STD history, self treatment, and healthcare behaviours among fishermen in the Gulf of Thailand and the Andaman Sea

Objective: Migrant populations are at higher risk for HIV infection. Access to health care and STD treatment is thought to lower this risk. This study aims to examine determinants of STD history and treatment and healthcare behaviours among fishermen in the Gulf of Thailand and the Andaman Sea. Methods: A cross sectional survey of fishermen working on commercial fishing trawlers was conducted in four provinces in Thailand in early 1998. Results: Of the 818 fishermen interviewed, 30% reported a history of STD, of which 31% reported self treatment of the last STD. 32% reported self care for general health while ashore. In multivariate analyses, a history of STD was significantly more often reported by older men compared with younger men, by owners and skippers compared with lower positions on the boat, and by men who have ever visited female sex workers. Self treatment of the last STD was related to being Burmese compared with being Thai, and to working as a steersman or ship hand compared with as a skipper. Self care for general health while ashore was significantly related to being Burmese or Khmer compared with being Thai, and to being unmarried compared with married. Conclusion: Burmese migrant fishermen and their needs should be targeted for culturally specific interventions to increase their understanding of STD treatment and improve their access to health care.