Sexual practices, partner concurrency and high rates of sexually transmissible infections among male sex workers in three cities in Vietnam
Michael C. Clatts A D , Lloyd A. Goldsamt B , Le Minh Giang C and Gary Yu BA School of Public Health, PO Box 365067, University of Puerto Rico Medical Science Center, San Juan, 00936, Puerto Rico.
B New York University College of Nursing, 433 First Avenue, New York, NY 10010, USA.
C Center for Research and Training on HIV/AIDS, Hanoi Medical University, 1 Ton That Tung Street, Room 601, Building A1, Hanoi, Vietnam.
D Corresponding author. Email: michael.clatts@upr.edu
Sexual Health 12(1) 39-47 https://doi.org/10.1071/SH14101
Submitted: 7 June 2014 Accepted: 8 December 2014 Published: 27 January 2015
Abstract
Background: This paper examines sexual practices, partner concurrency and sexually transmissible infections (STI)/HIV infection among male sex workers (MSWs) in Vietnam. Methods: Six hundred and fifty-four MSWs, aged 16–35 years, were recruited in Hanoi, Nha Trang and Ho Chi Minh City between 2009 and 2011. Survey measures included demographic characteristics, drug use, types of sexual partners and sexual practices. Subjects were screened for STIs, including HIV. Results: MSWs in Ho Chi Minh City (33%) were more likely than those from the other two sites to be current users of one or more types of illegal drugs (P < 0.001). MSWs with both male and female elective partners (compared with other partnership types) were more likely to have anal sex with male client partners (P < 0.001), elective male partners (P = 0.045) and elective female partners (P = 0.025). At last sex with a male client partner, only 30% used a condom during anal intercourse. At last sex with an elective female partner, only 31% used a condom during vaginal sex and only 3% during anal sex. Although rates of HIV are low (4%), other STIs are high, including chlamydia (17%), gonorrhoea (29%) and human papillomavirus (33%). Most (57.3%) have never been tested for HIV and only 17% have ever disclosed to a healthcare provider that they have sex with men. Conclusions: Complex patterns of sexual concurrency, coupled with high rates of STIs, signal the urgent need for health services interventions among MSWs, both to improve individual health outcomes and to reduce secondary STI/HIV transmission among sexual partner networks.
Additional keywords: HIV, epidemiological bridging patterns, sexual health.
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