Reaching men who have sex with men in Myanmar: population characteristics, risk and preventive behavior, exposure to health programs.

To estimate risk behavior and HIV program reach among men who have sex with men (MSM) in Myanmar, we conducted cross-sectional surveys in four cities (Yangon, Mandalay, Pathein, Monywa) using respondent-driven sampling (RDS). Prevention response indicators across the cities ranged from 56 to 70 % testing for HIV and receiving results last year, 89-100 % identifying ways of preventing transmission, 50-95 % rejecting misconceptions about HIV, and 82-94 % using a condom at last anal sex. MSM in smaller cities had similar or higher use of programs compared those in larger cities. MSM classified as Ah Chawk Ma (broadly feminine gender presentation) reported having more sex partners, less consistent condom use, and more frequent history of sexually transmitted infections compared to those described as Tha Ngwe (broadly masculine gender presentation). Our behavioral survey data help advocate for appropriate services and form a baseline to gauge future impact of the HIV response for this marginalized population.