Risk behaviors, sexually transmitted infections and hiv among men who have sex with men in Southern Vietnam.

摘要

Introductions: HIV infection is occurring more rapidly among men who have sex with men (MSM) than among other risk groups. This study was conducted to determine the prevalence and factors associated with HIV, syphilis, urethral gonorrhea and chlamydia infection, and anal sexual positions among MSM in southern Vietnam. Methods: A total of 2768 MSM participated in several surveys implemented in eight southern provinces of Vietnam. Information on socio demographic factors, sexual behavior risks, and treatment seeking behaviors were obtained via face-to-face interviews. Blood and urine samples were collected for HIV, syphilis, gonorrhea and chlamydia testing. Multivariate logistic regression analysis was used to determine factors associated with HIV, syphilis, urethral gonorrhea and chlamydia. Multivariate multinomial logistic regression analysis was performed to determine the correlates of anal sexual positions. Results: The prevalences (and 95%CI) of HIV, syphilis, urethral gonorrhea and chlamydia amongst MSM were 2.6% (2.0%-3.2%), 1.6% (1.1%-2.1%), 2.4% (1.7%-3.0%) and 4.3% (3.4%-5.1%), respectively. The prevalences of being exclusively insertive (EI), versatile and exclusively receptive (ER) among MSM were 25.6%, 64.5% and 9.9%, respectively. Demographic factors (age, marital status, whom currently living with, being religious, income, occupation), sexual risk behaviors (having ever had sex with a foreigner, condom use, anal sexual positions), alcohol use, recreational drug use, self assessment of HIV risk and syphilis seropositive were associated with HIV infection. Several factors were found to be associated with syphilis infection (occupation, HIV knowledge, multiple anal sex partners, condom use and HIV positive), urethral gonorrhea (religion, living with friends/male partners, engaging in sex with foreigners, middle/high income, ever acquired an STI and having urethral chlamydia), and chlamydia infection (age, occupation, exclusively receptive, drinking before anal sex, interaction between condom use and income and having urethral gonorrhea). Correlates of anal sexual positions included sociodemographic factors, sexual risk behaviors, recreational drug use, previous HIV testing, HIV and STI knowledge, STI related symptoms and receiving free or discounted-price condoms. Conclusions: HIV/STI and related risk behaviors are important public health issues among MSM in Southern Vietnam. On the basis of the study results, we make specific policy and intervention recommendations.