexual health seeking behaviours. Men were asked to describe their most recent sexual encounter with up to five men including sexual activities and condom and lubricant use.
Results / Comments: Several notable differences in condom and lubricant use were found between Thailand, Indonesia and Vietnam. The type of most recent partner (regular/casual etc.) was very similar across the three sites. However, of the men who reported anal sex with the last male partner a condom was used for insertive anal sex by 60% of Thai men, 53% of Vietnamese men and 47% of Indonesian men. Of the men who reported receptive anal sex with the last male partner a condom was used by 64% of Thai men, 47% of Vietnamese men and 37% of Indonesian men. Of the men who engaged in anal sex, water based lubricant was used more often by Vietnamese men (65% insertive and 64% receptive), and Thai men (64% insertive and 62% receptive), while Indonesian men reported much lower use of water based lubricant with (36% insertive and 37% receptive). Oil or body lotion was not mentioned by any Vietnamese men, while Indonesian men reported use of oil or body lotion for 25% (insertive) and 29% (receptive) of anal sex events. Between 5% and 10% of men across these three countries used no lubricant when engaging in either insertive or receptive anal sex. There was also considerable variability in patterns of condom use over the previous year with the proportion reporting always using a condom for receptive/ insertive anal sex being: Vietnam (38%/20%), Indonesia (24%/245) and Thailand (54%/57%).
Discussion: These three countries differ in their history of sexual health promotion among MSM and in the structural facilitators and barriers to the use of condoms and water based lubricants. While there are some basic principles that can be applied to enhance condom and lubrication utilisation, these efforts can never be truly effective without a full understanding of local context.
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