HIV prevalence among MSM in Thailand has increased at an alarming rate. In a 2003 survey, HIV prevalence among MSM in Bangkok was 17.3% (van Griensven et al., AIDS 2005, 19:521?526) and rose to 28.3% in 2005 (personal communication). The 2005 survey also documented high HIV prevalence in other geographic areas outside Bangkok. In two well-known tourist cities, Chiang Mai and Phuket, HIV prevalence among MSM was 15.3% and 5.5% respectively. HIV prevalence is also high among different subgroups of MSM?15.6% among male sex workers and 13.5% among transgenders. In response to the HIV problem facing this population, MOPH is developing a national strategic plan for HIV and STI prevention for MSM, with the goal of decreasing new HIV infections by half within 4 years. While a few peer-based condom outreach programs and STI services for MSM have started in some areas in Thailand, coverage by these programs is still low, and service models for MSM have not yet been consolidated. For the MSM national strategic plan to succeed, an effective service model for this population must be defined, and prevention programs and coverage must be expanded. For more than five years, GAP/Thailand has been providing support to foster new and existing peer-based outreach, STI and VCT services in Bangkok and Phuket provinces. MOPH now proposes to continue development of MSM services models which will include standardizing outreach contents, VCT, and STI services for MSM in both current and new sites. Capacity: A technical oversight committee consisting of representatives from MOPH, BMA, provincial health office or hospital staff, and the MSM community will be established and meet quarterly, to oversee project design and evaluation for all sites. Additional technical input will be from GAP/Thailand technical teams, including Special Populations; Care and Counseling; Surveillance, Monitoring and Evaluation; Laboratory Services; and Training and Communications. STI services and counseling will be provided by a local team of experienced provincial health and STI staff, and laboratory technicians available at each site. Outreach will be provided by a team of MSM peers identified through Rainbow Sky, a community-based outreach organization that works with MSM, as well as other local key informants. Standardized training packages for staff working with MSM will be developed, and staff will be trained accordingly by a team of experienced trainers identified through the GAP/Thailand training team network.
