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Among young Thai men who have sex with men, 6 in 100 acquire HIV each year. With the average age at infection being 26, this explosive epidemic is affecting a far younger group of men than the gay epidemics in Western countries. These are the headline findings of the first three years of a study to monitor HIV incidence, reported by Frits van Griensven to the Eighteenth International AIDS Conference in Vienna on Tuesday.

More encouragingly, a second study from Thailand, reported the same day, suggested that HIV prevalence could be declining in men who have sex with men, after having peaked at about 30% in 2007.

Thailand is often seen as a lesson in early and effective HIV control. However, until recently, efforts have largely concentrated on commercial sex workers, their clients and injecting drug users. The ongoing spread of HIV among men who have sex with men (MSM) was largely ignored until a much overdue study of Bangkok MSM in 2005 found an HIV prevalence of 17%.

In the incidence study, a cohort of 1292 Bangkok MSM was recruited, which is being followed at four-monthly intervals. Recruitment began in April 2006 and was completed by January 2008. Participants are all Thai nationals, male at birth, resident in the Bangkok area, aged 18 or over, and have had anal or oral sex with a man in the six months before recruitment. Participants were recruited from the sexual health clinic where follow-up visits were conducted, through a website, from a range of bars, saunas and parks used by MSM, and through community organisations.

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