ArticleLiterature Review

Men who have sex with men and HIV in Vietnam: A review

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Abstract

Men who have sex with men (MSM) in Vietnam's urban centers are increasing in numbers and visibility. Although limited to a few surveys, the available data on MSM in Vietnam show that they are at increased risk for HIV infection due to high numbers of sexual partners, high rates of unsafe sex, and inconsistent condom use. There are significant numbers of male sex workers in Vietnam and these men are also at high risk for HIV infection. The lack of data on HIV prevalence among MSM and the fact that the media and public health prevention programs ignore MSM as a population at risk leads many MSM to mistakenly believe that their risk for HIV is low. The low perception of risk, combined with inadequate knowledge, may make MSM less likely to actively protect themselves from HIV infection. More research is needed on current behavior and HIV prevalence among MSM and male sex workers in Vietnam. MSM in Vietnam's larger cities could easily be targeted for prevention using peer educators to decrease their risk for HIV infection.

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... MSM and transgender people in Vietnam face the same unfortunate plight as their international peers-under-represented, stigmatized, at high risks of HIV/STIs, and lacking access to proper healthcare [29][30][31][32][33][34][35][36][37]. The increased HIV infection among the MSM in Vietnam, including the male sex workers, is attributed to the high numbers of sexual partners, high rates of unsafe sex, and inconsistent condom use [32,[38][39][40]. ...
... MSM and transgender people in Vietnam face the same unfortunate plight as their international peers-under-represented, stigmatized, at high risks of HIV/STIs, and lacking access to proper healthcare [29][30][31][32][33][34][35][36][37]. The increased HIV infection among the MSM in Vietnam, including the male sex workers, is attributed to the high numbers of sexual partners, high rates of unsafe sex, and inconsistent condom use [32,[38][39][40]. Additionally, the syndemic condition of psychosocial factors, such as depression and substance use, may disproportionately burden male sex workers and increase their HIV risk [41,42]. ...
... On these grounds, it is important to be aware of this gap of knowledge in order to devise proper solutions and medical services for these groups as well as the gender incongruence population at large. This study contributes to the small body of research on transgender people's health care in Vietnam [29][30][31][32][33][34][35][36][37] by explaining the shortcomings of Vietnamese healthcare professionals in this matter. It invites other low-and middle-income countries to join the discussion on better ways to respond to the MSM and transgender communities. ...
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Protecting the rights of the lesbians, gays, bisexuals, transgender, intersex, and queers (LGBTIQ) population requires, first and foremost, a proper understanding of their sexual orientation and gender identity. This study highlights a severe misunderstanding and lack of knowledge among health professionals in Vietnam with regard to the men who have sex with men (MSM) and transgenders. This study uses (i) a survey based on the convenience sampling method among 150 health workers that covered 61 questions and (ii) 12 in-depth interviews in two metropolitan centres in Vietnam, Hanoi and Ho Chi Minh city. Three main topics are explored: (i) the general knowledge of healthcare workers about MSM and transgenders; (ii) their knowledge about the sexual reproductive health and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) risks of MSM and transgenders; and (iii) their attitudes and behaviors towards MSM and transgenders. One of the notable findings is how prevalent the misperceptions are across the board, namely, in staff of both sexes, in both cities, at various kinds of medical facilities, at different work positions and educational levels. Half of the respondents consider transgenders to have a curable mental problem while 45% say MSM only have sex with males. Most remarkably, 12.7% state if they have any choice, they want nothing to do with MSM and transgenders. The study finds there is a considerable percentage of health professionals who lack knowledge about the diversity of sexual orientation, gender identity, and health issues related to the sexual minorities and gender non-conforming population. To improve the clinical process for serving these at-risk groups, the study suggests the continual education for the health workers needs to be added to their formal as well as in-job training.
... The term 'social evil' (tệ nạn xã hội) was part of a governmental campaign in the 1990s against such 'immoral practices' as prostitution, drug use or gambling (Blanc 2005;Horton 2014). Having been portrayed as a high risk behaviour associated with the spread of HIV infection in Vietnam, homosexuality was labelled as a social evil (Blanc 2005;Colby et al. 2004;Horton 2014;UNDP and USAID 2014). It is widely believed that homosexuality is 'unreal', and those who self-identify as lesbian or gay are merely following a passing trend (Blanc 2005;Colby et al. 2004;ISEE 2011b). ...
... Having been portrayed as a high risk behaviour associated with the spread of HIV infection in Vietnam, homosexuality was labelled as a social evil (Blanc 2005;Colby et al. 2004;Horton 2014;UNDP and USAID 2014). It is widely believed that homosexuality is 'unreal', and those who self-identify as lesbian or gay are merely following a passing trend (Blanc 2005;Colby et al. 2004;ISEE 2011b). Thus, people who identify as lesbian or gay would eventually return to a heterosexual lifestyle perhaps with the benefit of proper education and treatment (Blanc 2005;Colby et al. 2004). ...
... It is widely believed that homosexuality is 'unreal', and those who self-identify as lesbian or gay are merely following a passing trend (Blanc 2005;Colby et al. 2004;ISEE 2011b). Thus, people who identify as lesbian or gay would eventually return to a heterosexual lifestyle perhaps with the benefit of proper education and treatment (Blanc 2005;Colby et al. 2004). Another popular belief among Vietnamese people is that homosexuality is a disease which could be transmitted through association and contact with sexual minority individuals (Le and Nguyen 2016). ...
Article
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This paper examines the ideological and philosophical underpinnings of attitudes toward sexual minorities in Vietnamese society. The analysis focuses on the so-called ‘Three Teachings’ (Tam giáo) consisting of Confucianism, Taoism and Buddhism which are widely regarded as the most influential philosophies that shape Vietnamese culture and society. It is argued that these ideologies and philosophies engender systems of thought that resonate with how Vietnamese people think about and act toward sexual minorities. The article concludes with implications for research and practice in advancing the rights of sexual minorities in contexts bearing such influences.
... MSM face increased vulnerability to HIV infection and challenges in the HIV care continuum due to a combination of biological, behavioral, social and structural factors [6]. For instance, stigma, discrimination and societal-and health care-level homophobia are associated with increased sexual risk behaviors, such as unprotected anal intercourse, and poorer access to community social support and health services [7,8]. These factors are in turn associated with higher rates of HIV infection and decreased rates of HIV testing [8,9]. ...
... For instance, stigma, discrimination and societal-and health care-level homophobia are associated with increased sexual risk behaviors, such as unprotected anal intercourse, and poorer access to community social support and health services [7,8]. These factors are in turn associated with higher rates of HIV infection and decreased rates of HIV testing [8,9]. In the last 5 years, more Vietnamese MSM are openly displaying their sexual identities in urban settings due to rapid globalization, spread of LGBT rights movements, and shifting attitudes towards acceptance of Abstract Many men who have sex with men (MSM) in low and middle income countries search for male sexual partners via social media in part due to societal stigma and discrimination, yet little is known about the sexual risk profiles of MSM social media users. ...
... and have more than ten lifetime male sexual partners (aOR 3.2; 95% CI 1.3-7.6) compared to those who did 1 3 homosexuality [8]. Despite this progress, stigma and discrimination remain pervasive in Hanoi and public spaces where MSM can congregate and find sexual partners are still limited as compared to Ho Chi Minh City in the southern Vietnam or other cities in Southeast Asia [8,10]. ...
Article
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Many men who have sex with men (MSM) in low and middle income countries search for male sexual partners via social media in part due to societal stigma and discrimination, yet little is known about the sexual risk profiles of MSM social media users. This cross-sectional study investigates the prevalence of social media use to find male sex partners in Hanoi, Vietnam and examines associations between social media use and sociodemographic and behavioral characteristics, including levels of internalized, perceived and enacted stigma, high-risk sexual behaviors, and HIV testing. 205 MSM were recruited from public venues where MSM congregate as well as through snowball sampling and completed an anonymous survey. MSM who found their male sexual partners using social media in the last year were more likely to have completed a university or higher degree (aOR 2.6; 95% CI 1.2–5.7), experience high levels of MSM-related perceived stigma (aOR 3.0; 95% CI 1.1–8.0), and have more than ten lifetime male sexual partners (aOR 3.2; 95% CI 1.3–7.6) compared to those who did not use social media. A niche for social media-based interventions integrating health and stigma-reduction strategies exists in HIV prevention programs for MSM.
... Since 1999, HIV has been reported in all provinces and cities of Vietnam (2). Although men who have sex with men (MSM) have been recognized as a key population affected by HIV in different parts of the world (3), in Vietnam, they were only identified as a priority population for HIV prevention in the last decade (4), despite warning signs in the early 2000s that HIV was spreading in this population (5,6). ...
... Previous studies have found that HIV infection among MSM in Vietnam is associated with younger age, lower education and injecting drug use (7,11), a higher number of recent sexual partners (5,7), and sex work and inconsistent condom use (5). MSM in Vietnam have consistently reported low levels of condom use with casual and regular male partners (8,9). ...
... Previous studies have found that HIV infection among MSM in Vietnam is associated with younger age, lower education and injecting drug use (7,11), a higher number of recent sexual partners (5,7), and sex work and inconsistent condom use (5). MSM in Vietnam have consistently reported low levels of condom use with casual and regular male partners (8,9). ...
Article
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Introduction Men who have sex with men (MSM) are a key population for HIV infection in Vietnam, and the use of amphetamine type substances (ATS) is prevalent and possibly increasing in this population. The reported analysis examines the association between ATS use before or during sex and HIV infection among MSM in Hanoi, Vietnam. Methods This cross-sectional study of 210 MSM was conducted in Hanoi, Vietnam, in late 2014. Men tested for HIV and answered questions about demographic characteristics, sexual sensation seeking, depression, belief in HIV prevention strategies, homosexuality-related stigma and discrimination, recent accessing of HIV prevention services, sexual behaviors and ATS, and other drug use behaviors. We performed logistic regression to assess correlates of HIV infection. Results HIV prevalence was 6.7% (14/210), and 85.7% (12/14) of HIV-positive men were not aware of their HIV status. Of the 210 participants, 10.5, 2.9, and 3.8% of men had used methamphetamine, amphetamine, and ecstasy before or during sex in the last 3 months. In multivariable analysis, HIV infection was associated with recent sex-related methamphetamine use [adjusted odds ratio (AOR): 5.03, 95% confidence interval (CI): 1.35–18.68], engaging in recent sex work (AOR: 3.55, 95% CI: 1.07–11.75), and homosexuality-related perceived stigma (AOR: 2.32, 95% CI: 0.98–5.47). Conclusion Findings underscore the importance of integrating methamphetamine use interventions into HIV prevention services and scaling-up of gay-friendly, non-stigmatizing HIV testing services for MSM in Hanoi. We recommend the routine assessment of ATS use and undiagnosed infection in this population.
... Vietnamese MSM continue to engage in sexual behaviors such as transactional sex and inconsistent condom use that put them at risk for HIV and sexually transmitted infections (STIs) (Bengtsson, Lu, Liljeros, Thanh, & Thorson, 2014;Colby, Cao, & Doussantousse, 2004;Colby, Minh, & Toan, 2008;Nguyen, Nguyen, Le, & Detels, 2008). Studies have also shown that this population has limited awareness of HIV transmission risk Vian, Semrau, Hamer, Loan le, & Sabin, 2012). ...
... Stigmatization and discriminatory practices by health care workers have been shown to hamper access to existing services for MSM(Mimiagaetal.,2013).Limitedawarenessandstigmaaround same-sex sexual behavior has likely contributed to the relatively slow HIV prevention response by managers and policy makers (UNGASS, 2014). While peer educators have been useful sources of condoms and HIV-related information (Colby et al., 2004;Mimiaga et al., 2013;Oldenburg et al., 2014a), to date, there are no evidenced-based behavioral interventions to reduce sexual risk among MSM in Vietnam. To address this need, through extensive formative research (Biello et al., 2013;Closson, Colby, Cohen,Biello, & Mimiaga,2015;Mimiaga etal.,2013), ...
... These included age, education, monthly income, hometown, religion, sexuality identity, and sexual attraction. Questions were based on those from previous studies among Vietnamese MSM (Biello et al., 2013;Colby et al., 2004Colby et al., , 2008Justumusetal.,2013;Mimiaga et al., 2013;Oldenburg et al., 2014a, b). ...
Article
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An emerging HIV epidemic can be seen among men who have sex with men (MSM) in Vietnam. There are currently no evidence-based behavioral sexual risk reduction interventions for MSM in this setting. Between October 2012 and June 2013, 100 high-risk MSM from Ho Chi Minh City were enrolled in an open pilot trial to assess feasibility and acceptability of a group-based, manualized sexual risk reduction intervention, and to preliminarily examine changes in primary and secondary outcomes. Participants completed a behavioral assessment battery and HIV testing at baseline, 3, and 6 months post-baseline. Over 80.0 % of the sample was <25 years old and 77.0 % identified as Bong kin ("hidden," masculine-appearing). Feasibility and acceptability of the program was evidenced by 87.0 % retention for the intervention sessions, 78.0 % completion of the 6 month assessment, and positive responses on evaluation forms and qualitative exit interviews. There was a decline in the number of condomless anal sex acts from baseline (6.32) to 3 month (2.06) and 6 month (2.49) follow-up (p < .0001). These data support the need for further testing of this group-based, behavioral HIV prevention intervention to reduce sexual risk behavior among MSM in Vietnam in a randomized controlled efficacy trial.
... It seems that the attempted marriage registration set in motion the wheels of the judiciary and led to the Marriage and Family Law being amended to explicitly forbid same-sex marriage (Khuat, Le, and Nguyen 2009; National Assembly of the Socialist Republic of Viet Nam 1986, 2000. Prior to the 2000 Marriage and Family Law, homosexuality had not been incorporated into any of the civil, penal or familial laws of Vietnam (Colby, Cao, and Doussantousse 2004;Khuat, Le, and Nguyen 2009;Newton 2012). By amending the Marriage and Family Law to explicitly forbid same-sex marriage, the National Assembly institutionalised a heterosexist cultural norm and denied parity of participation to non-heterosexuals (Fraser 2001). ...
... Social evils were said to pose a threat to Vietnam's otherwise 'beautiful traditions and customs', and participation in social evils was believed to demonstrate polluted morality (Nguyen-vo 2008, 45). The label social evil has since been used to categorise a vast array of social practices, including sex work, drug use, gambling, and homosexuality, and has been used as a flexible tool for governing the populace (Colby, Cao, and Doussantousse 2004;Horton and Rydstrom 2011;Koh 2001;Newton 2012;Nguyen-vo 2008;Vijeyarasa 2010). ...
... The first reported case of HIV in Vietnam in 1990 caused concern about HIV and AIDS, and in 2000 HIV programmes began focusing on men who have sex with men as a high-risk group (Ha and Fisher 2011;Hong, Van Anh, and Ogden 2004;Van Tuan 2010). In doing so, they inadvertently contributed to developing views of homosexuality as a form of social disease to be countered (Blanc 2005;Colby, Cao, and Doussantousse 2004;Khuat, Le, and Nguyen 2009). More recently, increasing international focus has been placed on Vietnam's stance on homosexuality and discussions of homosexuality have shifted from one of sexual health to one of sexual rights. ...
Article
While recent LGBT rights demonstrations and discussions about same-sex marriage have thrust the issue of homosexuality into the spotlight, it was not long ago that the issue of homosexuality was notable by its absence in Vietnam. Drawing on semi-structured interviews with young gay, lesbian and bisexual people in Vietnam's capital city Hanoi, this paper considers the increasing visibility of homosexuality through the theoretical lens of recognition, and illustrates the heterosexist misrecognition that LGBT young people have been subjected to in legislation, the media, their families, and through the education system. Drawing on the narratives of LGBT young people, the paper highlights the potentially negative impact such misrecognition may have on psychological and social wellbeing.
... These performances of 'intimate citizenship' (Plummer 2001), or negotiations of the numerous layers of sexual lives in society are complex negotiations between the personal and the political (Cossman 2002;Hanisch 1969;Yue and Zubillaga-Pow 2012). Such processes are rendered an additional layer of complexity when concerns of sexual health-notably HIV-are involved (Colby et al. 2004). ...
... The major focus of the moral panic is 'folk evil' (Cohen 2002) which in Vietnam corresponds to the concept of 'social evil'. 4 'Social evil' was used to label high-risk groups such as drug users, sex workers and men who have sex with men (Colby et al. 2004). Due to the understanding of LGBT as mentioned above, LGBT practices were also considered to be social evils and the fear of this 'trend' has spread. ...
Chapter
In the age of the ever-expanding Internet, peer engagement encouraged youths to mutually become spokespersons for one another amidst the slew of cultural rhetoric and are responsible for defining identities and subjective norms through the now electronic word-of-mouth. Initially, there existed a conundrum of what qualifies as a Muslim woman in Malaysia through the use of the hijab, or ‘veiling’ oneself with a headscarf—considering that by virtue, the dominating and vast majority of Malay women of the population are born into Islam
... Introduction research has highlighted high levels of vulnerability to HIV among men who have sex with men, largely due to sexual risk taking behaviours and low rates of HIV testing (Colby, Cao, and Doussantousse 2004;Nguyen et al. 2008;Sarraf 2010;Pham et al. 2012;Garcia et al. 2014). Research has also documented elevated risk behaviours among transgender women 1 in Vietnam (Pham et al. 2012;Vu et al. 2016;Clatts et al. 2016). ...
... This is a point worth emphasising, given that the HIV epidemiological categories in current use internationally (i.e. MSM and, increasingly, transgender women) have shown themselves to be largely inadequate in terms of guiding effective prevention programming and intervention (Colby, Cao, and Doussantousse 2004;Nguyen et al. 2008;Sarraf 2010;Pham et al. 2012;Garcia et al. 2014). ...
Article
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In Vietnam, HIV continues disproportionately to affect men who have sex with men and transgender women, and the increase in HIV prevalence in these populations may be related to a lack of tailoring of current prevention approaches, which often fail to address social diversity within these populations. To effectively respond to HIV in Vietnam, it is imperative to identify sub-populations within the broad category of ‘men who have sex with men’ (MSM), a term which in Vietnam as in many other sites frequently subsumes transgender women. In this paper, we document the different categories used to describe people who engage in same-sex sexual practices and/or non-normative gender performances drawing on data collected via in-depth interviews and focus groups with a total of 79 participants in Hanoi. We identified over 40 different categories used to describe men who have sex with men and/or transgender women. These categories could be described as behaviourally-based, identity-based, or emic, and each carried different meanings, uses (based on age and geography) and levels of stigma. The categories shine light on the complexity of identities among men who have sex with men and transgender women and have utility for future research and programming to more comprehensively address HIV in Vietnam.
... Not unlike governments in other contexts (see, for example, Dalacoura, 2014;Graff, 2010), the Vietnamese government became concerned about a number of cultural flows into Vietnam and their potential effects, in terms of what were deemed social evils (Horton, 2014;Khuat et al., 2009;Nguyen, 2016;Rydstrom, 2006Rydstrom, , 2010. Over the years, the label social evil has been applied by the government, in public discourse, and by citizens, to categorize a wide range of social practices deemed damaging for Vietnamese society and tradition, such as domestic violence, drug use, gambling, plagiarism, sex work, sexually transmitted diseases, and even homosexuality (Colby et al., 2004;Fewston, 2012;Horton & Rydstrom, 2011;Newton, 2012;Nguyen-vo, 2008;Pastoetter, 2004;Rydstrom, 2016;Vijeyarasa, 2010). ...
... Vietnam's first reported case of HIV in Ho Chi Minh City in 1990 served to reinforce the belief that social evils were a threat to traditional Vietnamese values and, in response, the government initiated a campaign to eliminate social evils in 1995 (Horton et al., 2015;Ngo et al., 2007;Vijeyarasa, 2010). Much of the focus of the subsequent HIV work was placed on men who have sex with men (MSM), a group that was seen to be particularly vulnerable to the HIV epidemic (Blanc, 2005;Colby et al., 2004;Khuat et al., 2009;UNDP & USAID, 2014). The linking of MSM with the HIV epidemic increased the risk of stigma for men engaging in same-sex relations and some organizations working with HIV issues focused their efforts on reducing stigma amongst those men (Khuat & Nguyen, 2010). ...
Article
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Although Vietnamese society is currently undergoing significant changes with regards to the rights and perceptions of gay, lesbian, bisexual, transgender, and queer (GLBTQ) people, dominant socio-cultural norms related to gender, sexuality, and the importance of the patrilineal family regime continue to cast a shadow over the lives of GLBTQ in contemporary Vietnam. Based on ethnographic fieldwork conducted in the urban centers of Hanoi and Ho Chi Minh City, as well as legal documents and secondary sources, this article illustrates how dominant heteronormative socio-cultural norms have contributed to the political, legal, and social exclusion of same-sex sexualities through a process of outlawing, whereby GLBTQ have been systematically excluded from the rights of law. Drawing on qualitative interviews with gay men and lesbian women between the ages of 20 and 50, the article also highlights how this relation of domination has allowed for instances of GLBTQ resistance, through subversive opposition, strategies of avoidance, and the seeking out of new opportunities in urban spaces outside the dominant sociality. The article thus provides a qualitatively nuanced account of family politics and GLBTQ resistance in urban Vietnam at a significant socio-political historical juncture.
... According to research, there is variation in what men engaging in sex with men know about HIV infection, HIV transmission and AIDS. This variation is also seen between studies, and whilst some studies have demonstrated a low level of knowledge [9], others report a good level of knowledge [10]. Even though people may be well informed about HIV infections, less may be known about its associated diseases. ...
... By and large the respondents showed a good awareness of HIV infection and sexually transmitted diseases. This corresponds with the findings of earlier research data [10], but contradictory studies also report that little is known [9]. There have been earlier connections drawn between the respondents' age and the size of their place of residence and, relating to those who live in cramped/shared accommodation but no extensive study has previously been carried out in Finland. ...
Article
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Background The purpose of this study was to describe what is known about HIV infection and other sexually transmitted diseases, infection transmission routes, care, and sources of information, from the viewpoint of men having sex with men. Methods National data (n = 2,072) was collected from June to August 2010 in Finland as part of a joint internet-based survey conducted in 38 countries (EMIS, European MSM Internet Sex Survey). ResultsThe respondents’ age, place of residence, highest education and employment status were statistically significantly related to how often the respondent sought information on HIV, testing and treatments, and what they knew about infection transmission routes. The respondents’ information seeking behavior was not seen as active regarding HIV infection and other sexually transmitted diseases. Conclusions We should also consider the possibility of using internet-based interventions, especially in smaller and northern catchment areas, in order to improve the knowledge level of men having sex with men.
... Vietnam is disproportionately affected by the HIV epidemic amongst countries in Southeast Asia (Colby and Cao 2004;Rao et al. 2010;Garcia et al. 2012). The HIV epidemic in Vietnam is concentrated in high-risk populations, including injection drug users, male and female sex workers, and men who have sex with men (MSM) (Hoang et al. 2006;Hoang et al. 2009). ...
... In addition to stigma related to sex work, homosexuality is stigmatized in Vietnam, although particularly in urban areas this may be decreasing (Colby and Cao 2004;Blanc 2005;Berry et al. 2013). In this study, disclosure of sexual orientation to healthcare workers was significantly associated with increased sex-work related stigma. ...
Article
Objectives: Male sex workers (MSW) in Vietnam face high levels of stigma related to sex work, which may be associated with depression and increased vulnerability to HIV. Methods: In 2010, 300 MSW completed a behavioral and psychosocial survey. Multivariable models assessed factors associated with sex work-related stigma and the association between stigma and depression. Results: Factors associated with increased stigma included having disclosed sexual orientation to healthcare workers (b 1.75, 95 % CI 0.69-2.80), meeting clients in the street/park (b 1.42, 95 % CI 0.32-2.52), and having been forced to have sex without a condom (b 2.36, 95 % CI 1.27-3.45). Factors associated with decreased stigma included meeting clients via the telephone or internet (b -1.26, 95 % CI -2.39 to -0.12) and receiving financial support from family or friends (b -1.31, 95 % CI -2.46 to -0.17). Stigma was significantly associated with increased odds of depression (AOR 1.07, 95 % CI 1.01-1.15). Conclusions: Addressing stigma and depression in HIV prevention interventions is crucial for tailoring these programs to MSWs' needs, and may result in decreased HIV spread.
... Hence, a 'social evils' campaign was launched in 1995 to combat vices (Aronson 1999;Rydstrom 2006;Vijeyarasa 2010). HIV/AIDS and men who have sex with men (MSM), a group identified as high-risk for HIV/AIDS transmission, were condemned and chief targets of the campaign (Blanc 2005;Colby, Cao and Doussantousse 2004;Khuất and Nguyễn 2010). ...
... Since the emergence of HIV/AIDS, Vietnamese men who have sex with men (MSM) have received attention from numerous scholars; however, most work examines their sex and sexuality only from a public health and at-risk perspective (Colby et al., 2004;Garcia et al., 2012). There is a lack of research exploring how they negotiate their life within a society framed by notions of dominant masculinity, homophobia, and body image. ...
Article
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In recent years, men and masculinities in Southeast Asia has begun to receive more attention from scholars as the result of increasing attention to intersections of race, gender space, colonialism, and place in countries such as Vietnam. This article provides an overview of current research on men and masculinities in Vietnam. It finds research on Vietnamese masculinities is predominantly understood through (i) concepts of Confucianism, with a particular focus on traditional ideas about gender and gender relations in kinship structures; (ii) considerations of Vietnamese masculinities post Đổi Mới (Renovation) and the impact of women's engagement in the labor market; and (iii) a focus on men as “at risk” or vulnerable, including a focus on alcohol consumption and engagement in domestic violence. We highlight limited focus in areas of sexuality and sexual practices, reflexive engagements with concepts of masculinity, focus on men residing in urban centres, considerations of bodywork and body project practices, and an overall Western approach to the study of masculinity in Vietnam. We conclude with a call for further research on men and masculinities in Vietnam framed through postcolonial epistemologies and research methodologies.
... The major focus of the moral panic is 'folk evil' (Cohen 2002) which in Vietnam corresponds to the concept of 'social evil'. 4 'Social evil' was used to label high-risk groups such as drug users, sex workers and men who have sex with men (Colby et al. 2004). Due to the understanding of LGBT as mentioned above, LGBT practices were also considered to be social evils and the fear of this 'trend' has spread. ...
Chapter
Full-text available
Meezan and Martin (Research Methods with Gay, Lesbian, Bisexual, and Transgender Populations, Routledge, New York, 2012, p. xx) call for researchers on LGBT issues to focus ‘less on why people are LGBT, and more on how LGBT people live their lives’.
... 6 Qualitative and quantitative surveys have found that MSM in Vietnam engage in high-risk sexual behaviors, including low condom use and sex with multiple partners, but that few use drugs. [6][7][8] HIV prevalence among MSM is estimated to be about 7%, compared to 10% among people who inject drugs (PWID) and 2% among female sex workers (FSWs); the overall prevalence of HIV among MSM is expected to increase as is the proportion of all new infections in Vietnam that are attributed to MSM. 9 HIV sentinel surveillance shows that HIV prevalence is very high in HCMC (up to 17% in 2017) and is increasing among MSM in the last 5 years in Vietnam (from 6.7% in 2014 to 11.4% in 2018). ...
Article
Vietnam has been conducting HIV/sexually transmitted infection (STI) integrated bio-behavioral surveillance surveys on men who have sex with men (MSM) as well as other key populations since 2005. Although HIV prevalence in the Vietnamese general population remains below 1%, it is expected to be much higher among MSM. Data on HIV prevalence and sexual and drug use behaviors were collected from MSM in Ho Chi Minh City (HCMC) in 2006 (n = 397), 2009 (n = 399) and 2013 (n = 350) using respondent-driven sampling. Eligible participants were males, aged ≥15 years who reported having manual, oral, or anal sexual activity with males in the past year and lived, worked or socialized in HCMC. HIV seroprevalence among MSM was 5.8% in 2006, 16.1% in 2009 and 12.1% in 2013 and prevalence of at least one STI (syphilis, gonorrhea and/or chlamydia infection) was 11.4% in 2006 and 15.6% in 2009 (no data for 2013). Significant, but small, increasing trends were found for MSM who reported ever testing and receiving results for HIV and for HIV prevalence. No significant changes for condom use, injecting and non-injecting drug use, or and receipt of free condoms were observed. Although a small percentage of MSM reported injecting drugs, HIV was positively associated with ever injecting drugs. Programs targeting MSM should include screening and treatment for injection drug use to most effectively control the HIV/AIDS epidemic among MSM in HCMC.
... Although the study was open for all types of sex workers above the age of 18, the study's participants were primarily female sex workers. Male sex workers have been found in the literature to be more marginalised and to experience higher levels of stigma (Colby, Cao and Doussantousse 2004), thus future studies could seek to include them. Younger sex workers (below the age of 18) were also not included due to ethical considerations; however, these sex workers may also have different experiences. ...
Article
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Sex workers are among the most stigmatised people globally, with sex workers in Vietnam being no exception. Self-stigma affects sex workers adversely, harming psychological health and acting as a barrier to seeking health care. To inform programmes and interventions to improve well-being, identifying unhelpful or negative core beliefs may provide the basis from which individuals can be supported. With this in mind, this study aimed to gain the perspective of sex workers in Vietnam on the contexts of their working lives. Data were collected in Hanoi. Fourteen semi-structured interviews were conducted with Vietnamese sex workers over the age of 18 who were working or formerly worked in Vietnam. Data were analysed manually, informed by theoretical models of self-stigma using inductive thematic analysis. The analysis identified negative/unhelpful core beliefs (disclosure, self-stigma and shame, sexuality, sexual pleasure relationships, health care); contextual life circumstances (sex work, violence, traditional education); and coping mechanisms (problem-focused coping, emotion-focused coping). Findings identify the importance of core beliefs in understanding self-stigma, paving the way for programmes and interventions to address self-stigma among sex workers.
... The national estimate of MSM population size in Viet Nam has not been based on any empirical method of estimation. A frequently used method to approximate the range of MSM population is to take a percentage of the male population as being MSM, based on regional percentages and consensus among experts, and adjusted for by the level of urbanization [10][11][12] This study used the social app multiplier method to estimate the population size of MSM in 12 provinces of Viet Nam. This method was piloted in Ho Chi Minh City and Nghe An province in 2016, and subsequently updated and improved based on learnings from the pilot study [9]. ...
Article
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Background: Although the prevalence of HIV among men who have sex with men (MSM) in Vietnam has been increasing in recent years, there are no estimates of the population size of MSM based on tested empirical methods. Objective: This study aimed to estimate the size of the MSM population in 12 provinces in Vietnam and extrapolate from those areas to generate a national population estimate of MSM. A secondary aim of this study was to compare the feasibility of obtaining the number of users of a mobile social (chat and dating) app for MSM using 3 different approaches. Methods: This study used the social app multiplier method to estimate the size of MSM populations in 12 provinces using the count of users on a social app popular with MSM in Vietnam as the first data source and a questionnaire propagated through the MSM community using respondent-driven sampling as the second data source. A national estimation of the MSM population is extrapolated from the results in the study provinces, and the percentage of MSM reachable through online social networks is clarified. Results: The highest MSM population size among the 12 provinces is estimated in Hanoi and the lowest is estimated in Binh Dinh. On average, 37% of MSM in the provinces surveyed had used the social app Jack'd in the last 30 days (95% CI 27-48). Extrapolation of the results from the study provinces with reliable estimations results in an estimated national population of 178,000 MSM (95% CI 122,000-512,000) aged 15 to 49 years in Vietnam. The percentage of MSM among adult males aged 15 to 49 years in Vietnam is 0.68% (95% CI 0.46-1.95). Conclusions: This study is the first attempt to empirically estimate the population of MSM in Vietnam and highlights the feasibility of reaching a large proportion of MSM through a social app. The estimation reported in this study is within the bounds suggested by the Joint United Nations Programme on HIV/AIDS. This study provides valuable information on MSM population sizes in provinces where reliable estimates were obtained, which they can begin to work with in program planning and resource allocation.
... The national estimate of MSM population size in Viet Nam has not been based on any empirical method of estimation. A frequently used method to approximate the range of MSM population is to take a percentage of the male population as being MSM, based on regional percentages and consensus among experts, and adjusted for by the level of urbanization [10][11][12]. In Viet Nam, the accepted MSM population size is concluded on by the national technical working group, which updates the epidemiological model for the country and revises the expected MSM population size, among other input values to the model, until it produces a validated epidemiological prediction. ...
Preprint
BACKGROUND While the prevalence of HIV among men who have sex with men (MSM) in Viet Nam has been increasing in recent years, there are no estimates of the population size of MSM based on tested empirical methods. OBJECTIVE This study attempts to estimate the size of the MSM population in 12 provinces in Viet Nam and extrapolate from those areas to generate a national population estimate of MSM. A secondary aim of this study is to compare the feasibility of obtaining the number of users of a social app for MSM, using three different approaches. METHODS This study uses the social app multiplier method to estimate the size of MSM populations in 12 provinces, using the count of users on a social app popular with MSM in Viet Nam as the first data source, and a questionnaire propagated through the MSM community using respondent driven sampling as the second data source. A national estimation of MSM population is extrapolated from the results in the 12 provinces and the percentage of MSM reachable through online social networks is clarified. RESULTS The highest MSM population size among the 12 provinces is estimated in Hanoi and the lowest is estimated in Binh Dinh. On average 27.7% of MSM in provinces surveyed had used the social app Jack’D in the last 30 days, (95% CI: 17.6-37.7). Extrapolation of the results from the 12 provinces results in an estimated national population of 174,944 MSM (95% CI: 120,631–523,233) in Viet Nam. The percentage of MSM among adult males 15-49 in Viet Nam is 0.67% (95% CI: 0.46–1.99). CONCLUSIONS This study is the first attempt to empirically estimate the population of MSM in Viet Nam, and highlights the feasibility of reaching a large proportion of MSM through a social app. The estimation reported in this study is lower than the estimated number of MSM in Viet Nam arrived at by profiling of urbanization of regions and modelling process. This study recommends that the updated estimation of the MSM population size be used to inform program planning and policy decision-making.
... Literature on homosexuality in Vietnam was limited before the 1990s until HIV began to be regarded as a public health problem (Colby, Cao, & Doussantousse, 2004). Traditionally, Vietnamese society did not accept or recognize the role of homosexual men, as opposed to other Southeast Asian countries like Thailand or Lao where there is a long tradition of accepting "effeminate men" (kathoey) even though their role is highly stigmatized (Chan et al., 1998). ...
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This paper examines the perceived barriers to general and sexual health care services and hormone use among 70 transgender women in five cities of Vietnam. Findings showed a range of barriers to health care access among transgender women, including stigma and discrimination at medical settings, limited use of health insurance, increased risk of HIV infection, and problematic hormone use, notably hormone self-medication and the practice of needle sharing. Insensitivity and lack of understanding towards transgender health among health care providers also prevented transgender women from attaining proper care and treatment. Our study then suggests further research on hormone use, and calls for the integration of related content in education and communication programs, and public health interventions. The conduct of needs assessment among health care staff at both public and private settings so as to better deliver trans-focused and trans-friendly care is also recommended.
... Since the early 2000s, there have been warning signs of HIV spreading among MSM in Vietnam [7]. An early study of MSM in Ho Chi Minh City pointed out that MSM who engaged in a number of risky sexual behaviors, such as condomless anal intercourse (CAI) and having multiple sexual partners, had inaccurate knowledge about HIV prevention and transmission [8]. ...
... Since that time, the prevalence rate among MSM has increased rapidly, from an initial estimate of 3.7% to a current estimate of 16% [1]. Epidemiological studies also show high rates of HIV risk among MSM in Vietnam, including among Male Sex Workers (MSWs) [2][3][4][5][6][7]. ...
Article
Abstract Background: HIV prevalence in urban populations of Men who have Sex with Men (MSM) in Vietnam has increased sharply in recent years. Owing to the confuence of both complex sexual partnering and high risk sexual practices, Male Sex Workers (MSW) are at especially high risk for both acquisition and transmission of HIV and other STIs. Methods: We developed, implemented and evaluated a Sexual Health Promotion intervention to engage MSW in health services (including routine testing for STIs and HIV). We implemented the intervention among MSW in Hanoi and Ho Chi Minh City, Vietnam, including pre- and post-intervention assessments of STI/HIV knowledge (n=200). Results: Overall, STI/HIV knowledge increased by 17.3% (p<0.001). All groups of participants showed improved STI/HIV knowledge following the intervention. However, those with the lowest knowledge scores at pre-intervention showed the greatest gains at post-test, so much so that between group disparities in STI/HIV knowledge at pre-test were eliminated following the intervention. Conclusion: Sexual Health Promotion is a promising intervention for increasing STI/HIV knowledge in MSW, and reducing knowledge disparities in this vulnerable population.
... Ministry also asked the government to label homosexual sex as social evil as well, although no action was taken (Colby, et al, 2004). Treating the epidemic among MARPs is key to addressing HIV/AIDS in Vietnam, yet it is difficult for the government to engage constructively with these groups. ...
Article
The impact of international donor arrival on local civil society organizations (CSOs) is well researched. Less understood is how local CSOs react and adapt to donor withdrawal. This article explores this phenomenon in the context of the HIV/AIDS sector in Vietnam. Using data from government, donor, and CSO sources in Vietnam, it examines how current and planned cuts in donor funding, including donor exit, impact local CSO agency and effectiveness. It finds that while donor withdrawal may reduce CSO capacity and independence, it can also prompt local innovations that – if successful – may improve CSOs’ responsiveness to local stakeholders. This article is protected by copyright. All rights reserved.
... Total (N=904) 2 n (%) they are stigmatised and we relied on patient self-report in a survey conducted by clinic staff. Similar to HIV epidemics in other countries, MSM in HCMC constitute both an increasing proportion of new HIV transmissions and a long-underserved population34353637383940. Compared to PWID, MSM in HCMC were significantly more likely to have been recently diagnosed with HIV, suggesting a shifting trend in HIV transmission in HCMC from injection drug use to homosexual sex. ...
Article
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Background: Limited data are available on factors associated with HIV-RNA viral load (VL) among antiretroviral treatment (ART)-naïve key populations in concentrated epidemics. Methods: We conducted a cross-sectional survey of 1211 adult ART-naïve patients at 19 HIV clinics in Ho Chi Minh City (HCMC), Vietnam. Data collection included a standardised questionnaire, routine laboratory testing, hepatitis serology and HIV VL. Correlation between CD4 cell count and VL was assessed across all participants. In 904 participants not meeting Vietnam criteria for ART (CD4 cell count >350 cells/mm(3), WHO clinical stage 1 or 2 and not pregnant), multivariate analyses were conducted to assess factors associated with HIV VL. Results: Pre-ART patients had a median age of 31 years and 54% were male. Median CD4 cell count was 533 cells/mm(3). Median HIV VL was 17,378 copies/mL; 60% had VL greater than 10,000 copies/mL and 16% had VL above 100,000 copies/mL. Although declining CD4 cell count was correlated with rising VL across all CD4 cell counts, correlation of VL with CD4 cell counts between 351 and 500 cell/mm(3) was not significant. On multivariate linear regression, higher HIV VL was independently associated with male sex, men who have sex with men (MSM), CD4 cell count 351-500, HIV diagnosis within the previous 6 months, and hepatitis B (HBV). Lower HIV VL was independently associated with hepatitis C (HCV). Conclusions: The majority of HIV patients who were not eligible for ART in HCMC in 2014 had HIV VL greater than 10,000 copies/mL. These data support expanded eligibility of ART to all HIV patients with the goal of treatment as prevention. This study is also among the first to demonstrate that MSM had a higher VL than women and heterosexual men and highlights the need for improved outreach and linkages to HIV care for this high-risk group.
... It is evident that the practise of unprotected sex is underlined by a dynamic interplay between sex workers and clients. Similar attitudes and condom practises have previously been documented (Colby et al. 2004;Kalichman et al. 2007;Parry et al. 2008). Key factors are: power relations; notions of trust; sexual pleasure; alcohol and drug use; and a belief that male-to-male sex has low risks of HIV transmission. ...
... However, as with the aforementioned studies, it is difficult to extrapolate the prevalence of EMS from this research, in part because these studies were designed to investigate problematic sexual behavior among populations identified as high risk for HIV/AIDS-particularly sex workers, men who have sex with men (MSM), and/or injection drug users-and not to gain a greater understanding of sexual behavior among married men in general. Broadly speaking, these studies suggest that increasing numbers of married men are engaging in unprotected sexual activities with sex workers and that these behaviors are contributing to the prevalence of HIV/ AIDS among married women and within the general population (Colby, Cao, & Doussantousse, 2004;Dao, Hirsch, Giang, & Parker, 2013;National Committee for AIDS, Drug, and Prostitution Prevention and Control, 2014;Ngo et al., 2008). An especially high-risk subset of men engaged in ESM are MSM. ...
Article
Research on extramarital sex (EMS) is commonly conducted from a perspective that implicitly understands this behavior as a violation of the marital relationship. In contrast, Vietnamese cultural norms have, at some points in history, condoned if not outright encouraged EMS in the name of preserving family lineage. Yet little is known about the prevalence of EMS among contemporary Vietnamese men and its association with marriage quality. This is a notable gap, given the enormous sociocultural and ideological shifts the country has experienced over the past several decades. Drawing upon a sample of 126 married men (Mean age = 45.56; SD = 10.52) surveyed in urban (Hanoi and Ho Chi Minh City) and rural areas (Ha Tay and Can Tho) in Vietnam, we examined the relationship between EMS and geographic region, demographic characteristics, sexual values, quality of marriage, and sexual satisfaction within marriage. Our results show that geographic location had a strong impact on EMS, while most marital relationship quality variables did not impact the odds of EMS for married men in Vietnam.
... In Vietnam, the HIV epidemic is concentrated in key populations including people who inject drugs (PWID) female sex workers (FSW), and men who have sex with men (MSM), including MSW [2,3]. Individual-level [4], interpersonal (such as stigma [5] and sex work), and structural-level (such as the legal and social environments [6] ) factors influence HIV risk among Vietnamese MSW. In Ho Chi Minh City, MSW are a marginalized population who may not have access to HIV prevention education and interventions. ...
Article
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There is little data on the burden of HIV and other infections that affect male sex workers (MSW) in Vietnam. We conducted behavioral and biological sexual health surveys with 300 MSW in Ho Chi Minh City. Generalized estimating equation models were built to assess factors associated with HIV, hepatitis C, and other sexually transmitted infections (STI). Of 300 MSW, 19 (6.3 %) were diagnosed seropositive for HIV, 11 (3.7 %) had hepatitis C, and 26 (8.7 %) had at least one prevalent STI. In a multivariable model, opiate use was significantly associated with HIV infection (aOR 6.46, 95 % CI 1.28-32.7) and hepatitis C (aOR = 19.6, 95 % CI 2.35-163.6). Alcohol dependency was associated with increased odds of hepatitis C (aOR = 4.79, 95 % CI 1.02-22.5) and decreased odds of other STI (aOR = 0.30, 95 % CI 0.10-0.97). These findings suggest that MSW in Vietnam would benefit from regular HIV and STI testing, as well as linkage to care and substance use rehabilitation services.
... The 'National Strategy on HIV/AIDS Prevention and Control in Vietnam until 2010 with a Vision to 2020' was released in 2004 and a HIV technical working group was established to promote dialogue between the government, mass organisations, donors, international and national NGOs and groups of people living with HIV (National Committee for AIDS, Drugs, and Prostitution Prevention and Control 2012). Furthermore, Decree 54 was issued, which aimed to increase public awareness about HIV and identified men who have sex with men as a particularly high-risk group (Colby, Cao, and Doussantousse 2004; Blanc 2005; Khuat, Le, and Nguyen 2009). Similar to the case in India, technical assistance and funding came from a wide range of sources (National Committee for AIDS, Drugs, and Prostitution Prevention and Control 2012). ...
Article
Recent public debates about sexuality in India and Vietnam have brought the rights of lesbian, gay, bisexual and transgender people sharply into focus. Drawing on legal documents, secondary sources and ethnographic fieldwork conducted in the urban centres of Delhi and Hanoi, this article shows how the efforts of civil society organisations dedicated to the fight for lesbian, gay, bisexual and transgender rights have had different consequences in these two Asian contexts. The paper considers how these organisations navigated government regulations about their formation and activities, as well as the funding priorities of national and international agencies. The HIV epidemic has had devastating consequences for gay men and other men who have sex with men, and has been highly stigmatising. As a sad irony, the epidemic has provided at the same time a strategic entry point for organisations to struggle for lesbian, gay, bisexual and transgender recognition. This paper examines how the fight for lesbian, gay, bisexual and transgender recognition has been doubly framed through health-based and rights-based approaches and how the struggle for recognition has positioned lesbian, gay, bisexual and transgender people in India and Vietnam differently.
... Những nơi mà người ta có thể bắt gặp người đồng tính nam cũng dường như đang mở rộng. Vào thời điểm đầu những năm 2000s, Colby cho rằng khu vực sống của những người đồng tính nam chủ yếu là ở các thành phố lớn như là Hà Nội và Thành phố Hồ Chí Minh (Colby 2004;2003). Gần đây, ông lại tin rằng có thể tìm thấy nhiều người đồng tính nam ở các vùng nông thôn nữa (xem nghiên cứu của Colby về MSMs ở nông thôn Khánh Hòa, 2008). ...
Article
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... For the first decade of HIV/AIDS intervention in Vietnam, almost all HIV/AIDS-related activities focused exclusively on the populations of injected drug users (IDUs) and female sex worker (FSWs); this trend has unintentionally left the population of men who have sex with men (MSM) vulnerable to the spread of HIV in the community (Colby et al., 2004;Giang, 2009;Nguyen et al., 2008). According to the Vietnam Administration for AIDS Control and Prevention (2009), Vietnam's MSM population is estimated to be larger and growing faster than other at-risk populations (IDUs and FSWs), particularly in urban centers when there was greater liberation of sexual expression and representation of sexual identity among young people due to rapid socioeconomic transformation. ...
... For the first decade of HIV/AIDS intervention in Vietnam, almost all HIV/AIDS-related activities focused exclusively on the populations of injected drug users (IDUs) and female sex worker (FSWs); this trend has unintentionally left the population of men who have sex with men (MSM) vulnerable to the spread of HIV in the community (Colby et al., 2004;Giang, 2009;Nguyen et al., 2008). According to the Vietnam Administration for AIDS Control and Prevention (2009), Vietnam's MSM population is estimated to be larger and growing faster than other at-risk populations (IDUs and FSWs), particularly in urban centers when there was greater liberation of sexual expression and representation of sexual identity among young people due to rapid socioeconomic transformation. ...
Article
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Objectives: The objective of this study was to examine the levels and correlates of homosexual stigma among men who have sex with men (MSM) in Hanoi, Vietnam. Meth-ods: A cross-sectional study design using a respondent-driven sampling (RDS) method was conducted in 2011 to collect data from 451 MSM in Hanoi, Vietnam. A cross-validation tech-nique and factor analysis were used to refine the constructs of a homosexual stigma scale. Data weighted to adjust for the RDS design were evaluated to estimate the population-based prevalence of homosexual stigma, depression, drug and alcohol use, multiple sexual partners, and unprotected sex. Weighted logistic regression was used to determine demographic, psy-chosocial, and behavioral predictors of three forms of homosexuality-related stigma. Results: Enacted homosexual stigma was significantly linked to place of birth (adjusted odds ratio [AOR] = 0.58; 95% confidence interval [CI] [0.36, 0.95]), self-reported sexual identity (AOR = 0.63; 95% CI [0.41, 0.98]), multiple sexual partners (AOR = 2.24; 95% CI [1.21, 4.14]), and unprotected sex (AOR = 2.83; 95% CI [1.64, 4.87]). High levels of self-homosexual stigma were reported and were significantly associated with being married/divorced/separated (AOR = 2.49; 95% CI [1.02, 6.09]), being in a monogamous sexual relationship (AOR = 0.59; 95% CI [0.36, 0.98]), depression (AOR = 2.21; 95% CI [1.21, 4.06], and AOR = 3.13; 95% CI [1.76, 5.27]). Conclusions: The study presents the evidence for understanding the factors contributing to different forms of homosexual stigma and provides important evidence for evidence-based intervention development for stigma reduction targeting MSM in Vietnam.
... Hence whilst general knowledge of HIV is typically high among MSM, many still report not knowing how to act on this knowledge to protect themselves from HIV (Colby, 2003;Toan, Colby, & Minh, 2005). Furthermore, low percentages of MSM rate their HIV risk to be high despite their low condom use (Colby, Cao, & Doussantousse, 2004;Colby et al., 2008). ...
Article
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Background: Men who have sex with men (MSM) in Vietnam are receiving increased attention in recognition of their high-risk behaviours and potential for human immunodeficiency virus (HIV) infection and transmission. Due to societal pressures, many MSM in Vietnam are also bisexually active, which ultimately increases the transmission risks beyond the MSM population. Evidence is emerging that indicates a greater proportion of women in Asia with low-risk sexual activities are contracting HIV from their male partners who have become HIV infected through male–male sex. Methodology: Fourteen focus group discussions exploring sexual and social networks were conducted in Hanoi between July 2010 and September 2010. A total of 96 individuals participated in these sessions. Findings: A risk environment approach was used to analyse the focus group themes of social stigma and marriage, sex with other men in closed settings and transactional sex in Hanoi, an increasingly urbanising and westernising city. Implications: Despite limited evidence globally that bisexual men act as a bridge for sexually transmitted diseases, there is particular concern in Vietnam about this potential risk. HIV rates amongst MSM are rapidly rising and there are reports of women contracting HIV from their male partners who are bisexually active.
... Overall, MSM who engaged in unprotected sex were more likely to have low levels of HIV/AIDS knowledge or education, and were relatively likely to be misinformed about HIV/AIDS [11e13]. Possibly due to rampant misinformation regarding condoms and sexually transmitted infections (STIs), most MSM do not consistently use condoms, and often feel uncomfortable asking their partners to do so [12]. Cultural barriers may also make it difficult to talk about sexual issues [7]. ...
Article
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In South Korea, men who have sex with men (MSM) are rather understudied, but are known to be at high risk for human immunodeficiency virus infection (HIV)/acquired immunodeficiency syndrome (AIDS). This study was to access HIV/AIDS knowledge, attitudes, and risk behaviors, and to identify the factors of condom use in HIV prevention. We recruited 1070 MSM in Korea, using the Internet to maximize the confidentiality of the MSM. The prevalence of self-reported and sexually transmitted infections and HIV in the total sample was 10.7% and 2.7%, respectively. Factual knowledge and phobias regarding HIV/AIDS and self-efficacy were relatively high among the MSM. After controlling for age, education, marital status, and sexual identity, predictors of condom use at most recent anal sex included knowledge (OR = 1.25; p < 0.0001); self-efficacy (OR = 1.33; p = 0.02), additionally, having HIV testing (OR = 1.45; p = 0.02); and having a regular partner (OR = 0.53; p < 0.0001) were also positively associated with condom use. The intervention programs for MSM in Korea may need to take the idiosyncratic societal and cultural pressures of the region into consideration in order to reduce infection risk.
... In Ho Chi Minh City over the 2009–2011 period, the HIV prevalence estimated among MSM ranged between 14.3 and 16.3% [16], [17]. This high HIV burden among MSM in Vietnam has been explained by individual risk-taking such as unprotected anal intercourse, multiple sex partners, history of drug use and history of sexually transmitted infections (STI) [18], [19], [20]. Moreover, as MSM in Vietnam experience stigma and discrimination, they face many barriers to accessing health care and HIV prevention messages [9], [21] . ...
Article
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In Vietnam, men who have sex with men (MSM) are highly affected by HIV and need new targeted HIV prevention strategies. To assess the willingness to use the Internet to seek information on HIV prevention and care and associated factors among MSM in Ho Chi Minh City. A descriptive cross-sectional study was conducted in 2012. Participants were recruited using a convenience sampling method in venues most frequented by MSM and completed a self-administered questionnaire. Logistic regression models were performed to estimate factors associated with the willingness to use the Internet to seek information on HIV prevention and care. A total of 358 MSM were approached for the survey and 222 questionnaires (62.0%) were eligible for analyses. Overall, 76.1% of the respondents reported that they were willing to use the Internet to seek information on HIV prevention and care. A number of male partners in last year less than or equal to 3 (Adjusted Odds Ratio: 3.07, 95% Confidence interval: 1.40-6.73), a history of STI screening (4.10, 1.02-16.48) and HIV testing (3.23, 1.20-8.64) and having ever sought a male sexual partner through the Internet (3.56, 1.55-8.18) were significantly positively associated with the willingness to use the Internet to seek information on HIV prevention and care. The MSM interviewed in Ho Chi Minh City reported a high willingness to use the Internet to seek information on HIV prevention and care. In a context where new media are increasingly considered as promising options for reaching this HIV risk group, further research should be conducted on developing and testing tailored online tools adapted to the needs of Vietnamese MSM.
... For MSM, these studies used quantitative methods to describe individual-level analysis of risk behaviours such as sexual practices, drug use, local hangouts, and knowledge about HIV transmission (Colby 2003, Colby et al. 2004. Research using qualitative methods also found similar risk-related behaviours (Clatts et al. 2007, Bao Ngoc et al. 2012. ...
Article
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Social science research can enhance the response to Vietnam's growing HIV epidemic by capturing the country's rapidly changing social and political context. The present paper reviews the published, peer-reviewed and English-language social science literature on HIV in Vietnam in order to identify critical theoretical and substantive gaps, while laying the groundwork for future research. We found four broad foci for work on the social context of HIV and AIDS in Vietnam: the cultural meanings and social relationships that shape Vietnam's HIV epidemic; stigma and discrimination; social inequality and structural violence as contributors to HIV risk; and, finally, how broader global and social systems shape Vietnam's HIV epidemic. We signal the particular need for additional research on the effects of the media on attitudes towards HIV and AIDS, on social movements, and on health systems, as well as on a number of other key areas. Work along these lines, in addition to more effective communication of policy-relevant findings to those responsible for the development and implementation of policies and programmes, will strengthen Vietnam's response to HIV and AIDS.
... The number of partners reported by MSM in China is also 1.5-4 times fewer than reported in other developing countries such as Brazil and India. [17][18][19] Only reports from countries in Africa, 20,21 Eastern Europe 22 and neighbouring Asian countries that are traditionally influenced by Chinese culture [23][24][25] suggest comparable numbers of sexual partnerships among MSM. This could be due to similar conservative social structures or a tendency to underreport by study participants. ...
Article
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HIV prevalence is increasing rapidly among men who have sex with men (MSM) in China and potentially associated with the number of male sexual partners that each man has on average. This study estimates the distribution of the number of male sexual partners among Chinese MSM through a comprehensive review of English and Chinese published literature. The overall median number of male sexual partners of Chinese MSM in the past 6 months China was estimated to be 1.5 (95% CI, 1.1-1.8) and 3.8 (95% CI 1.5-6.9) sexual partners in the past 6-month and 12-month periods respectively. An estimated 31% of sexual partners of MSM in China are regular partners, 54% are casual partners, and 16% are commercial partners. The reported numbers of sexual partners has not changed over time during the past decade. The numbers of male sexual partners reported by Chinese MSM is consistently lower than other settings and may not be sufficient to explain the recent rapid increase in HIV prevalence.
Article
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Purpose The purpose of this paper is to investigate the effectiveness of the national HIV prevention outreach program for men who have sex with men (MSM) and transgender women (TGW). Design/methodology/approach It examined changes in condom use, lubricant use, HIV testing and counseling (HTC) uptake and sexually transmitted infection (STI) screening uptake, as well as how and why changes did or did not occur. The study applied mixed methods of both quantitative and qualitative approaches. Findings There were 16,539 MSM, and TGW reached at least three times in the program during October 2011‒September 2012. The program was found to affect changes in condom use with steady partners ( p <0.000), condom use with casual partners ( p <0.000), water-based lubricant use ( p <0.000), HTC uptake ( p <0.000) and STIs screening uptake ( p <0.000). Age and province of outreach are associated with HTC uptake and STI screening ( p <0.000), slightly as well as gender identity ( p <0.1). Gender identity and province of outreach are associated with condom use with steady partners ( p <0.000). Gender identity ( p <0.000) and sex work ( p <0.05) are associated with the use of lubricant. The qualitative results showed that the program had an immediate effect on HTC and STIs screening due to successful bond between the outreach workers and their clients, leading to trust and influencing behavior change. Originality/value HIV prevention by peer educators continues to be proved the most effective method, assuming its program consistency. TGW are more vulnerable to MSM to protect themselves, and they have steady partners. Future program for MSM can be replicated and scaled up, but more empowerment component and self-esteem building should be integrated to target TGW.
Article
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Men who have sex with men (MSM) in Vietnam experience disproportionate rates of HIV infection. To advance understanding of how structural barriers may shape their engagement with HIV prevention services, we draw on 32 in-depth interviews and four focus groups (n = 31) conducted with MSM in Hanoi between October 2015- March 2016. Three primary factors emerged: (1) Diversity, both in relation to identity and income; Vietnamese MSM described themselves as segregated into Bóng kín (hidden, often heterosexually-identified MSM) and Bóng lộ (‘out,’ transgender, or effeminate MSM). Lower-income, ‘hidden’ MSM from rural areas were reluctant to access MSM-targeted services; (2) Stigma: MSM reported being stigmatized by the healthcare system, family, and other MSM; and (3) Healthcare access: this was limited due to economic barriers and lack of MSM-friendly services. Our research suggests the need for multiple strategies to reach diverse types of MSM as well as to address barriers in access to health services such as stigma and costs. While a great deal has been written about the diversity of MSM in relation to gender performance and sexual identities, our research points to the substantial structural-level barriers that must be addressed in order to achieve meaningful and effective HIV prevention for MSM worldwide.
Book
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This book presents results from the qualitative study on sexuality conducted in Hanoi, Ho Chi Minh City, Ha Tay, and Can Tho with 254 people from different social and economic backgrounds, representing all relevant generations in contemporary Vietnam. In this study we examined the social processes through which sexuality has been constructed in contemporary Vietnam. In essence, this book aims at finding initial answers for the following questions: 1) How has sexuality been taught in contemporary Vietnam? Who is responsible for the teaching of sexuality? And what has been taught about sexuality? 2) What does sexuality mean to people in contemporary Vietnam? 3) What social, historical, economic, and political factors parallel and possibly contribute to the construction of sexuality in contemporary Vietnam?
Chapter
On a balmy summer evening, the crowds for Vu Ngoc Dang’s Nhung Co Gai Chan Dai, or Long-Legged Girls (2004), at the Korean-owned Diamond Plaza in Ho Chi Minh City were enormous. Sleek motorbikes were stacked in rows around the mall; throngs of young, fashionable people animatedly congregated to meet for drinks and watch the latest film. Comprising four floors devoted to various consumerist pleasures, the mall is flanked by tall business towers and lies adjacent to the Notre Dame Cathedral and a national park, at night a notorious meeting place for lovers and for prostitutes and their clients. Diamond Plaza offers foreigners and an emerging Vietnamese middle class an air-conditioned respite from the heat during the summer months. It remains a place of leisure for a well-heeled generation of Vietnamese youth, also called the “@ generation.”
Article
This study investigated sex differences in homonegativity and their correlates among 197 Vietnamese college students (males = 49, females = 148, M = 20.9 years, SD = 2.9) in Ho Chi Minh City. The survey included Vietnamese-language versions of four scales measuring attitudes toward homosexuality (ATHS), traditional masculinity ideology, knowledge of homosexuality, and contact experiences with homosexuals. An exploratory factor analysis indicated a 3-factor structure for the ATHS: Homonegativity, Tolerance, and Positive Images. Male respondents reported significantly higher scores on homonegativity. Traditional masculinity ideology was positively related to females’ homonegativity, but negatively correlated with tolerant attitudes of both males and females. Knowledge about homosexuality was negatively correlated with homonegativity. Media contact with homosexuals was negatively correlated with males’ homonegativity, but positively correlated with both females and males’ tolerant attitudes. Results suggest that future research develop a new scale to measure Vietnamese’s homonegativity and that media contact as well as ample and accurate knowledge about homosexuality can alter homonegativity.
Book
The last twenty years have seen a growth in multi-disciplinary work in the area of sexuality, culture and health. What was once a set of specialist concerns has been steadily mainstreamed. Alongside this, a broader interest has developed in 'social' and 'cultural' factors relating to sexuality and sexual health, from family planning and STI management to gender and intimate partner violence and the technologisation of sex. This book offers a research-based overview of key topics relevant to social and cultural perspectives on sexuality and sexual health. Beginning with an extended introduction and divided into six sections, it looks at culture, sex and gender, sexual diversity, sex work, migration and sexual violence. Each section opens with an editorial discussion which places the theme, and the chapters that follow, in a contemporary context. Six additional substantive chapters can be accessed online at www.routledge.com/cw/aggleton. Including cutting-edge conceptual and empirical material from around the world, this is a key resource for students in, and across, a variety of academic disciplines in the social and health sciences. It is especially suitable for readers from sexuality studies, gender studies, development studies, anthropology and sociology as well as those with public health and social work backgrounds. © 2015 P. Aggleton, R. Parker and F. Thomas. All rights reserved.
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Treacherous Subjects is a provocative and thoughtful examination of Vietnamese films and literature viewed through a feminist lens. Lan Duong investigates the postwar cultural productions of writers and filmmakers, including Tony Bui, Trinh T. Minh-ha, and Tran Anh Hung. Taking her cue from the double meaning of "collaborator," Duong shows how history has shaped the loyalties and shifting alliances of the Vietnamese, many of whom are caught between opposing/constricting forces of nationalism, patriarchy, and communism. Working at home and in France and the United States, the artists profiled in Treacherous Subjects have grappled with the political and historic meanings of collaboration. These themes, which probe into controversial issues of family and betrayal, figure heavily in fictions such as the films The Scent of Green Papaya and Surname Viet Given Name Nam. As writers and filmmakers collaborate, Duong suggests that they lay the groundwork for both transnational feminist politics and queer critiques of patriarchy.
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Purpose – The purpose of this chapter is to use the particulars of a single case study (Vietnam) to underscore common pitfalls that several governments have made during the emerging and concentrated stages in their policy responses to the HIV/AIDS epidemic and to underscore much needed actions in the HIV/AIDS prevention realm. Methods – Literature syntheses, policy reports, interviews with in-country stakeholders, and a case study approach are used to explore key issues regarding common government missteps at the concentrated epidemic phase. Findings – These include coverage of the history of social ills in the country and how these intersect with – first, myths about the spread of HIV within a given region; second, inadequate intervention with high-risk groups and lack of consideration of the ways in which high-risk groups interact with the general population (neglect of bridge populations); and third, poor emphasis on women and young women, who are disproportionately affected by key epidemic transitions, particularly the transition from emerging to the concentrated epidemic phase. Contribution to the field – Documenting policy lessons in emerging and concentrated epidemics is urgent and can assist within and across nations to help control the spread of HIV/AIDS.
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Abstract The concept of possible selves was proposed in 1986 and has since been implemented in many different contexts such as schools, prisons, career planning and sports training. This paper describes how the concept can be put into practice in mental health settings for people in recovery from severe and persistent mental illness. Future studies are required to establish the clinical utility and effectiveness of the proposed intervention.
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In Vietnam, there is an emerging HIV epidemic among men who have sex with men (MSM). Male sex workers engage in high-risk sexual behaviours that make them particularly vulnerable to HIV infection. In 2010, 23 MSM in Ho Chi Minh City (HCMC) who recently received payment for sex with another man completed in-depth qualitative interviews exploring motivations for sex work, patterns of sex work disclosure and experiences of social stigma. Interviews were recorded, transcribed and translated into English and analysed using a qualitative descriptive approach. Low wages, unstable employment and family remittances were motivating factors for MSM in HCMC to sell sex. Participants described experiences of enacted and felt social stigma related to their involvement in sex work. In response, they utilised stigma management techniques aimed at concealment of involvement in sex work. Such strategies restricted sexual communication with non-paying sex partners and potentially limited their ability to seek social support from family and friends. Departing from decontextualized depictions of sex work disclosure, our findings describe how decisions to reveal involvement in sex work are shaped by social and structural factors such as social stigma, techniques to minimise exposure to stigma, economic imperatives and familial responsibilities.
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We examined the impact of acculturation on attitudes toward gay men and lesbians in the Vietnamese American community. We recruited 114 Vietnamese American participants at a large community organization. The Suinn–Lew Asian Self‐Identity Acculturation Scale (Suinn, 1992) was used to measure participants' acculturation levels, while the Attitudes Toward Lesbian and Gay Men Scale (Herek, 2004) was used to measure participants' attitudes toward homosexuality. It was hypothesized that Vietnamese Americans with higher levels of acculturation would have more positive attitudes toward homosexuality. The results supported this hypothesis. Additionally, we found a complicated pattern of results explaining attitudes based on acculturation level, age, and gender.
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In Vietnam, the co-occurrence (i.e., "syndemic") of psychosocial factors (e.g., depression and substance use) may disproportionately burden male sex workers and increase their HIV risk. A comprehensive survey was conducted among 300 male sex workers in Ho Chi Minh City, Vietnam in 2010. We performed logistic regression to examine the association between the syndemic variable-a count score of the number of five psychosocial conditions endorsed-and unprotected anal sex (UAS) in the past. One-third of participants reported any UAS, and 42 % reported ≥2 psychosocial health problems. In multivariable models, experiencing ≥4 psychosocial health problems was significantly associated with UAS. Every unit increase in number of psychosocial health problems was associated with a 25-30 % increase in odds of UAS. Understanding the syndemic condition and its association with HIV risk among male sex workers in Vietnam may lead to the development of more effective, comprehensive interventions.
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This paper introduces changes in concepts, attitudes and behavior towards sexuality over different periods of Vietnam's history and reviews studies on sexuality and related topics that have been conducted. The main purpose of this paper is to bring forth some issues for designing a research agenda on sexuality and reproductive health in Vietnam. The paper is divided into four sections. The first section analyzes changes in the Vietnamese people's concepts, attitudes and behavior towards sexuality from the past to the present. This section is followed by a review of existing studies on sexuality and related topics. The third section is a brief introduction of publications on sexuality in Vietnam. The paper concludes with a summary and suggestions for a research program.
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Objective: To measure the prevalence of and trends in HIV infections in populations defined by sentinel surveillance in Vietnam. Methods: Surveillance was conducted in eight provinces in 1994, expanded to 12 in 1995 and to 20 in 1996. Sentinel populations were sexually transmitted disease (STD) patients, female sex workers (FSW), injecting drug users (IDU), tuberculosis (TB) patients, pregnant women, and military conscripts. Samples were collected twice yearly for high-risk populations and once yearly for low-risk populations. Results: The overall HIV epidemic in Vietnam comprises several different smaller epidemics. It is primarily associated with injecting drug use, but its extent varies widely throughout the country. In 1998, HIV prevalence rates ranged from 0 to 85% (median, 13.1%), with an aggregate prevalence rate (APR; i.e., the sum of HIVpositive study subjects divided by the sum of all study subjects tested in sentinel provinces) of 17% among IDUs; this ranged from 0 to 14.7% (median, 0.8%), with the APR of 2.4% among FSWs; and from 0 to 6% (median, 0%), with the APR of 0.9% among STD patients. The APRs among antenatal women and army conscripts were less than 0.15%. APRs increased significantly from 1994 to 1998 among STD patients (p < .001), FSWs (p < .001), TB patients (p < .001), and pregnant women (p < .05) in original sentinel provinces. HIV prevalence also increased significantly among younger age groups of IDUs and FSWs. Conclusion: Vietnam's HIV epidemic is increasing predominantly and most rapidly among IDUs. However, prevalence rates among FSWs and STD patients are rising but are still low among pregnant women and army conscripts. Vietnam, at present, is still in the early phase of the HIV epidemic and has time to take effective and appropriate actions. (C) 1999 Lippincott Williams & Wilkins, Inc.
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Appropriate AIDS prevention information is not available in Vietnam for men who have sex with men. Current AIDS prevention messages can be misunderstood with potentially dangerous results. We outline some features of gay culture in a provincial city in Vietnam. We describe the activities of a peer educator who made contact with a small group of young gay men during 1996 and 1997. All the young men were ill-informed about AIDS. Their attitudes and sexual practices made them vulnerable to AIDS. The peer educator provided clear information and emotional support. The peer education was done without government endorsement and on a very low budget.
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Objective: To examine the prevalence and incidence of HIV and syphilis, and risk behaviors for these infections, among 1172 male commercial sex workers (CSW) followed prospectively from 1989 to 1994 in Chiang Mai, northern Thailand. Methods: Twice yearly visits were conducted by the Thai Ministry of Public Health at all cooperating gay bars and clubs (17 sites) in Chiang Mai City as part of a national HIV sentinel surveillance. Men and boys who agreed were followed prospectively. Sentinel visits included an interview, HIV pre-test counseling, HIV and syphilis serology, condom distribution, and referral for post-test counseling. Participation was voluntary, confidential, and individual HIV results were available only to participating subjects. A total of 219 CSW were seen at least twice, allowing for incidence estimates based on 100 person-years (PY). Results: Median age of male CSW was 20 years. Median time of work as a CSW was 4 months. Most men (57.6%) described themselves as heterosexual. Median number of clients was 2.5 per week, and reported condom use with clients was low: 42% reported inconsistent or no condom use, while 58% reported always using condoms. Reactive Venereal Disease Research Laboratory results were 7.6%, overall, but showed a declining trend. HIV prevalence was 1.4% in June 1989, 13.9% in June 1990, and 20.1% in December 1993, and showed a significant increasing trend. There were 27 incident HIV infections in 227.3 PY of observation, for an overall incidence during the 4.5-year period of 11.9 per 100 PY (95% confidence interval, 7.42-16.38). Conclusion: Male CSW in northern Thailand are at high risk for HIV despite current prevention efforts. The majority are heterosexual, which may be an important epidemiologic link in the spread of HIV between male CSW users and heterosexual women in Thailand. AIDS 1995, 9:517-521 (C) Lippincott-Raven Publishers.
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To assess the risks for HIV infection and sexually transmitted diseases (STD) among young northern Thai men who have sex with men (MSM), and to examine the possible role of male same-sex behavior in the northern Thai HIV/AIDS epidemic. Two cohorts of northern Thai military conscripts and one cohort of recently discharged conscripts, a total of 2047 men, were studied. Data were collected by interview on behavioral risk factors, and sera were examined for syphilis and HIV-1 antibodies. Univariate and multiple logistic regression analyses were used to determine risk factors associated with HIV and STD, and to assess the frequency and patterns of same-sex behaviors among these men. Of 2047 men, 134 (6.5%) reported one or more male lifetime sex partners. Of these MSM, 130 (97.0%) also had female partners, and four (3.0%) had exclusively male partners. Compared with men who reported only female sex partners, MSM had a higher number of lifetime sex partners, a higher mean number of female sex partners, more female and male commercial sex worker (CSW) partners, and were more likely to be married. MSM were significantly more likely than exclusively heterosexual men to report having had any STD [odds ratio (OR), 2.72], gonorrhea (OR, 2.05), syphilis (OR, 3.17), non-gonococcal urethritis (OR, 4.54) and penile discharges (OR, 6.24). They were at borderline increased risk for HIV infection [OR, 1.51; 95% confidence interval (CI), 0.95-2.41]. Men with more than one lifetime male sex partner compared with those with only one partner were significantly more likely to be HIV-infected (OR, 2.81; 95% CI, 1.09-7.19). Northern Thai MSM are a high-risk population for STD, including HIV. Reported same-sex behavior in this population appears to vary considerably with data collection techniques. HIV and STD prevention strategies aimed at changing unsafe sexual practices may need to be targeted to the general population of young Thai men.
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To determine the effect of recombinant human interleukin (IL)-2 on HIV-1 replication and macrophage colony stimulating factor (M-CSF) production by HIV-1-infected monocyte-derived macrophages (MDM). Therapeutic use of IL-2 increases the number and function of CD4+ T cells. IL-2 also increases M-CSF production and M-CSF receptor expression by human monocytes, but the subsequent effects on HIV-1 replication in MDM have yet to be determined. MDM from HIV-1-seronegative donors were cultured in the presence and absence of IL-2 and infected with HIV-1. Harvested supernatants were monitored for reverse transcriptase activity and M-CSF production. Reverse transcriptase activity was significantly lower when MDM cultures were treated with IL-2 for 10 days prior to infection with HIV-1. IL-2 did not stimulate production of inhibitory chemokines or cytokines, but FACS analysis revealed that expression of CD4, the primary HIV-1 receptor, and CC-chemokine receptor-5, a coreceptor used by macrophage-tropic viruses, are down modulated after treatment with IL-2. IL-2 may not only be of benefit in restoring immune function in AIDS patients, but may also help to prevent the infection of healthy macrophages by decreasing their expression of HIV-1 receptors.
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HIV infection is increasing among sex workers and injection drug users in southern Vietnam. Vietnamese sex workers returning from Cambodia are an important factor. This phase I growth stage is being accelerated by widespread prostitution and escalating heroin use. Sexually transmitted disease (STD) rates are significant in sex workers but low in the general population. STD epidemics in developing countries may not follow the dynamic topology that is common in developed countries. Vietnam has the potential for significant HIV and STD epidemics but also the capacity to respond to these threats.
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To describe health risk behavior, knowledge, and attitudes about HIV/AIDS and its prevention in men who have sex with men (MSM) in Ho Chi Minh City (HCMC), Vietnam. A cross-sectional survey of 219 MSM using a standardized questionnaire. Men who have sex with men were easy to locate and willing to answer detailed questions about their sexual behavior. Self-identified sexual orientation was 67% homosexual, 31% bisexual, and 1.4% heterosexual. High-risk sexual behavior was common. The mean number of sexual partners was 3.3 in the previous month and 14.8 in the previous year. Only 32% used condoms during their last intercourse, and only 40% used a condom when their last intercourse included anal sex. Eighty-one percent reported sex with nonregular male partners, and 22% also had sex with women in the past year. Drug use other than alcohol was rare. Most correctly identified high-risk sexual behavior and body fluids that could transmit HIV; however, only about half knew that someone who appeared healthy could transmit HIV or that there was no cure for AIDS. Self-rated risk for HIV was very low, and fewer than one third believed that homosexuals in Vietnam are at increased risk for HIV. Men who have sex with men in HCMC are at high risk for HIV. Knowledge about HIV transmission and prevention could be improved. Education and interventions specifically aimed at MSM are needed, because education targeted at the general population may not reach MSM or influence their behavior.
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