Male sex work and HIV risk among young heroin users in Hanoi, Vietnam
Michael C. Clatts A D , Le M. Giang B , Lloyd A. Goldsamt C and Huso Yi C
A Center for Research on Global Health and Youth at Risk, School of Public Health, University of Puerto Rico, San Juan, Puerto Rico.
B Center for Research and Training on HIV/AIDS, Hanoi Medical University, Hanoi, Vietnam.
C National Development and Research Institutes, Inc., New York, NY, USA.
D Corresponding author. Email: Clatts@ndri.org
Sexual Health 4(4) 261-267 http://dx.doi.org/10.1071/SH07018
Submitted: 27 March 2007 Accepted: 6 October 2007 Published: 23 November 2007
The present study describes complex drug and sexual risk in a group of male sex workers (n = 79) who were recruited in the context of a larger study of young heroin users in Hanoi, Vietnam (n = 1270). Male sex workers were significantly more likely than male non-sex workers to be migrants (P < 0.001) and to have unstable housing (P < 0.001), to have lifetime exposure to marijuana (P < 0.001), 3,4 methylenedioxymethamphetamine (MDMA, ecstasy) (P < 0.01), amphetamines (P < 0.05), cocaine (P < 0.01) and morphine (P < 0.001). Male sex workers are more likely to currently use MDMA (P < 0.05), amphetamines (P < 0.001), morphine (P < 0.05) and to ‘smoke’ as their most frequent mode of heroin administration (P < 0.01). Male sex workers are more likely to have both male and female concurrent sex partners (P < 0.001), to have a history of sexual victimisation (P < 0.001), to have had more than three different sex partners in the past 30 days (P < 0.001), and to have had partners who injected drugs before sex (P < 0.001) or who used drugs during sex (P < 0.01). In their last sexual encounter with a client partner, approximately one-third (31.1%) reported having had receptive anal sex. In nearly three-quarters of these exchanges (71.4%), no condom was used. Similarly, in their last sexual encounter with a client partner, 42.2% reported having had insertive anal sex and in nearly half (47.4%) of these encounters no condom was used. Consistent with recent data from elsewhere in the region, there is an urgent need for additional research on male sex work in South-east Asia in order to properly situate behavioural interventions for male sex workers in this region.
Additional keywords: drug abuse, epidemiological bridging patterns, high risk youth, masculinities, migration, sexual risk, sexually transmissible infections.
United Nations Programme on HIV/AIDS. Report on the global AIDS epidemic 2006. Geneva: UNAIDS; 2006. Available at: http://www.unaids.org/en/HIV_data/2006GlobalReport/default.asp [verified 26 October 2007].
de Lind Van Wijngaarden
HIV, STIs, and sexual behaviors among men who have sex with men in Phnom Penh, Cambodia.
AIDS Educ Prev
Population Foundation of India. HIV/AIDS in India: the hard-hit states. New Delhi: Population Foundation of India; 2003. Available at: http://www.prb.org/pdf/Tamil-Nadu.pdf [verified 26 October 2007].
HIV in Singapore–past, present, and future.
AIDS Educ Prev
. HIV testing and safer sex among gay Asian men. The 115th American Psychological Association Conference, San Francisco, CA, 2007.
Update and projection on HIV/AIDS in Taiwan.
AIDS Educ Prev
Thailand Ministry of Public Health. HIV infection soars among men who have sex with men. Bangkok: Thailand Ministry of Public Health; 2005. Available at: http://www.dreadedned.com/images/news/2005/050905-moph.pdf [verified 26 October 2007].
Men who have sex with men and HIV in Vietnam: a review.
AIDS Educ Prev
Treat ASIA, American Foundation for AIDS Research. MSM and HIV/AIDS risk in Asia: what is fueling the epidemic among MSM and how can it be stopped? Available at: http://www.amfar.org/binary-data/AMFAR_PUBLICATION/download_file/47.pdf [verified 26 October 2007].
. Walking the tightrope: sexual risk and male sex work in the Philippines. In: Aggeleton P, ed. Men who sell sex: international perspectives on male prostitution and HIV/AIDS. Philadelphia: Temple University Press; 1999. pp. 242–62.
. Rehearsing gender and sexuality in modern Thailand: masculinity and male-male sex behaviours. In: Sullivan G, ed. Lady boys, tom boys, rent boys: male and female homosexualties in contemporary Thailand. New York: Haworth Press; 1999. pp. 141–60.
. The friends thou hast: support systems for male commercial sex workers in Pattaya, Thailand. In: Sullivan G, ed. Lady boys, tom boys, rent boys: male and female homosexualties in contemporary Thailand. New York: Haworth Press; 1999. pp. 161–92.
De Lind van Wijngaarden
. Between money, morality and masculinity: bar-based male sex work in Chiang Mai. In: Sullivan G, ed. Lady boys, tom boys, rent boys: male and female homosexualties in contemporary Thailand. New York: Haworth Press; 1999. pp. 193–218.
. Hitting a moving target: the use of ethnographic methods in the evaluation of AIDS outreach programs for homeless youth in NYC. In: Lambert E, ed. Qualitative methods in drug abuse and HIV research. National Institute on Drug Abuse Research Monograph, 1995; 157: 17–135. Available at: http://www.fhi.org/en/HIVAIDS/country/VietNam/ [verified 26 October 2007].
Targeted sampling: options for the study of hidden populations.
. HIV risks among young male migrants using heroin in Hanoi, Vietnam. XVI International AIDS Conference, Toronto, 2006. [abstract WEAD0204]
The irony of agency in space: displacement and vulnerability in two highways in Viet Nam. In: Development, spatial mobility and HIV/AIDS. UNDP SE Asia HIV and Development Programme 2004 Dec; 50–65. Available at: http://www.hivdevelopment.org/Publications_english/spatial_mobility.htm
A2 Technical Working Group. The HIV Epidemic in Ho Chi Minh City: where is it going? Health policy initiative of constella futures; family health international; and Ho Chi Minh AIDS Committee; 2006.
MAP. Male-Male Sex and HIV/AIDS in Asia. Mapping the AIDS Pandemic, 2005. http://www.mapnetwork.org/docs/MAP_&M%20Book_04July05_en.pdf [verified 11 October 2007].
Research directions in male sex work.
Understanding the new context of the male sex work industry.
J Interpers Violence
The social meanings behind male sex work: implications for sexual interactions.
Br J Sociol
. Guardians of the flutes: idioms of masculinity. Chicago: The University of Chicago Press; 1981.
Sodomy in the new world: anthropologies old and new.
Culture, sexualities, and identities: men who have sex with men in India.