Understanding on Sub-Populations of Men who have Sex with Men (MSM) in Ho Chi Minh City, Vietnam: Implication for HIV intervention among MSM Público

Abstract

Background. Men who have sex with Men (MSM) is an emerging HIV high risk population in Vietnam. Understanding on specific characteristics of MSM subpopulations is critical to design specific HIV interventions for each group. Current studies categorize MSM subpopulations by their visibility (hidden vs. unhidden), sexual orientation (homosexual vs. bisexual) or transaction sexual behavior (selling vs. non-selling sex). Very few studies define MSM subpopulations by their location of networking and HIV status.

Objective. This study explores the differences between 1) MSM recruited from street-based (MSMS) versus facility-based venues (MSMF), and 2) HIV negative and HIV positive MSM.

Methods. This is a secondary data analysis using a sub-dataset sampled by Time - Location sampling method on 400 MSM in Ho Chi Minh City, Vietnam. MSMS were compared to MSMF by demographic and HIV related characteristics, and networking locations. HIV negative and HIV positive MSM were compared by four major parameters: HIV risk perception, sexual behaviors, drug use behaviors and overlapping risks. Logistic regression was performed to define factors associated with HIV positive.

Results. There were no significant differences between MSMS and MSMF except higher proportion of test result for drug use among MSMF (9.5% vs. 1.6%, p=0.005). MSMF were 2.5 times more likely to use opiate drug over the last 30 days than MSMS (p = 0.013). There were no significant differences between HIV negative and HIV positive MSM. Results of logistic model showed that MSM with low education levels were 5 times more likely to be HIV positive than MSM with higher education level (adjusted OR = 4.85; 95%CI=1.41 - 16.65, p-value = 0.01) and MSM with correct HIV knowledge were 3 times more likely to be HIV positive than MSM who did not (adjusted OR = 3.36; 95% CI=1.24 - 9.10, p-value = 0.019).

Discussion. Significant difference in drug use suggested more studies needed to define the existence of possible MSM subpopulation by their networking locations. No significant differences between HIV negative and HIV positive MSM suggested notable risky behavior trend among HIV negative group. Effective interventions for HIV positive MSM should be continued. Intensive interventions should be prioritized for HIV negative MSM for constant HIV risk reduction.

Table of Contents

Table of Contents

List of figures and tables iii

Definition of key terms iv

I. Introduction 1

Objectives 3

Background and Rationale. 3

II. Literature Review 7

Measurement of HIV prevalence among MSM in Vietnam.. 7

International guidelines and evidence of risk factors leading to HIV infection among MSM.. 9

Evidence of HIV risk factors among MSM in Vietnam.. 14

Conclusions about knowledge gaps. 18

III. Method 21

Study design and sample size. 21

Measurements. 24

Analysis. 31

IV. Results 33

Comparison between MSM recruited from street-based versus facility-based venues. 33

Comparison between HIV-positive and HIV-negative MSM.. 40

Risk factors associated with HIV positive status. 46

V. Discussion 47

Conclusions. 47

Limitations. 52

Recommendations. 53

References 54

A nnexes

List of figures and tables

Figure 1. Diagram of Primary Study Design. 21

Figure 2. Participants Recruited in a Secondary Data Analysis of the Primary Study. 23

Table 1. Variables Studied of MSM recruited from Street-based versus Facility-based Venues, HCMC 2011 - 2012. 25

Table 2. Variables Chosen to Comparison of HIV-negative vs. HIV-positive MSM, Vietnam, 2011 - 2012. 28

Table 3. Comparison of demographic characteristics between MSM Recruited from HCMC Street-based versus Facility-based Venues, 2011 - 2012. 33

Table 4. Comparison of HIV-related Characteristics between MSM Recruited from HCMC Street-based versus Facility-based Venues, 2011 - 2012. 35

Table 5. Comparison of HIV-related characteristics between MSM Recruited from HCMC Street-based versus Facility-based Venues, 2011 - 2012. 38

Table 6. Comparison of drug use behaviors between MSM recruited from street-based versus facility-based venues. 39

Table 7. Opiate drug test result between MSM Recruited from HCMC Street-based versus Facility-based Venues, 2011 - 2012. 39

Table 8. Comparison of HIV risk perception between HCMC HIV-positive and HIV-negative MSM, 2011 -- 2012. 41

Table 9. Comparison of sexual and drug use behaviors between HCMC HIV-positive and HIV-negative MSM, 2011 - 2012. 43

Table 10. Comparison of overlap risks HCMC HIV-positive and HIV-negative MSM, 2011 - 2012. 44

Table 11. Result of Multivariate Analyses to define risk factors associated with HIV positive 46

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About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Health Care Management
Palavra-chave	Vietnam MSM
Committee Chair / Thesis Advisor	McNabb, Scott JN, Emory University
Committee Members	Del Rio, Carlos, Emory University
Partnering Agencies	Non-US governmental agency (e.g., Minister of Health in Haiti)

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