Men who have sex with men in Cambodia: Population size, HIV risky behaviors, and HIV prevalence

Abstract

Background: Men who have sex with men (MSM) constitute a significant proportion of HIV key populations in Cambodia. We conducted this study to estimate the national population size, assess HIV-related risk behaviors, and determine HIV prevalence among MSM in Cambodia. Methods: This research was conducted in 2014 in 12 study sites in Cambodia. MSM size estimation was performed using capture-recapture method with data collected in two time points within an 18-day interval. To assess HIV risk behaviors, a total of 838 MSM were randomly selected for face-to-face interviews during the capture round. A separate survey using a time location sampling approach was conducted to estimate HIV prevalence. Results: The estimated size of MSM in Cambodia was 31,000. Of the total, 52.0%were in urban areas; 89.0% were sexually active; and 65.0% were reachable MSM. Phnom Penh had the largest MSM population. More than two-thirds (69.4%) of MSM reported always using condoms in the last month. The majority (71.6%) of them reported receiving HIV information, while 66.6% and 49.3% reported having been tested for HIV and sexual transmitted infections (STI), respectively in the past six months. Eight percent reported having at least one STI symptom in the past 12 months; of whom, 93.6% reported receiving treatment for the most recent symptoms.HIV prevalence among MSM in this study was 2.3%. The highest HIV prevalence was found in Siem Reap (5.9%) and Phnom Penh (3.0%). The prevalence was higher among MSM aged 25 years or older (4.6%) and those with lower formal education level (4.5%). MSM who reported sex work being their main job had the highest HIV prevalence (17.2%) compared to those in other occupation categories who had a prevalence ranging from 1.0% to 4.7%. Conclusions: With a population size of approximately 31,000, MSM in Cambodia remain at high HIV risk due to their engagement in multiple risky sexual behaviors. Continued efforts to prevent, manage, and treat HIV in this population are essential to eliminate new HIV infections by 2020. Considerations of sub-groups are imperative to better inform resource allocation to refine the efficacy of intervention programs for this population.