Determinant Contextual Factors towards Condom Use Behavior among Men Who Have Sex with Men in Bangkok, Chiang Mai, and Phuket

Abstract

Background: HIV prevalence among men who have sex with men (MSM) is still high comparing with general population in Thailand. The utilization of information, motivation, and behavioral skill (IMB) model as a framework to design HIV preventive interventions particularly condom use in MSM population is insufficient.
Objective: This study aimed for proposing a new robust the oretical framework to explain condom use behavior among MSM in selected sites in Thailand in terms of identifying characteristics among MSM on condom use behavior and testing hypotheses regarding determinant factors influencing on condom use behavior among MSM.
Method: A cross-sectional survey was conducted during June 2014 and October 2014 to collect data using structured-questionnaire from 301 respondents living in Chiang Mai, Phuket and Bangkok more than six months and willing voluntary to answer about their sexual behavior in the past two week.
Results: 34 from 301 (15 percent) respondents reported that they did not use condom with their partners every time they have anal sexual intercourse. A path analysis demonstrated that attitude towards condom use under motivation factor was the highest predictive factor towards condom use ratio. In addition, sexual excitement towards unprotected anal sexual intercourse as mediating factor increased IMB model explanatory power.
Conclusion: Attitudes toward condom use was the highest predictive factor towards condom use ratio. Sexual excitement as a contextual powerful moderating factor should be added into a new robust IMB model to better predict condom use behavior among MSM population.