[health menu] XI International Conference on AIDS
July 7-12, 1996

Beyrer, C., Celentano D.D., Nelson K.E.
Johns Hopkins University, Baltimore MD

Suprasert S., Phanupak P., Sittitrai W.
Program on AIDS, The Thai Red Cross Society
Bangkok, Thailand

Mo.C.1509

Widely Varying HIV Prevalence and Risk Among Nine Ethnic Minority Groups in Northern Thailand

Objectives

To estimate and compare HIV prevalence, risk behaviors, and social and sexual norms among 9 ethnic minority (Hilltribe) groups in upper northern Thailand.

Subjects and Methods

Communities were selected on size, ethnicity, and geographic diversity. Subjects, aged 15-45 years, were stratified by gender, and selected by household using a two-stage randomization. Forty volunteers were identified in each of 27 villages. Participation was voluntary and anonymous. HIV status was determined using salivary ELISA and WB. Risks for HIV were measured with a structured interview; interviewers were gender-matched to subjects and fluent in local languages. Analysis was done with Fisher's exact test, Chi Square, non-parametric t tests, multiple logistic regression and correlation coefficients.

Results

Overall HIV prevalence was 23/1080 or 2.13%. The male-female ratio of infection was 11:12. Crude HIV prevalence for each ethnic group were; Shan 8.75%, Akha 5.0%, Yao 5.0%, Thin 1.25%, Hmong 0.63%, Lahu 0.63%, Lisu 0.63%, Karen 0, and Pa-Long 0. Sex worker (CSW) use was an HIV risk for men (p = .001); injecting drug use was not. For women having been a CSW was a significant HIV risk (p <.0001). Social norms and sexual behavior varied considerably between ethnic groups, as did HIV risks and attitudes toward CSW work and use.

Conclusions

HIV rates and risks appear to vary considerably between ethnic minority groups in northern Thailand; rates range from 0 to 8.75% among a randomly selected sample of adults. HIV prevention needs to target the Shan, Akha, and Yao communities, and to focus on reduction of CSW work and use. Native language and culture specific HIV prevention programs are urgently needed.

Chris Beyrer MD, MPH,
Research Institute for Health Sciences
Chiang Mai University
PO Box 80, CMU, Chiang Mai
50200 Thailand
Tel: 66 53 221-966; Fax: 66 53 221-849

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Created: July 16, 1996
Last modified: July 17, 1996
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