No abstract

Rapid socioeconomic transformation in Vietnam in last 15 years has been followed by more liberation of sexual expression and representation of sexual identity among young people. There has been an increase in the visibility of homosexual men in major cities of Vietnam who were largely an unknown population until the emergence of the HIV epidemic. Men who have sex with men (MSM) are now considered as one of the target groups in many HIV prevention programs. This qualitative study examines local identities, relationships, and sexual practices among young MSM aged 15-24 in the cities of Hanoi and Ho Chi Minh City. Our analyses were based on 26 in-depth interviews and 10 focus group discussions with young MSM recruited through public place intercepts and cruising areas. Data document the linguistic classification, sexual relationships and behaviors, identity and process of homosexual identification, and the potential linkage between sexual identity and sexual behaviors of MSM in Vietnam. Data also highlight the stages of homosexual community development in urban Vietnam and important differences between Vietnam and the West in the representation of homosexual identity, relationships, and practices. In light of the findings, we suggest that the continuing development and elaboration of a homosexual community in Hanoi and Ho Chi Minh City offers significant opportunities for targeted HIV/AIDS prevention activities in the Vietnamese MSM population.As in many other cultures, homosexuality is not considered a normal or acceptable practice in Vietnam. Although homosexuality has never been explicitly illegal in Vietnam, men who engage in homosexual practices are regarded as a "deviant" group, subject to social stigma and discrimination. As a result, they often attempt to keep their sexual identities and desires secret. Rapid socioeconomic transformation in last 15 years has led to greater freedom of sexual expression among young people, and advances in communication technologies have enabled homosexuals in Vietnam to interact with and learn about their counterparts in other countries. There are now a growing number of men who openly assert homosexual identities in major cities such as Hanoi and Ho Chi Minh City, and their increasing visibility has garnered greater public attention (Blanc, 2005; Colby, Cao, & Dousntouse, 2004).

Outreach and education for students should target specific deficits in knowledge such as those identified in this study.

Since the publication of the World Health Report 2008, there has been renewed interest in the potential of primary health care (PHC) to deliver global health policy agendas. The WHO Western Pacific Regional Strategy 2010 states that health systems in low- and middle-income countries (LMICs) can be strengthened using PHC values as core principles. This review article explores the development of an evidence-based approach for assessing the effectiveness of PHC programs and interventions in LMICs. A realist review method was used to investigate whether there is any internationally consistent approach to evaluating PHC. Studies from LMICs using an explicit methodology or framework for measuring PHC effectiveness were collated. Databases of published articles were searched, and a review of gray literature was undertaken to identify relevant reports. The review found no consistent approach for assessing the effectiveness of PHC interventions in LMICs. An innovative approach used in China, which developed a set of core community health facility indicators based on stakeholder input, does show some potential for use in other LMIC contexts.

No abstract

No abstract

No abstract

No abstract