Prevalence and risk factors for HIV infection among men having sex with men in Metro Manila, Philippines.

HIV incidence in the Philippines is increasing at an alarming rate. We conducted this study to understand the factors catalyzing the HIV epidemic among men having sex with men (MSM) in Metro Manila. From November 2009 to January 2010, an HIV testing booth was set up adjacent to bars and restaurants in Metro Manila frequented by MSM at night. Participants aged > or =18 years were interviewed using a structured questionnaire. Rapid HIV antibody screening was performed using SD Bioline HIV 1/2 3.0 (Standard Diagnostics). Of 406 MSM included in the study, the mean age was 26.2 years [standard deviation (SD) 5.4]; 96% believed condoms reduced HIV risk but only 3% reported consistent use. The leading reasons for not using condoms were belief that the partner was HIV negative (34.4%), diminished pleasure (32%), and unavailability (23.4%). The HIV prevalence using the rapid test was 11.8% [95% confidence interval (CI): 8.7- 15.0]. All 40 cases who had a confirmatory Western blot test were positive, of whom 24 were business process outsourcing employees (BPOEs). On multivariate analysis, work as a BPOE [adjusted OR (aOR): 3.37; p=0.001], preference for receptive anal sex (aOR: 5.26; p=0.04), and sex while under the influence of excessive alcohol (aOR: 2.71; p=0.04) were independently associated with HIV. The proportion of BPOEs who consistently use condoms when having insertive anal sex with a stranger was significantly lower compared to non-BPOEs (24.5% versus 38.2%; p=0.02). Urgent interventions are needed to address the HIV epidemic in the Philippines.

[1]  J. Rehm,et al.  The effectiveness of interventions for reducing stigma related to substance use disorders: a systematic review , 2012, Addiction.

[2]  S. Braunstein,et al.  Men Who Have Sex With Men Have a 140-Fold Higher Risk for Newly Diagnosed HIV and Syphilis Compared With Heterosexual Men in New York City , 2011, Journal of acquired immune deficiency syndromes.

[3]  C. Beyrer,et al.  HIV Incidence, Risk Factors, and Motivation for Biomedical Intervention among Gay, Bisexual Men, and Transgender Persons in Northern Thailand , 2011, PloS one.

[4]  J. Parry.  Philippines faces expanding HIV epidemic, shows research , 2010, BMJ : British Medical Journal.

[5]  S. Weitzen,et al.  Bisexuality, Sexual Risk Taking, and HIV Prevalence Among Men Who Have Sex With Men Accessing Voluntary Counseling and Testing Services in Mumbai, India , 2010, Journal of acquired immune deficiency syndromes.

[6]  Nurhayati,et al.  Sexual Risk Taking, STI and HIV Prevalence Among Men Who Have Sex with Men in Six Indonesian Cities , 2011, AIDS and Behavior.

[7]  L. Hernandez,et al.  Men-who-have-Sex-with-other-Males (MSM) in the Philippines – Identities, Sexualities and Social Mobilities: A Formative Assessment of HIV and AIDS Vulnerabilities , 2009 .

[8]  S. Baral,et al.  The global epidemic of HIV infection among men who have sex with men , 2009, Current opinion in HIV and AIDS.

[9]  S. Vermund,et al.  Predictors of unprotected sex among men who have sex with men in Beijing, China. , 2008, The Southeast Asian journal of tropical medicine and public health.

[10]  J. Catania,et al.  HIV Prevalence and Sexual Risk Behaviors Among Men Who Have Sex With Men: Results From a Statewide Population-Based Survey in California , 2006, Journal of acquired immune deficiency syndromes.