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dc.contributor.advisorAnchana NaRanong
dc.contributor.authorPanus Rattakitvijun Na Nakorn
dc.date.accessioned2018-06-05T08:50:13Z
dc.date.available2018-06-05T08:50:13Z
dc.date.issued2015
dc.identifierba188470th
dc.identifier.urihttp://repository.nida.ac.th/handle/662723737/3694
dc.descriptionDissertation (Ph.D. (Development Administration))--National Institute of Development Administration, 2015th
dc.description.abstractThailand National AIDS Strategy (NAS) 2012-2016 was developed comprehensively and implemented intensively at the provincial level. It utilized an information-motivation-behavioral skills model as a framework to design HIV preventive interventions, including condom distribution interventions, that was insufficient in increasing the rate of condom use among men who have sex with men (MSM). HIV prevalence in the MSM population has increased dramatically compared with the general population across Thailand, particularly in major cities. There is therefore an urgent need to identify the gaps in the Thailand NAS in terms of how policy is formed at the national level and how it is implemented at the provincial level. In addition, it is necessary to seek out a new, robust theoretical framework in order to design effective interventions and in order to halt HIV transmission in the MSM population in Thailand.th
dc.description.abstractThere were three objectives for this study. First was to explore the current Thailand NAS 2012-2016 in terms of its characteristics, formation, application, and implementation at the provincial level. Second was to analyze the theoretical perspectives that underlie the Comprehensive Package of Services (CPS) Model used as a framework for the HIV preventive model mentioned in the Thailand NAS 2012- 2016. Third was to propose a robust theoretical framework to explain condom use behavior among the MSM population in selected sites in Thailand in terms of identifying the characteristics of condom use behavior and testing the hypotheses on which determinant factors have influenced on condom use behavior these individuals in selected sites.th
dc.description.abstractThis study employed a mixed-method approach in order to respond to all three main objectives mentioned above. Objective #1 and #2 utilized a semi-structured questionnaire for interviewing key informants both at the national and provincial levels. This semi-structured questionnaire consisted of eight dimensions, which attempted to look at the efficiency, effectiveness, and sustainability of the organizations that formed, applied, and implemented Thailand NAS 2012-2016, which included structure and process, partnership and networking, project management, monitoring and evaluation, technical capacity building, financial management, and human resource management. Meanwhile, objective #3 utilized a structured-questionnaire to collect data from the MSM population in those selected sites. The questionnaire consisted of demographic data and condom use behavior, HIV-related information, motivation, behavioral skills, self-efficacy, perceived cost and perceived benefits of condom use, contextual situation-sexual excitement, intimacy, and behavioral setting, all of which were obtained from the literature reviewed. A cross-sectional survey was conducted from June 2014 to October 2014. Three hundred and one respondents that had lived in these three provinces for more than 6 months, that were willing to voluntarily participate in this study, and that were willing to answer sensitive questions about their sexual behavior in the past month responded to the structured questionnaire.th
dc.description.abstractIt was obvious that by 2016, based on mathematic modeling projection, the MSM group would be the most newly-HIV-infected persons; therefore, they were prioritized in Thailand’s NAS for 2012-2016. These significant data led the country to call for an urgently-needed curving down of HIV prevalence among the MSM population across country. In order to achieve the ultimate national goal in this context, called the three zeros—namely, zero on new infections, zero on AIDS-related death, and zero on stigma and discrimination—Thailand NAS 2012-2016 employed two directions and five strategies in order to halt this severe situation in key populations, particularly the MSM population. Thailand NAS 2012-2016 was formed strategically through evidence-based data from various sources. In addition, engagement with non-governmental, governmental, and international aid agencies occurred throughout the development processes.th
dc.description.abstractIn terms of applying and implementing Thailand NAS 2012-2016 at the provincial level, it showed good collaboration between the representatives of nongovernmental organizations (NGOs) and governmental organizations (GOs). However, lack of good governance in selecting representatives, sharing roles, and responsibilities between the representatives from the NGOs and GOs and information sharing among the Provincial Coordinating Mechanism Committee members led to incomprehensive implementation of Thailand NAS 2012-2016, as anticipated at the national level.th
dc.description.abstractThe Comprehensive Package of Services (CPS) model mentioned in Thailand NAS 2012-2016 as an HIV preventive framework was built from five reviewed theoretical frameworks. These five-theoretical frameworks included the Health Belief Model (HBM), Social Cognition Theory (SCT), the Theory of Reasoned Action (TRA), The Planned Behavior (TPA), and the Information-motivation-behavioral skills model (IMB). However, the main contributing theories regarding the CPS model fell under the HBM and IMB. In addition, these five theoretical frameworks were also interconnected through having overlapping key critical concepts used for explaining the HIV preventive behavior of people, such as attitude, subjective norms, intention, HIV information, motivation, behavior skills, and self- efficacy.th
dc.description.abstractIn terms of the factors predicting condom use, 227out of the 301 that have reported using condom with their partner whenever having every time anal intercourse within last two weeks, 34 (15%) reported that they still did not use a condom with their partners every time they had anal sexual intercourse, which was still high and leads to HIV transmission in the MSM population. A path analysis demonstrated that attitude towards condom use, as one of three key concepts under the motivation factor, was the highest predictive of condom use. In addition, information, attitude towards condom use, perceived social support as two critical concepts of motivations, and behavioral skills were found to be predictive of condom use among the MSM population, with sexual excitement towards unprotected anal sexual intercourse as a mediating factor. This was a robust concept that was able to increase the power of explanation of the IMB model regarding condom use in this population.th
dc.description.abstractAlthough Thailand NAS 2012-2016 has engaged with various stakeholders, including NGOs, GOs, and international aid agencies throughout the development and implementation processes, lack of sharing roles and responsibilities and an information-sharing system between the representatives of the NGOs and GOs has led to less comprehension in the application and implementation of Thailand NAS 2012- 2016 and non-cohesive collaboration between both of them at the provincial level. Therefore, enhancing the sharing roles and responsibilities and a information-sharing system between both of them needs to be taken systematically into considerationth
dc.description.abstractRather than distribute condoms, it is necessary to be sure that MSM that have a low monthly income and could not access condoms are able to access whenever needed. A routine tracking system both for the number of condoms distributed and condom use needs to be established in order to monitor the situation and to be able to reshape intervention as needed.th
dc.format.extent180 leaves.th
dc.format.mimetypeapplication/pdfth
dc.language.isoength
dc.publisherNational Institute of Development Administrationth
dc.rightsผลงานนี้เผยแพร่ภายใต้ลิขสิทธิ์ของสถาบันบัณฑิตพัฒนบริหารศาสตร์th
dc.subjectSexual behavior surveysth
dc.titleExplaining condom use behavior among men who have sex with men in Bangkok, Chiang Mai, and Phuket, Thailand : A contextual perspectiveth
dc.typeTextth
dc.rights.holderNational Institute of Development Administrationth
mods.genreDissertationen
mods.physicalLocationสถาบันบัณฑิตพัฒนบริหารศาสตร์. สำนักบรรณสารการพัฒนาth
thesis.degree.nameDoctor of Philosophyen
thesis.degree.levelDoctoralth
thesis.degree.disciplineDevelopment Administrationth
thesis.degree.grantorNational Institute of Development Administrationth
thesis.degree.departmentคณะรัฐประศาสนศาสตร์th


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