Introduction The HIV/AIDS epidemic in Vietnam is concentrated in groups including men who have sex with men (MSM). Pre-exposure prophylaxis (PrEP) is a viable strategy for HIV prevention, but knowledge about and preferences for PrEP delivery among Vietnamese MSM are not well understood. Methods In 2015, an online survey was conducted via social networking websites for MSM and by peer recruitment. A description of daily oral, long-acting injectable, and rectal microbicide formulations of PrEP was provided to participants. Participants were asked about their prior awareness of and interest in PrEP, and ranked their most preferred PrEP modality. Multivariable logistic regression models were used to assess factors associated with having heard of PrEP, and with preference for each PrEP modality. Results Of 548 participants who answered demographic and PrEP-related questions, 26.8% had previously heard of PrEP, and most (65.7%) endorsed rectal microbicides as their most preferred PrEP delivery modality. Commonly-cited perceived barriers to uptake of PrEP included concern about side-effects, perception about being HIV positive, and family/friends finding out about sexual behavior. In multivariable models, older participants less often endorsed rectal microbicides (aOR 0.95 per year, 95% CI 0.91–0.99) and more often endorsed long-acting injectables (aOR 1.08 per year, 95% CI 1.03 to 1.14) as their preferred PrEP modality. Participants who were willing to pay more for PrEP less often endorsed rectal microbicides (aOR 0.81, 95% CI 0.72–0.92) and more often endorsed long-acting injectables (aOR 1.17, 95% CI 1.01–1.35) and daily oral pills (aOR 1.16, 95% CI 1.00–1.35) as their preferred form of PrEP. Conclusions A variety of PrEP modalities were acceptable to MSM in Vietnam, but low knowledge of PrEP may be a barrier to implementation.
Globally, transgender women have higher risk for HIV than the general population and men who have sex with men, but there is little data on this population in Vietnam. In 2015 we conducted a biological and behavioral survey of 205 transgender women in Ho Chi Minh City, Vietnam. Factors associated with HIV and syphilis infection were assessed through multivariable logistic regression models. Median age was 25 years (range 18-64). Overall prevalence was 18.0 % for HIV and 17.6 % for syphilis. Factors independently associated with HIV infection included risky alcohol use [adjusted Odds Ratio (aOR) 3.55, 95 % confidence interval (CI) 1.53-8.21], amphetamine stimulant use (aOR 2.90, 95 % CI 1.27-6.61), sex with male sex workers (aOR 4.73, 95 % CI 1.72-13.0), and history of sex with an adult before the age of 18 years (aOR 2.97, 95 % CI 1.06-8.34). Two factors associated with syphilis infection were HIV infection (aOR 2.37, 95 % CI 1.03-5.45) and condomless anal sex with casual partners (aOR 2.27, 95 % CI 1.03-5.00). In order to address the HIV and syphilis epidemics in Vietnamese transgender women, interventions are needed to make HIV and sexually transmitted infection screening and treatment more accessible.
Few studies have considered acceptability of HIV pre-exposure prophylaxis (PrEP) among transgender women in Southeast Asia. We assessed PrEP indications and readiness among a sample of HIV-uninfected transgender women in Ho Chi Minh City, Vietnam. Of 168 HIV-uninfected transgender women, 72.6% met criteria for PrEP based on United States CDC guidelines. PrEP indication was inversely associated with PrEP interest (76.0% interested among those for whom PrEP was indicated; 89.1% among those for whom it was not; aOR 0.16, 95% CI 0.04–0.67, P=0.01). PrEP readiness, defined as having heard of, being interested in taking, and believing that PrEP is efficacious, was low (7.7%). The results of this study indicate potential need for PrEP among transgender women in Ho Chi Minh City, but very low awareness of PrEP in the community. Future PrEP implementation programs should include counseling on HIV risk and eligibility for PrEP to ensure that PrEP is available to those who may benefit the most from it.
In Vietnam, the national public healthcare services and statistics reveal problems with antibiotic use in the community with misunderstandings leading to the irrational and inappropriate use of these drugs resulting in bacterial resistance together with its consequences. There have been studies in Vietnam revealing a major problem in prescribing in the acute sector, but most antibiotics are prescribed in the community and there had been no studies exploring the situation in the community. This study was therefore an evaluation of the knowledge, skills and prescribing practice of those primarily responsible for administering antibiotics in the community, and was the first of its kind in Vietnam. The study used method triangulation to evaluate antibiotic use in the study location, a district in one province in North Vietnam. The district was chosen as it was typical of other rural areas in North Vietnam. The findings revealed a very high rate of antibiotic administration (79.8%) of which more than half (54%) were incorrectly prescribed for non-infectious conditions. Also, misunderstandings, limited knowledge and perceptions regarding the use of antibiotics, with staff having had little post basic training and education. It is further recommended that similar studies will be conducted along this line to verify the findings of the study.
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