Program Development for HIV Prevention and Treatment in Men Who Have Sex with Men, Buriram Province, Thailand

Abstract

This study is the action research. The objectives were to situation analysis of risk factors related to HIV infection and
to develop model regarding to HIV prevention and treatment for key populations (Men Who Have Sex with Men; MSM) in
Buriram Province. There were 4 steps. 1) Planning; researcher review and analyze problematic situations for plan at each step
2) Action; follow the plan 3) Observing; observe plan compliance by observing technique, questionnaire and performance
evaluation and 4) Reflection; reflect the results by after action review activities and summarize obstacles to developing
program and implementation. The researcher conducted 3 cycles in 3 phases as following; Phase 1 was to develop program
of HIV prevention and treatment in key population (Men who have sex with men; MSM). Phase 2 was to experiment the
program in Buriram province and phase 3 was to expand the program cover all key population (MSM) in Buriram province.
The population in the study consisted of the committee for development model both district level and
provincial level and MSM who willing to join the project. The subjects was selected by purposive sampling including
project’s staff (33 persons in phase 1, 40 persons in phase 2, and 142 persons in phase 3) and project’s
client who received care in the project (2,784 cases in phase 2 and phase 3). The tools used in this
study were secondary data (document review) and questionnaire. The values ofKuder-Ricahardson20
(KR-20) of questionnaire regarding the understanding of the integration of HIV prevention and treatment in the
project’s staff and MSM group were 0.78 and 0.82, respectively. In addition, key population’s
satisfaction and opinion on the program were also take to account. The data analysis using the Epi info
version 7. Descriptive statistics (such as frequency, percentage, mean and standard deviation) and inferential
statistics such as Pair t-test (P=0.05) were used for statistical analysis in part of quantitative analysis. The content
analysis used for the qualitative analysis. The results of this study shown that the model have been successful
in the integration of HIV service package (Reach-Recruit-Test-Treat-Retain: RRTTR) in Buriram province.
Project’s staff who have passed the training have significantly knowledge increased (P<0.001) in all 3 phases.
To achieved the success model, several factors were taken to account including the strength of public – private
partnership, assessing key populations, community analysis, proactive services, providing information, friendly
services, personnel staff’s attitude, waiting time as well as the screening and referral system. In the outcomes
from 2016 – 2018 found that MSM increased accessibility rate to preventive services. They have been HIV screened
from 82.62 percent, 77.28 percent and 74.55 in respectively. Moreover, positive HIV results have been shown in 8.73
percent, 4.06 percent and 6.51 in respectively. In addition, 100 percent of MSM with HIV positive results have been sent
to receive care. In the year 2017 and 2018, 97.89 percent and 95.61 percent of them still being treated continuously

and remaining in the system and were satisfied in the highest level at 59.77 percent and 55.30 percent. Recommendations
for the development program of HIV prevention and treatment. There were essential factors to drive mechanisms
including1. Preparing and training project’s staff to increase their knowledge, understanding and attitude correction
2. Potential development of project’s staff for proactive and passive working 3. The covering of services packagein all
level of health care service 4. Linking system for prevention, treatment and referral in both service area and out of service area
5. Developing cooperation among the government, community, organization’s leader in formal and informal method
6. Friendly services providing in accordance with the context of the target group that is confidential and private.