A social ecology of rectal microbicide acceptability among young men who have sex with men and transgender women in Thailand

摘要: Introduction: With HIV-incidence among men who have sex with (MSM) in Bangkok the highest world, a topical rectal microbicide would be tremendous asset to prevention. Nevertheless, ubiquitous gaps between clinical trial efficacy and real-world effectiveness of existing HIV preventive interventions highlight need address multi-level factors that may impact on implementation.We explored social ecology acceptability MSM transgender women Chiang Mai Pattaya, Thailand. Methods: We used qualitative approach guided by ecological model. Five focus groups were conducted Thai using semi-structured interview guide. All interviews digitally recorded, transcribed verbatim translated into English. thematic analysis line-by-line axial coding constant comparative method. Transcripts codes uploaded customized database programmed Microsoft Access.We then content calculate theme frequencies group, Chi-square tests Fisher’s exact test compare themes sexual orientation/gender expression age. Results: Participant’s (n=37) mean age was 24.8 years (SD=4.2). The majority (70.3%) self-identified as gay, 24.3% women. Product-level (side effects, formulation, efficacy, scent, etc.) accounted for 42%, individual (increased risk, packaging/portability, timing/duration protection) 29%, interpersonal (trust/communication, power/negotiation, stealth) 8% socialstructural (cost, access, community influence, stigma) 21% total codes, significant differences identity. intersections influences included product formulation timing use preferences contingent communication partner type, context constraints posed stigma, venues access cost. Discussion: intersecting influence suggests ensure widespread low cost mitigate stigma discrimination against gay other health care system broader society will support microbicides, combination prevention technologies, reducing transmission. Education, outreach small-group acknowledge implementation most-at-risk populations Keywords: prevention; microbicide; healthcare; model; men; women; Thailand; research. (Published: 1 August 2013) Citation: Newman PA et al. Journal International AIDS Society 2013, 16 :18476 http://www.jiasociety.org/index.php/jias/article/view/18476 | http://dx.doi.org/10.7448/IAS.16.1.18476