As of April 2003, 64,801 HIV cases have been documented in Vietnam (Policy Project 2003), 53.9 % of which are among individuals 20-29 years of age. Although HIV education efforts have increased, there remains a need for proven effective programs. We present findings from a randomized-controlled effectiveness trial of an HIV prevention program for adolescents 15-20 years. Four hundred eighty adolescents were randomized into control and intervention groups. Evaluation data were collected using the Vietnamese Youth Health Risk Behavior Instrument, including scales based on the protection motivation theory (PMT). Findings presented show significant differences in knowledge of severity and vulnerability of HIV/AIDS ( p < .05), perceptions of self-efficacy ( p < .001), and response efficacy for condom use ( p < .05) between control and intervention youth at immediate and 6-month postintervention. A significant difference was also found for response cost of condom use ( p < .05) at immediate postintervention. No significant difference was found for the construct of response cost at 6 months, and there were no significant differences for the constructs external and internal rewards. Reported engagement in vaginal sex (1.7%), or anal and/or oral sex (3.1%) was extremely low, and therefore changes in actual behaviors could not be accurately measured. However, intention to use condoms in possible future sexual encounters increased significantly ( p < .05) for the intervention youth compared to control youth between baseline (74/240, 30.8%) and both immediate postintervention (132/230, 57.4%), and six month follow-up (123/228: 53.9%). These data suggest the potential applicability of the PMT for HIV program development with non-Western adolescents but also point to the need for further studies on how constructs within behavioral theories might need to be modified in different sociocultural settings.
As rates of HIV increase in Viet Nam, there is a need for data on social relations and sexual risk and protective behaviors among Vietnamese adolescents in a context of rapid social and economic changes. We report findings from our qualitative interviews with 159 Vietnamese adolescents living in Ha Noi, Nha Trang City and Ninh Hoa District and survey of 886 adolescents in these same three sites. In the qualitative interviews, youth report a strong adherence to ideals and values regarding abstinence outside of marriage. Youth reported low rates of engagement in vaginal, anal, and/or oral sex with a significant difference in reported behaviors between males (29/469, 6.2%) and females (7/416, 1.7%) [p=.000]. 15/32 (46.9%) sexually active youth reported "rarely" or "never" using condoms. Females had significantly higher scores for perceived sexual stigma than males [t=−10.22 (95% CI −3.72 to −2.52), p=.000] while males scored significantly lower than females on a scale of perceived self-efficacy for abstinence [t=5.31 (95% CI 0.27 to 0.59), p=.000]. The stigmatization of sexual relations outside of marriage particularly for young women reinforces abstinence, however these same values decrease adolescents' abilities to obtain accurate information about sexuality and HIV/STIs, and engage in safer sex.
The perceived private economic benefits of a cholera vaccine were high, but not evenly distributed across the population. A minority of the people in Hue place no value on receiving a cholera vaccine.
The demand function for vaccines against typhoid fever was estimated using stated preference data collected from a random sample of 1065 households in Hue, Vietnam, in 2002. These are the first estimates of private willingness-to-pay (WTP) and demand functions for typhoid vaccines in a developing country. Mean respondent WTP for a single typhoid fever vaccine ranged from USD 2.30 to USD 4.80. Mean household WTP estimates (vaccinating all members of the household) ranged from USD 21 to USD 27. Demand was similar for vaccines with different degrees of effectiveness and intervals of duration. These results suggest a significant potential for private sector provision of typhoid fever vaccines in Hue.
Summaryobjectives To identify demand for Vi typhoid fever vaccine for school-age children; obstacles and enabling factors for vaccine delivery; and socio-behavioural factors associated with trial participation and possible predictors of future vaccine acceptance, in Hue City, Viet Nam.methods Pre-and post-trial surveys of randomly selected households with children aged 6-17 years. Simple multinomial logistic analyses for ratios of relative risks (RRR) and significance on trial participation by demographics and variables related to typhoid fever, vaccination, and pre-trial experiences with information and consents. Multiple logistic regressions to assess differences in participation based on child's characteristics.results As many as 62.6% of households let all school age children participate, 10.2% let some participate, and 26. conclusions Inter-related factors contribute to participation in a clinical vaccine trial, which may differ from desire to participate in a public health campaign. Educational campaigns need to be targeted to children and adolescents, and consideration for assent procedures for minors. Obtaining informed consent may affect trial participation within a social and political system unaccustomed to these procedures.
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