Impact of Sexual History and Life Skills on Unprotected Anal Sex: A Cross-sectional Study Among Men Who Have Sex with Men in Mandalay, Myanmar

Authors

  • Myo Zin Oo Faculty of Public Health, St Theresa International College, Nakhon Nayok, Thailand https://orcid.org/0000-0001-9980-6343
  • Soe Sandi Tint Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
  • Alessio Panza College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand
  • Somporn Naklang Faculty of Public Health, St Theresa International College, Nakhon Nayok, Thailand
  • Felicitas Calugan Boleyley Faculty of Public Health, St Theresa International College, Nakhon Nayok, Thailand

Keywords:

Life skills, Men who have sex with men, Myanmar, Sexual history, Unprotected anal sex

Abstract

Objective: To study the impact of sexual history and life skills on unprotected anal sex among men who have sex with men (MSM) in Mandalay, Myanmar.

Materials and Methods: Using a cross-sectional study design, 309 MSM between the ages of 15 and 50 participated in the study. The seven townships of Mandalay city in Myanmar were purposely chosen, and the snowball sampling technique was applied to recruit MSM. The study took place between August 2011 and May 2012.

Results: Two thirds of MSM (76.1%) reported having their first anal sex with a man without using a condom. The ability to consistently refuse unwanted sex was reported by a large percent of MSM (84.5%). About 17.5% of MSM admitted to engaging in anal sex without using a condom when their partner proposed it. “Using a condom during anal sex in the previous four months” was statistically strongly associated with life skills to proposing action if partner refuses to use a condom (p < 0.001).

Conclusion: Regarding sexual behaviour, life skills, and condom use, MSM in Myanmar has relatively little information. Focus should be placed on developing and conducting life skills training because it is crucial for MSM to engage in safe sex activity. Additionally, it is critical to expand the accessibility of services targeted at MSM, such as sex education, condom distribution and promotion.

References

UNAIDS. A technical brief: HIV and young men who have sex with men. [Internet] 2015. [Cited 2022 November 10]. Available from: https://www.unaids.org/sites/default/files/media_asset/2015_young_men_sex_with_men_en.pdf

UNAIDS. 2020 Global AIDS Update —Seizing the moment —Tackling entrenched inequalities to end epidemics. [Internet] 2020. [Cited 2022 November, 16]. Available from: https://www.unaids.org/sites/default/files/media_asset/2020_global-aids-report_en.pdf

Centers for Disease Control and Prevention. Sexually Transmitted Infections Treatment Guideline, 2021. [Internet] 2021. [Cited 2022 November, 17]. Available from: https://www.cdc.gov/std/treatment-guidelines/msm.htm

World Health Organization. Know Your Status-WHO Myanmar World AIDS Day Special. [Internet] 2018. [Cited 2022 November, 17]. Available from: https://cdn.who.int/media/docs/default-source/searo/myanmar/hiv-aids-(english).pdf?sfvrsn=c7a9f945_0

Oo HN, Hone S, Fujita M, Maw-Naing A, Boonto K, Jacobs M, Phyu S, Bollen P, Cheung J, Aung H, Aung Sang MT, Myat Soe A, Pendse R, Murphy E. Evolution of the health sector response to HIV in Myanmar: progress, challenges and the way forward. J Virus Erad. 2016; 2(Suppl 4): 20-26.

UNAIDS. Situational Analysis of the HIV response among men who have sex with men and transgendered persons in Myanmar. [Internet] 2015. [Cited 2022 November, 20]. Available from: https://themimu.info/node/56815

National AIDS Programme. National Strategic Plan on HIV and AIDS: Myanmar 2016–2020. Myanmar. [Internet] 2016. [Cited 2022 November 16]. Available from: https://www.aidsdatahub.org/sites/default/files/resource/myanmar-national-strategic-plan-hiv-and-aids-2016-2020.pdf

Patel P, Borkowf CB, Brooks JT, Lasry A, Lansky A, Mermin J. Estimating per-act HIV transmission risk: a systematic review. AIDS. 2014; 28: 1509–1519.

Reid G, Sharma M, Higgs P. The long winding road of opioid substitution therapy implementation in South-East Asia: challenges to scale up. J Public Health Res. 2014; 3(1): 204.

World Health Organization. Life skills education school handbook, prevention of noncommunicable diseases. [Internet] 2020. [Cited 2022 November, 20]. Available from: https://www.who.int/publications/i/item/9789240005020

Postma l, Getkate R, Van Wijk-Sijbesma CA. Life skills-based hygiene education: a guidance document on concepts, development and experiences with life skills-based hygiene education in school sanitation and hygiene education programmes. [Internet] 2004. [Cited 2022 November 20]. Available from: https://www.ircwash.org/resources/life-skills-based-hygiene-education-guidance-document-concepts-development-and-experiences

Seangpraw K, Somrongthong R, Choowanthanapakorn M, Kumar R. The effect of sex education and life skills for preventive sexual risk behaviours among university of students in thailand. J Ayub Med Coll Abbottabad. 2017; 29(4): 540-546.

Barros AB, Dias SF, Martins MRO. Hard-to-reach populations of men who have sex with men and sex workers: a systematic review on sampling methods. Syst Rev. 2015; 4(141): 1-8.

Zou H, Xu J, Hu Q, Yu Y, Fu G, et al. Decreasing age at first anal intercourse among men who have sex with men in China: A multicentre cross-sectional survey. J. Int. AIDS Soc. 2016; 19.

Mmbaga EJ, Leyna GH, Leshabari MT, et al. Early Anal Sex Experience Among Men Who Have Sex with Men in Dar Es Salaam Tanzania: Implications for HIV Prevention and Care. Arch Sex Behav. 2020; 49: 2045–2055.

Oidtman J, Sherman SG, Morgan A, et al. Satisfaction and Condomless Anal Sex at Sexual Debut and Sexual Risk Among Young Black Same-Sex Attracted Men. Arch Sex Behav. 2017; 46: 947–959.

Kaplan DL, Jones EJ, Olson EC, Yunzal-Butler CB. Early age of first sex and health risk in an urban adolescent population. Journal of School Health. 2013; 83(5): 350–356.

Kubicek K, Beyer WJ, Weiss G, Iverson E, Kipke MD. In the dark: young men's stories of sexual initiation in the absence of relevant sexual health information. Health Educ Behav. 2010; 37(2): 243-63.

Outlaw AY, Phillips G 2nd, Hightow-Weidman LB, et al. Age of MSM sexual debut and risk factors: results from a multisite study of racial/ethnic minority YMSM living with HIV. AIDS Patient Care STDS. 2011; 25: 23-29.

Centers for Disease Control and Prevention. Sexually Transmitted Diseases, CDC Fact Sheet; Information for Teens and Young Adults: Staying Healthy and Preventing STDs. [Internet] 2022. [Cited 2022 November, 25]. Available from: https://www.cdc.gov/std/life-stages-popul ations/stdfact-teens.htm

Balthasar H, Jeannin A, Dubois-Arber F. First anal intercourse and condom use among men who have sex with men in Switzerland. Arch Sex Behav. 2009; 38(6): 1000-1008.

Cheung DH, Suharlim C, Guadamuz TE, Lim SH, Koe S, Wei C. Earlier anal sexarche and co-occurring sexual risk are associated with current HIV-related risk behaviors among an online sample of men who have sex with men in Asia. AIDS Behav. 2014; 18(12): 2423-2431.

Veronese V, Traeger M, Oo ZM, et al. HIV incidence and factors associated with testing positive for HIV among men who have sex with men and transgender women in Myanmar: data from community-based HIV testing services. J Int AIDS Soc. 2020; 23(2): e25454.

Siegler AJ, Voux Ad, Phaswana-Mafuya N, et al. Elements of Condom-Use Decision Making among South African Men Who Have Sex with Men. J Int Assoc Provid AIDS Care. 2014; 13(5): 414-423.

Tucker A, Liht J, de Swardt G, et al. Homophobic stigma, depression, self-efficacy and unprotected anal intercourse for peri-urban township men who have sex with men in Cape town, South Africa: A cross-sectional association model. AIDS Care. 2014; 26(7): 882–889.

Lehrer JA, Lehrer EL, Koss MP. Unwanted sexual experiences in young men: evidence from a survey of university students in Chile. Arch Sex Behav. 2013; 42(2): 213-23.

Tesema D, Tamirat M, Tadele A. Sexual behaviors and its association with life skills among school adolescents of Mettu town, South West Ethiopia: A school-based cross-sectional study. SAGE Open Med. 2020; 8: 1-8.

Sun S, Pachankis JE, Li X, Operario D. Addressing Minority Stress and Mental Health among Men Who Have Sex with Men (MSM) in China. Curr HIV/AIDS Rep. 2020; 17(1): 35-62.

Published

2023-01-21

How to Cite

1.
Oo MZ, Tint SS, Panza A, Naklang S, Boleyley FC. Impact of Sexual History and Life Skills on Unprotected Anal Sex: A Cross-sectional Study Among Men Who Have Sex with Men in Mandalay, Myanmar. J. Med. Glob. [Internet]. 2023 Jan. 21 [cited 2024 Mar. 29];1(3):121-7. Available from: https://he01.tci-thaijo.org/index.php/JMedGlob/article/view/260672