Women's Communication Self-Efficacy & Expectations of Primary Male Partners' Cooperation in Sexually Transmitted Infection Treatment in Ho Chi Minh City, Vietnam

BACKGROUND:

Effective control of sexually transmitted infections (STIs) depends on affected patients notifying their sexual partners, and partners following through with screening and treatment. Our study assessed high-risk-STI women's confidence in STI-diagnosis-related communications with their primary male partners in Ho Chi Minh City, Vietnam, and determined associated characteristics of the women and their partners.

METHODS:

We employed convenience and snowball sampling in a clinic-based setting to recruit 126 women from August to October 2013. All data were obtained from women's self-report.

RESULTS:

The proportions of participants who were "slightly confident" or "very confident" that they could disclose their STI positivity to partners, ask partners to have an STI examination or treatment, and give partners bacterial-STI medications were 70.3 %, 62.1 %, and 69.0 %, respectively. The proportions who perceived that their partners would be "very likely" to have an STI examination and to take STI medications were 16.2 % and 38.8 %, respectively. Significantly lower self-efficacy was observed in women who had a lower education level, who had ever traded sex, or whose primary partners were not husbands or fiancés.

CONCLUSIONS:

Our results suggest potential for piloting STI-partner-targeted interventions. To be effective, these programs should improve women's self-efficacy and primary partners' cooperation with screening and treatment.

Participants’ self-efficacy in STI-diagnosis-related communications and perceived likelihood of primary male partners’ cooperation

Main variable	No.	%
Participants’ self-efficacy in disclosing their STI positivity to primary male partner (n = 118)
Not confident at all	20	17.0
Slightly not confident	4	3.4
So-so	11	9.3
Slightly confident	15	12.7
Very confident	68	57.6
Participants’ self-efficacy in asking primary male partner to have an STI examination (n = 116)
Not confident at all	19	16.4
Slightly not confident	7	6.0
So-so	18	15.5
Slightly confident	19	16.4
Very confident	53	45.7
Participants’ self-efficacy in giving medications for STI treatment to primary male partner (n = 116)
Not confident at all	5	4.3
Slightly not confident	5	4.3
So-so	26	22.4
Slightly confident	35	30.2
Very confident	45	38.8
Primary male partners’ likelihood to get an STI examination (n = 105)
Not likely at all	20	19.1
Unlikely	15	14.3
Maybe	26	24.8
Likely	27	25.7
Very likely	17	16.2
Primary male partners’ likelihood to take medications for STI treatment given by the participants (n = 116)
Not likely at all	5	4.3
Unlikely	5	4.3
Maybe	26	22.4
Likely	35	30.2
Very likely	45	38.8
Primary male partners’ frequency of accompanying participants to gynecological clinics (n = 89)a
Never	48	53.9
< 1/2 the time	18	20.2
= 1/2 the time	7	7.9
> 1/2 the time	7	7.9
Every time	9	10.1

aAmong those who had previously visited a gynecology clinic due to an STI symptom

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

By:  Tran LT1, Bui TC2, Markham CM3, Swartz MD4, Tran QM5, Nyitray AG6, Huynh TT7, Hwang LY8.

• 1Department of Epidemiology, School of Public Health, The University of Texas Health Science Center at Houston (https://sph.uth.edu/), Houston, TX, USA. Ly.T.Tran@uth.tmc.edu.
• 2Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. tcbui@mdanderson.org.
• 3Department of Health Promotion and Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA. Christine.Markham@uth.tmc.edu.
• 4Department of Biostatistics, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA. Michael.D.Swartz@uth.tmc.edu.
• 5Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam. tranminhquan12332192@gmail.com.
• 6Department of Epidemiology, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA. Alan.G.Nyitray@uth.tmc.edu.
• 7Tu Du Hospital, Ho Chi Minh City, Vietnam. thuthuy_bstudu@yahoo.com.vn.
• 8Department of Epidemiology, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA. Lu-Yu.Hwang@uth.tmc.edu. 

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A Group-Based Sexual Risk Reduction Intervention for Men Who Have Sex with Men in Ho Chi Minh City, Vietnam: Feasibility, Acceptability, and Preliminary Efficacy

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.

Purchase full article at: http://goo.gl/HGGdo9 

By:   Mimiaga MJ^1,2,3,4, Closson EF^5,6, Biello KB^7,8,5, Nguyen H⁹, Nguyen QH^9,10, Oldenburg CE¹¹, Lan HT¹², Safren SA^5,13, Mayer KH^5,14, Colby DJ¹⁰.

¹Department of Epidemiology and Behavioral & Social Health Sciences, Brown University School of Public Health, Providence, RI, USA. matthew_mimiaga@brown.edu.

²Institute for Community Health Promotion, Brown University, Providence, RI, USA. matthew_mimiaga@brown.edu.

³Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA. matthew_mimiaga@brown.edu.

⁴The Fenway Institute, Fenway Health, 1340 Boylston Street, Boston, MA, 02215, USA. matthew_mimiaga@brown.edu.

⁵The Fenway Institute, Fenway Health, 1340 Boylston Street, Boston, MA, 02215, USA.

⁶Department of Social and Environmental Health, The London School of Hygiene and Tropical Medicine, London, UK.

⁷Department of Epidemiology and Behavioral & Social Health Sciences, Brown University School of Public Health, Providence, RI, USA.

⁸Institute for Community Health Promotion, Brown University, Providence, RI, USA.

⁹Harvard AIDS Initiative in Vietnam, Ho Chi Minh City, Vietnam.

¹⁰Center for Applied Research on Men and Health, Ho Chi Minh City, Vietnam.

¹¹Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

¹²The Life Centre, Ho Chi Minh City, Vietnam.

¹³Department of Psychology, The University of Miami, Miami, FL, USA.

¹⁴Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

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Prevalence and Behavioral Correlates of Depression and Anxiety among Male Sex Workers in Vietnam

OBJECTIVES:

This study assessed depression and anxiety symptoms, and their association with high-risk sexual and drug behaviors, among male sex workers in three Vietnamese cities.

METHODS:

Male sex workers ages 16 to 35 completed an interview that included the CES-D to assess depressive symptoms and the BAI to assess anxiety symptoms, as well as questions assessing drug and sexual risk practices.

RESULTS:

A majority of participants reported depressive symptomatology although fewer report symptoms of anxiety. Risky sexual and drug use practices predicted both types of symptoms.

CONCLUSIONS:

Mental distress is associated with drug and sexual risk among male sex workers.

Table 3

Sexual attraction, sexual identity and sexual behaviors by city

	Hanoi	Nha Trang	HCMC	Overall	Significance
Sexual attraction
Exclusively/mostly men	15.7%	22.1%	30.5%	23.4%	x2=38.6, p<.001
Both men and women	49.8%	60.4%	35.7%	46.0%
Exclusively women	34.5%	17.5%	33.8%	30.5%
Sexual identity
Think of myself as a man	68.4%	55.8%	60.3%	62.2%	x2=101.1, p<.001
Think of myself as a woman	5.2%	2.6%	8.9%	6.2%
Think of myself as a transgender person	4.8%	14.9%	3.0%	6.2%
Other	1.2%	1.3%	16.7%	7.9%
Not sure	20.4%	25.3%	11.1%	17.5%
Years since first sex work	1.97	2.50	2.82	2.45	F=6.32, p=.002
Elective male partners
Lifetime	30.8%	52.6%	47.1%	42.5%	x2=23.0, p<.001
Current (past 30 days)	18.0%	35.1%	30.7%	27.2%	x2=17.4, p<.001
Elective female partners
Lifetime	83.2%	81.8%	65.0%	75.1%	x2=29.1, p<.001
Recent (past 90 days)	64.8%	61.0%	43.5%	54.8%	x2=28.4, p<.001
UAI last sex work	28.2%	54.5%	24.8%	32.7%	x2=43.7, p<.001

Table 4

Drug use by city

	Hanoi	Nha Trang	HCMC	Overall	Significance
Current drug use (past 30 days)
Alcohol	82.4%	93.5%	80.4%	83.9%	x2=13.75, p=.001
Tobacco	74.4%	73.4%	70.9%	72.7%	n.s.
Marijuana	12.0%	13.0%	6.9%	10.0%	n.s.
Ecstasy	8.0%	12.3%	15.7%	12.3%	x2=7.56, p=.023
Amphetamines	3.6%	8.4%	32.0%	16.9%	x2=89.18, p<.001
Any illicit drug
Lifetime use	52.0%	59.1%	66.0%	59.6%	x2=11.24, p=.004
Current use (past 30 days)	29.2%	28.6%	40.8%	34.1%	x2=10.97, p=.004

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

By:   Goldsamt LA1, Clatts MC2, Giang LM3, Yu G1.

• 1New York University College of Nursing, New York, NY.
• 2School of Public Health, University of Puerto Rico, San Juan, PR.
• 3Hanoi Medical University, Hanoi, Vietnam. 

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