KNOWLEDGE, ATTITUDES AND BEHAVIOR AMONG HIV-POSITIVE AND HIV-NEGATIVE CLIENTS OF A CONFIDENTIAL HIV COUNSELING AND TESTING CENTER IN THAILAND

Objective: To describe the clients, operation and impact of an Asian public HIV counselling and testing centre. Design and setting: Analysis of samples from clients attending the Thai Red Cross Anonymous Clinic (TRC-AC) in Bangkok, Thailand in 1993. Subjects: HIV-positive and HIV-negative consecutive clients (250 of each). Main outcome measures: HIV seroprevalence rates, knowledge, attitudes and behaviour. Results: Overall HIV-1 prevalence was 16%; 13% in men and 24% in women. Reasons for requesting an HIV test were high-risk behaviour (21%), feeling unwell (20%), checking a previous HIV test result (18%), a planned marriage or new relationship (10%), and planning a baby (5%). Heterosexual risk behaviour was reported by 85% of clients, while in each case only 1% reported male homosexual or intravenous drug use risk behaviour. Factors associated with HIV infection on univariate analysis included a history of sexually transmitted disease, not using condoms, a low level of education and salary, and being female. Knowledge about HIV transmission risks and AIDS prevention measures was good, and most clients expressed a caring attitude towards people with HIV and AIDS. A former negative HIV test result was associated with higher levels of condom use, and most clients expressed the intention to reduce their HIV risk behaviour in response to a positive or negative HIV test result (more so if positive). Conclusions: Our study demonstrates the demand for and the feasibility of confidential HIV counselling and testing services in Thailand and illustrates the value of these services in achieving behaviour changes. Such services should be considered as an additional approach for reducing HIV transmission in Asia, especially in areas with high HIV seroprevalence rates.