Prevalence and correlates of willingness to participate in a rectal microbicide trial among men who have sex with men in Bangkok

Abstract

Rectal microbicides (RMs) hold promise as a HIV prevention method to reduce transmission among men who have sex with men (MSM). To assess RM trial feasibility in Bangkok, we measured prevalence and correlates of willingness to participate among Thai MSM observational cohort participants. Between April 2006 and December 2010, 1744 MSM enrolled in the Bangkok MSM Cohort Study; at 12 months, RM trial participation willingness was measured. We evaluated correlates of RM trial participation willingness using logistic regression analysis. Participants completing the 12-month visit (81.4%, n = 1419) had a mean age of 27.3 years (SD = 6.1), and 65.5% and 86.1% reported having a steady partner or anal intercourse (AI) in the past four months, respectively. Most (79.1%, n = 1123) participants reported willingness to participate in an RM trial, which, in multivariable analysis, was independently associated with insertive only (adjusted odds ratio [AOR] = 3.25, 95% CI: 1.82–5.81) or receptive/versatile role AI (AOR = 3.07, 95% CI: 1.88–5.01), and being paid for sex (AOR = 12.15, 95% CI: 1.67–88.21) in the past four months, and believing that people with AIDS look sick (AOR = 1.92, 95% CI: 1.23–2.98). Of hypothetical RM trial features to increase enrollment likelihood, the most (91.1%) compelling was that the study be approved by the Thai ethics committee, followed by the study site offering evening hours (88.9%). Reasons not to participate were not wanting a rectal examination (29.5%) or fluid collected from the penis or anus (24.6%) and not wanting the placebo (23.0%). RM trial participation willingness was high, particularly for those with greater HIV acquisition risk, within this Thai MSM cohort, suggesting feasibility of an RM trial. Addressing potential barriers to trial entry may be useful in educational materials to optimize recruitment.

Keywords:

• rectal microbicide
• men who have sex with men
• clinical trial
• HIV
• prevention

Acknowledgments

The authors are grateful to all study participants, the Rainbow Sky Association of Thailand and outreach team, the SCC staff, and the laboratory and IT teams and thank Katie McCarthy, Sarika Pattanasin, and Philippe Girault for critically reviewing this paper.

The findings and views presented in this paper are those of the authors and do not necessarily represent the views of the US Centers for Disease Control and Prevention. Any use of trade product in this paper is for descriptive purposes only and does not imply endorsement by the US Government.

Supplementary material

Supplementary material is available via the “Supplementary” tab on the article's online page (http://dx.doi.org/10.1080/09540121.2014.913763).