Interpersonal Communication Activities of PSI/Laos Associated with Trends toward Safer Sexual Behavior among Transgender in Laos

Objectives: In Laos, “katoey” are biological males who self identify as female and are sexually active with men. This study investigates trends in condom use with katoey and their male partners and evaluates the association between exposure to IPC activities and changes in behavior.

Data and Methods: Quantitative surveys were conducted in 2004 and 2006 among katoey using time-location sampling in Luang Prabang, Vientiane capital and Savannakhet provinces. UNIANOVAs were used to monitor changes in key indicators over time and compare exposure groups while controlling for demographic characteristics (2004, N=288; 2006, N=324).

Results: Increases in condom use at last anal sex with casual (75.5% vs. 57.5%, p<.001) and regular male partners (76.7% vs. 23.5%, p<.001) were apparent. The use of water-based lubricant also increased (81.1% vs. 54.6%, p<.001). High exposure to IPC interventions had a positive effect on condom use with casual partners (p<.001), but not with regular partners. In 2006, katoey were more likely to believe that condom use with regular partners is important (91.7% vs. 58.7%, p<.001), and to report that condoms are available (84.6% vs. 55.0%, p<.001), though improvements could not be attributed to program exposure. Misconceptions about oil-based lubricants, STIs, and the asymptomatic nature of HIV persist.

Conclusions: While some risk behaviors decreased over time, existing IPC programs must improve messages related to consistent condom use with all partners, improve knowledge, and reduce misconceptions about HIV.