{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T12:46:30Z","timestamp":1777293990967,"version":"3.51.4"},"reference-count":36,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2013,8,1]],"date-time":"2013-08-01T00:00:00Z","timestamp":1375315200000},"content-version":"vor","delay-in-days":212,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["OGE\u2010111397"],"award-info":[{"award-number":["OGE\u2010111397"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["HIB\u2010120230"],"award-info":[{"award-number":["HIB\u2010120230"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["THA\u2010118570"],"award-info":[{"award-number":["THA\u2010118570"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of the International AIDS Society"],"published-print":{"date-parts":[[2013,1]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>With HIV\u2010incidence among men who have sex with men (MSM) in Bangkok among the highest in the world, a topical rectal microbicide would be a tremendous asset to prevention. Nevertheless, ubiquitous gaps between clinical trial efficacy and real\u2010world effectiveness of existing HIV preventive interventions highlight the need to address multi\u2010level factors that may impact on rectal microbicide implementation. We explored the social ecology of rectal microbicide acceptability among MSM and transgender women in Chiang Mai and Pattaya, Thailand.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We used a qualitative approach guided by a social ecological model. Five focus groups were conducted in Thai using a semi\u2010structured interview guide. All interviews were digitally recorded, transcribed verbatim in Thai and translated into English. We conducted thematic analysis using line\u2010by\u2010line and axial coding and a constant comparative method. Transcripts and codes were uploaded into a customized database programmed in Microsoft Access. We then used content analysis to calculate theme frequencies by group, and Chi\u2010square tests and Fisher's exact test to compare themes by sexual orientation\/gender expression and age.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Participant's (<jats:italic>n<\/jats:italic>=37) mean age was 24.8 years (SD=4.2). The majority (70.3%) self\u2010identified as gay, 24.3% transgender women. Product\u2010level themes (side effects, formulation, efficacy, scent, etc.) accounted for 42%, individual (increased sexual risk, packaging\/portability, timing\/duration of protection) 29%, interpersonal (trust\/communication, power\/negotiation, stealth) 8% and social\u2013structural (cost, access, community influence, stigma) 21% of total codes, with significant differences by sexual orientation\/gender identity. The intersections of multi\u2010level influences included product formulation and timing of use preferences contingent on interpersonal communication and partner type, in the context of constraints posed by stigma, venues for access and cost.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>The intersecting influence of multi\u2010level factors on rectal microbicide acceptability suggests that social\u2013structural interventions to ensure widespread access, low cost and to mitigate stigma and discrimination against gay and other MSM and transgender women in the Thai health care system and broader society will support the effectiveness of rectal microbicides, in combination with other prevention technologies, in reducing HIV transmission. Education, outreach and small\u2010group interventions that acknowledge differences between MSM and transgender women may support rectal microbicide implementation among most\u2010at\u2010risk populations in Thailand.<\/jats:p><\/jats:sec>","DOI":"10.7448\/ias.16.1.18476","type":"journal-article","created":{"date-parts":[[2013,7,24]],"date-time":"2013-07-24T18:01:36Z","timestamp":1374688896000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["A social ecology of rectal microbicide acceptability among young men who have sex with men and transgender women in Thailand"],"prefix":"10.1002","volume":"16","author":[{"given":"Peter A","family":"Newman","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Surachet","family":"Roungprakhon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suchon","family":"Tepjan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,8]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e32835c546e"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0040339"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e3181c2fc86"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a010003"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.1193748"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1011205"},{"key":"e_1_2_10_8_1","doi-asserted-by":"crossref","unstructured":"McGowanI.Rectal microbicides: can we make them and will people use them? 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