Behavioral & Quality-of-Life Outcomes in Different Service Models for Methadone Maintenance Treatment in Vietnam

BACKGROUND:

Integrating HIV/AIDS and methadone maintenance treatment (MMT) services with existing health care delivery system is critical in sustaining efforts to fight HIV/AIDS in large injection-driven epidemics. However, efficiency of different integrative service models is unknown. This study assessed behavioral and health-related quality-of-life (HRQOL) outcomes of MMT in four service delivery models and explored factors associated with these outcomes of interest.

METHODS:

A cross-sectional survey was conducted in two HIV epicenters in Vietnam: Hanoi and Nam Dinh Province. All patients in five selected MMT clinics were invited to participate, and 1016 were interviewed (80-90 % response rate).

RESULTS:

Respondents had a mean age of 35.8, taken MMT for average 16.5 months and 3.3 % on MMT for 36-60 months. The MMT integrated with rural district health center (DHC) has the highest prevalence of concurrent drug use (11.3 %). The percentage of condom use (last sexual intercourse) with primary and casual partners was lowest in the MMT at urban DHCs. Patients at the rural DHC reported very high proportions of pain/discomfort (37.8 %), anxiety/depression (43.1 %), and mobility (13.3 %). In regression models, poorer HRQOL outcomes were found in MMT models in the rural areas or without general health care, and among those patients who were HIV positive, reported concurrent drug use, and had higher numbers of previous drug rehabilitation episodes. Mobility and anxiety/depression are factors that increased the likelihood of concurrent drug use among MMT patients.

CONCLUSIONS:

Outcomes of MMT were diverse across different integrative service models. Policies on rapid expansion of the MMT program in Vietnam should also emphasize on the integration with comprehensive health care services including psychological supports for patients.

History of drug use and rehabilitation

			MMT + VCT + ART + DGH
	MMT + VCT		Rural		Urban		MMT + RPC		All		p value
	Mean	SD	Mean	SD	Mean	SD	Mean	SD	Mean	SD
History of drug use
Age first used drug	24.3	7.0	26.6	7.4	25.3	6.7	23.5	6.1	24.1	6.5	0.21
Time since first episode (year)	13.5	5.1	11.2	5.3	12.2	5.9	14.5	6.2	13.5	5.7	<0.01
Time since first drug injection (year)	10.9	4.4	7.9	3.9	9.2	4.6	11.0	5.5	10.9	4.9	0.02
Drug rehabilitation
Number of episodes	5.7	7.2	3.4	3.0	4.2	5.2	5.1	6.9	4.8	6.2	0.02
	N	%	N	%	N	%	N	%	N	%
Location of rehabilitation
Home, self-managed	213	85.9	103	75.7	132	68.8	226	61.8	674	71.6	<0.01
Voluntary centers	108	43.6	50	36.8	97	50.5	195	53.3	450	47.8	<0.01
Compulsory centers	74	29.8	13	9.6	32	16.7	137	37.4	256	27.2	<0.01
Reason for relapse
Boredom	91	36.7	31	22.8	80	41.7	162	44.3	364	38.6	<0.01
Peer inducement	115	46.4	67	49.3	106	55.2	189	51.6	477	50.6	0.30
Craving	107	43.2	62	45.6	96	50.0	168	45.9	433	46.0	0.56
Unemployment	11	4.4	3	2.2	6	3.1	29	7.9	49	5.2	0.02

Full article at:   http://goo.gl/gQ6GS4

By:  Tran BX1,2, Nguyen LH3,4, Nong VM3, Nguyen CT5, Phan HT6, Latkin CA7.

• 1Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam. bach@hmu.edu.vn.
• 2Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. bach@hmu.edu.vn.
• 3Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam.
• 4School of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam.
• 5Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam.
• 6Authority of HIV/AIDS Control, Ministry of Health, Hanoi, Vietnam.
• 7Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. 
• Harm Reduct J. 2016 Feb 2;13(1):4. doi: 10.1186/s12954-016-0091-4.

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Erectile Dysfunction, Boredom, and Hypersexuality among Coupled Men from Two European Countries

INTRODUCTION:

Much of the research on the association between erectile dysfunction (ED) and possible clinical relevant hypersexuality up to now has been only descriptive in nature.

AIM:

The present study aimed to explore the relationships among hypersexuality, ED, and sexual boredom in a sample of coupled community men.

METHODS:

An Internet-based survey was conducted in two European countries. The sample included 911 Croatian and 210 German coupled men. The survey comprised the Hypersexual Disorder Screening Inventory, the International Index of Erectile Function and the Sexual Boredom Scale. Poisson regression analysis was used to examine how ED, solitary sexual activities and sexual boredom were associated with hypersexuality.

RESULTS:

Among Croatian and German men, hypersexuality was significantly correlated with proneness to sexual boredom and more problems with erectile function.

CONCLUSIONS:

In some men, hypersexual behavior may serve as a coping mechanism for sexual fantasy poverty-associated boredom. In addition, ED within an intimate relationship can accompany this simultaneously. Klein V, Jurin T, Briken P, and Štulhofer A. Erectile dysfunction, boredom, and hypersexuality among goupled men from two European countries.

Purchase full article at:   http://goo.gl/zohl0m

By:  Klein V1, Jurin T2,3, Briken P1, Štulhofer A2.

• 1Institute for Sex Research and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
• 2Sexology Unit, Department of Sociology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia.
• 3Unit for Health and Clinical Psychology, Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia. 

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Masturbation and Pornography Use among Coupled Heterosexual Men with Decreased Sexual Desire: How Many Roles of Masturbation?

The relation between masturbation and sexual desire has not been systematically studied. The present study assessed the association between masturbation and pornography use and the predictors and correlates of frequent masturbation (several times a week or more often) among coupled heterosexual men who reported decreased sexual desire. 

Analyses were carried out on a subset of 596 men with decreased sexual desire (mean age = 40.2 years) who were recruited as part of a large online study on male sexual health in 3 European countries. 

A majority of the participants (67%) reported masturbating at least once a week. Among men who masturbated frequently, 70% used pornography at least once a week. A multivariate assessment showed that sexual boredom, frequent pornography use, and low relationship intimacy significantly increased the odds of reporting frequent masturbation among coupled men with decreased sexual desire. 

These findings point to a pattern of pornography-related masturbation that can be dissociated from partnered sexual desire and can fulfill diverse purposes. 

Clinical implications include the importance of exploring specific patterns of masturbation and pornography use in the evaluation of coupled men with decreased sexual desire.

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By:  Ana Carvalheira^a*, Bente Træen^b & Aleksandar Stulhofer^c

^a Department of Clinical Psychology, ISPA-University Institute, Lisbon, Portugal

^b Department of Psychology, University of Oslo, Oslo, Norway

^c Department of Sociology, University of Zagreb, Zagreb, Croatia

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Is High Sexual Desire a Facet of Male Hypersexuality? Results from an Online Study

Despite of a growing number of studies, hypersexuality remains controversial and empirically elusive. Using a group comparison approach, this study revisited the claim that hypersexuality cannot be reliably distinguished from high sexual desire. 

An online survey, advertised as focusing on pornography use and sexual health was carried out in 2014 among 1,998 Croatian men aged 18-60 years (M_age = 34.7, SD = 9.83). Membership in the hypersexuality group (HYP; n = 57) was determined using the Hypersexual Disorder Screening Inventory and the Hypersexual Behavior Consequences Scale. The highest values on two indicators of sexual desire/interest set membership in the HSD group (HSD; n = 70). The overlap between the groups was negligible (n = 4). 

Compared to the rest of the sample, men in the HYP group had significantly higher odds of being single, not exclusively heterosexual, religious, depressed, prone to sexual boredom, experiencing substance abuse consequences, holding negative attitudes toward pornography use, and evaluating one's sexual morality more negatively. In contrast, the HSD group differed from controls only in reporting more positive attitudes toward pornography use. 

The study findings point to a distinct phenomenology of HSD and HYP in men. Clinical implications of the findings are briefly discussed.

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By:  Štulhofer A1, Jurin T1, Briken P2.

• 1 Department of Sociology , Faculty of Humanities and Social Sciences, University of Zagreb , Zagreb , Croatia.
• 2 Institute for Sex Research and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf , Hamburg , Germany.

 

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Boredom Prone or Nothing to Do? Distinguishing Between State and Trait Leisure Boredom and its Association with Substance Use in South African Adolescents.

Via: http://ht.ly/OxXqI  HT @WSUPullman