Demographic and behavioral correlates of HIV/STI among Vietnamese female sex workers in southwest China

Previous literature has suggested high rates of HIV/STIs among Chinese FSWs. However, limited data were available regarding HIV-related risks among Vietnamese FSWs – a rapidly increasing, vulnerable population in southwest China. 

The current study examined the demographic and behavioral factors associated with the infection rates of HIV, syphilis, and Hepatitis C (HCV) among Vietnamese FSWs in Guangxi, China. We conducted a secondary data analysis of a cumulative sample of 1026 Vietnamese FSWs (aged 14–66) recruited over five years (2010–2014) from 35 National Sentinel Surveillance sites in Guangxi. 

Analyses included Fisher’s exact chi-square test, t-test, and binary logistic regression. The overall prevalence of HIV, syphilis, and HCV infections among the cross-border women were 3.2%, 6.9%, and 2.6%, respectively. 

Multivariate analysis showed that greater lengths of sex work and low paying work venues were significant risk factors for HIV infection; for syphilis infection, older age, drug use experience, and forgoing condom use were significant risk factors; for HCV infection, drug use experience was the only significant risk factor. 

Our findings suggest that elevated HIV-related risks among the Vietnamese FSWs are closely related to their financial disadvantages and that drug use is a prominent risk factor for cross-border women in the sex trade. 

Furthermore, culturally tailored and linguistically accessible HIV prevention and intervention initiatives that target cross-border FSWs, with a close international collaboration between China and Vietnam, are urgently needed.

Purchase full article at:  http://goo.gl/OaUB1w

By: Yu YJ1, Li X1, Tam CC2, Zhou Y3, Chen Y3, Shen Z3.

• 1a Arnold School of Public Health, University of South Carolina , Columbia , SC , USA.
• 2b Department of Psychology , Virginia Commonwealth University , Richmond , VA , USA.
• 3c Guangxi CDC, HIV&STD Prevention Center , Nanning , Guangxi , People's Republic of China.
• AIDS Care. 2016 May 30:1-6

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Methadone Maintenance Treatment Promotes Referral and Uptake of HIV Testing and Counselling Services amongst Drug Users and Their Partners

BACKGROUND:

Methadone maintenance treatment (MMT) reduces HIV risk behaviors and improves access to HIV-related services among drug users. In this study, we assessed the uptake and willingness of MMT patients to refer HIV testing and counseling (HTC) service to their sexual partners and relatives.

METHODS:

Health status, HIV-related risk behaviors, and HTC uptake and referrals of 1,016 MMT patients in Hanoi and Nam Dinh were investigated. Willingness to pay (WTP) for HTC was elicited using a contingent valuation technique. Interval and logistic regression models were employed to determine associated factors.

RESULTS:

Most of the patients (94.2%) had received HTC, 6.6 times on average. The proportion of respondents willing to refer their partners, their relatives and to be voluntary peer educators was 45.7%, 35.3%, and 33.3%, respectively. Attending MMT integrated with HTC was a facilitative factor for HTC uptake, greater WTP, and volunteering as peer educators. Older age, higher education and income, and HIV positive status were positively related to willingness to refer partners or relatives, while having health problems (mobility, usual care, pain/discomfort) was associated with lower likelihood of referring others or being a volunteer. Over 90% patients were willing to pay an average of US $17.9 for HTC service.

CONCLUSION:

The results highlighted the potential role of MMT patients as referrers to HTC and voluntary peer educators. Integrating HIV testing with MMT services and applying users' fee are potential strategies to mobilize resources and encourage HIV testing among MMT patients and their partners.

Below:   Sexual behaviors among respondents

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

By:  Tran BX1,2, Nguyen LH1,3, Nguyen LP4, Nguyen CT5, Phan HT6, Latkin CA2.

• 1Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam.
• 2Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
• 3School of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam.
• 4Harvard T.H Chan School of Public Health, Boston, Massachusetts, United States of America.
• 5Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam.
• 6Authority of HIV/AIDS Control, Ministry of Health, Hanoi, Vietnam. 

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

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.

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Alcohol Abuse Increases the Risk of HIV Infection & Diminishes Health Status of Clients Attending HIV Testing Services in Vietnam

BACKGROUND:

Vietnam is among those countries with the highest drinking prevalence. In this study, we examined the prevalence of alcohol use disorders (AUDs) and its associations with HIV risky behaviors, health care utilization, and health-related quality of life (HRQOL) among clients using voluntary HIV testing and counseling services (VCT).

METHODS:

A cross-sectional survey of 365 VCT clients (71 % male; mean age 34) was conducted in Hanoi and Nam Dinh province. AUD and HRQOL were measured using the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C), and EuroQol-five dimensions-five levels (EQ-5D-5L). Risky sexual behaviors, concurrent opioid use, and inpatient and outpatient service use were self-reported.

RESULTS:

67.2 % clients were lifetime ever drinkers of those 62.9 % were hazardous drinkers and 82.0 % were binge drinkers. There were 48.8 % respondents who had ≥2 sex partners over the past year and 55.4, 38.3, and 46.1 % did not use condom in the last sex with primary/casual/commercial sex partners, respectively. Multivariate models show that AUD was significantly associated with risky sexual behaviors, using inpatient care and lower HRQOL among VCT clients.

CONCLUSIONS:

AUD was prevalent, was associated with increased risks of HIV infection, and diminished health status among VCT clients. It may be efficient to screen for AUD and refer at-risk clients to appropriate AUD counseling and treatment along with HIV-related services.

Sexual risk behaviors and history of drug use among VCT clients in 2013 (n = 365)

Factors	Rural		Urban		Total		p value
	N	%	N	%	N	%
Ever had sex	90	90.9	257	96.6	347	95.1	0.03
Number of sex partners (in the last 12 months)
Not had anyone	34	34.3	18	6.8	52	14.3	<0.01
One sex partners	52	52.5	118	44.4	170	46.6
2–3 sex partners	6	6.1	94	35.3	100	27.4
>4 sex partners	7	7.1	36	13.5	43	11.8
Type of sex partners
Primary partners	68	68.7	238	89.5	306	83.8	<0.01
Casual sex partners	0	0.0	64	24.1	64	17.5	<0.01
Sex workers	16	16.2	64	24.1	80	21.9	0.10
Non-condom use with last sex
With primary sex partners (n = 305)	42	62.3	127	53.4	169	55.4	0.18
With casual sex partners (n = 60)	0	0.0	23	38.3	23	38.3	-
With sex workers (n = 76)	16	100.0	19	31.7	35	46.1	<0.01
Ever drug use	4	4.0	34	12.8	38	10.4	0.02
Ever inject drug	2	2.0	23	8.7	25	6.9	0.03
Current drug use	2	50.0	13	38.2	15	39.5	0.65

Full article at:   http://goo.gl/3cJBg1

By:  Tran BX1,2, Nguyen LH3,4, 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 16;13(1):6. doi: 10.1186/s12954-016-0096-z.

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health