HIV Prevention Interventions for Female Sexual Partners of Injection Drug Users in Hanoi, Vietnam: 24-Month Evaluation Results
Abt Associates Inc, 72 Xuan Dieu, Floor 3, Tay Ho District, Hanoi, Vietnam. AIDS and Behavior
(Impact Factor: 3.49).
10/2011; 16(5):1164-72. DOI: 10.1007/s10461-011-0062-4
Vietnam's HIV epidemic is driven by injection drug use. Most IDUs are sexually active and may infect their female sexual partners (SPs). We implemented peer-based HIV prevention interventions for SPs in Hanoi. This paper reports on an evaluation of these interventions based on cross-sectional surveys of SPs. Our data show that this population can be reached, relationships improved, and consistent condom use increased (27% at 24 months up from 16% at 12 months: P = 0.002). Self-reported condom use at last sex was 3.5 times higher among participants in the intervention than among non-participants after controlling for selection bias, indicating a possible intervention effect. However, no significant association was found for consistent condom use in the previous 6 months. Many SPs remain at risk for HIV and interventions must promote a range of HIV prevention strategies including consistent condom use, lower risk sexual activity, and ARV treatment as prevention.
- "The HIV epidemic in Vietnam has been concentrated primarily in persons who use drugs (PWUD) who account for 65% of reported HIV infections, at least 90% of whom are men (FHI, 2010; Hammett et al., 2012; VAAC, 2009). "
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ABSTRACT: It is hypothesized that persons who use drugs (PWUD) in Vietnam who are also HIV-positive may face additional challenges in psychosocial outcomes, and these challenges may extend to their family members. In this study, we examined depressive symptoms, stigma, social support, and caregiver burden of HIV-positive PWUD and their family members, compared to the outcomes of HIV-negative PWUD and their family members. Baseline, 3-month, and 6-month assessment data were gathered from 83 PWUD and 83 family members recruited from four communes in Phú Thọ Province, Vietnam. For PWUD, although we observed a general decline in overall stigma over time for both groups, HIV-positive PWUD consistently reported significantly higher overall stigma for all three periods. Depressive symptoms among family members in both groups declined over time; however, family members of HIV-positive PWUD reported higher depressive symptoms across all three periods. In addition, family members of HIV-positive PWUD reported lower levels of tangible support across all three periods. Caregiver burden among family members of HIV-positive PWUD increased significantly over time, whereas the reported burden among family members of HIV-negative PWUD remained relatively unchanged. The findings highlight the need for future interventions for PWUD and family members, with targeted and culturally specific strategies to focus on the importance of addressing additional stigma experienced by PWUD who are HIV-positive. Such challenges may have direct negative impact on their family members' depressive symptoms, tangible support, and caregiver burden.
Available from: Steffanie A Strathdee
- "In addition, couple-based approaches often have positive effects on sexual communication skills and balancing power within the relationship (Roberts, Mathers, & Degenhardt, 2010). Evidence from a harm reduction program in Vietnam shows that reaching out to female partners of MWID is possible and may be effective in promoting condom use by the couple (Hammett et al., 2012). "
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Women who use drugs, irrespective of whether these are injected or not, are faced with multiple issues which enhance their vulnerability to HIV.
In this commentary, we explore the HIV risks and vulnerabilities of women who use drugs as well as the interventions that have been shown to reduce their susceptibility to HIV infection.
Women who inject drugs are among the most vulnerable to HIV through both unsafe injections and unprotected sex. They are also among the most hidden affected populations, as they are more stigmatized than their male counterparts. Many sell sex to finance their own and their partner's drug habit and often their partner exerts a significant amount of control over their sex work, condom use and injection practices. Women who use drugs all over the world face many different barriers to HIV service access including police harassment, judgmental health personnel and a fear of losing their children.
In order to enable these women to access life-saving services including needle-syringe and condom programs, opioid substitution therapy and HIV testing and treatment, it is essential to create a conducive environment and provide tailor-made services that are adapted to their specific needs.
- "In Asian countries, which place more emphasis on family-oriented culture than Western nations, the link between drug treatment and family support is even more pronounced (Rudolph et al., 2012; Salter et al., 2010). Research has consistently suggested potential benefits for including families in an intervention for a drug-using population (Hammett et al., 2012; Maher et al., 2007). "
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ABSTRACT: The interrelationship between the well-being of injecting drug users (IDUs) and their family environment has been widely documented. However, few intervention programs have addressed the needs of both IDUs and their family members.
This study describes a randomized intervention pilot targeting 83 IDUs and 83 of their family members from four communes in Phú Thọ province, Vietnam. The IDUs and family members in the intervention condition received multiple group sessions, with the intent to improve psychological well-being and family relationships. The intervention outcomes (depressive symptoms and family relations) were evaluated at baseline, 3-month and 6-month follow-up assessments.
Depressive symptoms and family relations reported by IDUs were found to be correlated to those reported by their family members. Overall, significant intervention effects on depressive symptoms and family relations were observed for both IDUs and family members. A similar improvement pattern in family relations emerged for both the IDU and family member samples, although the intervention effect of reducing depressive symptoms was more sustainable for family members at the 6-month assessment when compared to the IDU sample.
The intervention pilot addressed challenges faced by IDUs and their family members and revealed correlated outcomes for the two groups. Findings suggest a vital need to include family members in future drug prevention and harm reduction intervention efforts.
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