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RESEARCH ARTICLE

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

Abstract

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.


References

[1]  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].

[2]  Girault P Saidel T Song N de Lind Van Wijngaarden JW Dallabetta G Stuer F et al 2004 HIV, STIs, and sexual behaviors among men who have sex with men in Phnom Penh, Cambodia. AIDS Educ Prev 16 31 44 doi:10.1521/aeap.16.1.31.27727

[3]  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].

[4]  Cutter JL Lim WY Ang LW Tun Y James L Chew SK 2004 HIV in Singapore–past, present, and future. AIDS Educ Prev 16 110 18 doi:10.1521/aeap.16.3.5.110.35528

[5]  Yi H , Kimmel DC . HIV testing and safer sex among gay Asian men. The 115th American Psychological Association Conference, San Francisco, CA, 2007.

[6]  Twu SJ Huang YF Lai AC Ming N Su IJ 2004 Update and projection on HIV/AIDS in Taiwan. AIDS Educ Prev 16 53 63 doi:10.1521/aeap.16.3.5.53.35530

[7]  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].

[8]  Colby D Cao NH Doussantousse S 2004 Men who have sex with men and HIV in Vietnam: a review. AIDS Educ Prev 16 45 54 doi:10.1521/aeap.16.1.45.27722

[9]  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].

[10]  Tan M . 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.

[11]  Storer G . 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.

[12]  McCamish M . 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.

[13]  De Lind van Wijngaarden JW . 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.

[14]  Clatts MC , Davis WR , Atitlasoy A . 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].

[15]  Watters JK Biernacki P 1989 Targeted sampling: options for the study of hidden populations. Soc Probl 36 416 30 doi:10.1525/sp.1989.36.4.03a00070

[16]  Le GM , Clatts MC , Goldsamt LA , Yi H . HIV risks among young male migrants using heroin in Hanoi, Vietnam. XVI International AIDS Conference, Toronto, 2006. [abstract WEAD0204]

[17]  Le GM. 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

[18]  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.

[19]  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].

[20]  Browne J Minichiello V 1996 Research directions in male sex work. J Homosex 31 29 56 doi:10.1300/J082v31n04_02

[21]  Scott J Minichiello V Marino R Harvey GP Jamieson M Browne J 2005 Understanding the new context of the male sex work industry. J Interpers Violence 20 320 42 doi:10.1177/0886260504270334

[22]  Browne J Minichiello V 1995 The social meanings behind male sex work: implications for sexual interactions. Br J Sociol 46 598 622 doi:10.2307/591574

[23]  Herdt G . Guardians of the flutes: idioms of masculinity. Chicago: The University of Chicago Press; 1981.

[24]  Goldberg J 1991 Sodomy in the new world: anthropologies old and new. Social Text 29 46 56 doi:10.2307/466298

[25]  Khan S 2001 Culture, sexualities, and identities: men who have sex with men in India. J Homosex 40 99 115 doi:10.1300/J082v40n03_06



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