Factors associated with unsafe sex behaviors for prevention of HIV/AIDS transmission among Myanmar migrant fishermen in Ranong, Thailand

The study was conducted on late February 2009, to describe independent variables (socio-demographic characteristics, condom availability, HIV/AIDS information, peer pressure, drug and alcohol use, HIV related knowledge, attitudes & skills), and to assess any association of these independent variables with the dependent variable (unsafe sex with sex workers) among Myanmar migrant fishermen in Ranong, Thailand. The data was collected using interviewer administrated questionnaire and Focus Group Discussion. The majority of the respondents was in the 26-35 years age group, single, had attained middle school education, Barma, Buddhist, had an income of 4,000-5,000 Baht per month, stayed in Thailand for 1-4 years and never went back home. The mean knowledge score for total respondents was 0.6941. Most of the respondents received HIV/AIDS information and knew where they could get condoms. About 63% of the respondents have had sex with sex workers and 70.7% of them always used a condom when having sex with sex worker. 18.0% of the respondents had casual sexual partners. 40.1% of them always used condom when they had sex with casual partners in the six months previous to the study. In bivariate analysis, The results showed that longer duration of stay in Thailand and earning of more than 5,000 Thai baht, negative attitude towards HIV/AIDS and condom use, and injected narcotic drugs were statistically associated with practice of unsafe sex with sex workers (p-value <0.005). Receiving HIV/AIDS information, known sources of condom, life skills such as refusing undesired sex, pressure to use drug, to have sex without condom and discussing to use a condom were statically associated with safe sex practice in sex workers (p-value <0.005). In multivariate, the results suggest that Age, Duration of stay Thailand, Knew where to get condoms, Refusal to have sex without a condom, and Discussing condom use maintained significant association with unsafe sex while controlling for other independent variables. Given the high prevalence of risk behavior, providing health education together with condoms constantly to this group of Myanmar migrant fishermen in Ranong is crucial. Health education should include teaching life skills such as refusal to have sex without a condom, and discuss to use condoms. The 100% condom use program should be promoted among Myanmar migrant fishermen