In a context with limited attention to mental health and prevalent sexual prejudice, valid measurements are a key first step to understanding the psychological suffering of sexual minority populations. We adapted the Patient Health Questionnaire as a depressive symptom severity measure for Vietnamese sexual minority women, ensuring its cultural relevance and suitability for internet-based research. Psychometric evaluation found that the scale is mostly unidimensional and has good convergent validity, good external construct validity, and excellent reliability. The sample’s high endorsement of scale items emphasizes the need to study minority stress and mental health in this population.

We developed the first Vietnamese internalized homophobia (IH) scale, for use with Vietnamese sexual minority women (SMW). Drawing from existing IH scales in the international literature and based on prior qualitative research about SMW in the Viet Nam context, the scale covers two domains: self-stigma (negative attitudes toward oneself as a sexual minority person) and sexual prejudice (negative attitudes toward homosexuality/same-sex relations in general). Scale items, including items borrowed from existing scales and items based on local expressions, were reviewed and confirmed by members of the target population. Quantitative evaluation used data from an anonymous web-based survey of Vietnamese SMW, including those who identified as lesbian (n=1187), or as bisexual (n=641) and those who were unsure about their sexual identity (n=353). The scale was found to consist of two highly correlated factors reflecting self-stigma (not normal/wholesome and self-reproach and wishing away same-sex sexuality) and one factor reflecting sexual prejudice, and to have excellent internal consistency. Construct validity was evidenced by subscales’ associations with a wide range of hypothesized correlates including perceived sexual stigma, outness, social support, connection to other SMW, relationship quality, psychological well-being, anticipation of heterosexual marriage and endorsement of same-sex marriage legalization. Self-stigma was more strongly associated with psychosocial correlates and sexual prejudice was more associated with endorsement of legal same-sex marriage. The variations in these associations across the hypothesized correlates and across sexual identity groups were consistent with the Minority Stress Model and the IH literature, and exhibited context-specific features, which are discussed.

Understanding HIV-related behaviours and the factors that influence these behaviours among people living with HIV (PLHIV) is critical to the design of effective HIV-prevention strategies; however, this subject has yet to receive the attention it deserves in Vietnam. Given that greater proportions of new HIV infections in the country stem from heterosexual transmission, it is essential to examine the sexual behaviours of Vietnamese PLHIV. The purpose of this qualitative study was to explore the sexual behaviour of individuals following HIV diagnosis and to gain insight into how and why HIV diagnosis affects sexual practices and relationships. Seventy PLHIV in Thaibinh province participated in semi-structured, in-depth interviews. Qualitative data were supported by a quantitative questionnaire on demographics and sexual and drug use history. Nearly all of the participants reported adopting safer sexual practices following HIV diagnosis by using condoms consistently and reducing the number of sex partners. This was true for injecting drug users, female sex workers, unmarried individuals and participants in both HIV serodiscordant and seroconcordant marriages. Motivations for adopting these preventive measures included avoiding HIV transmission, reinfection or cross-resistance as well as preservation of one's own health. Due to stigma, depression, fear of transmission, health status and/or drug addiction, HIV diagnosis dramatically impacted the sexual health of most participants by reducing sexual desire, pleasure and frequency. Implications for HIV prevention and care programmes and policies in Vietnam are discussed.

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This population requires public health attention, with emphasis placed on interventions targeting the family to promote acceptance and to prevent negative treatment, and interventions supporting those SMW who encounter the worst types of negative family treatment.

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There is a need to understand how social and cultural expectations of being a woman shape the challenges women face when trying to access antiretroviral therapy (ART) and to continue the treatment over time. Based on a 7-month prospective study of 15 HIV-infected women, the particular challenges met by these women in northern Vietnam are discussed in this article. We argued that, by taking ART to maintain their health and to fulfill their responsibilities to family and community, the women managed to reclaim the "moral worth" they had lost as a result of having HIV infection. At the same time, certain social and economic contingencies related to ART made it difficult for the women to uphold this moral position. The study demonstrated the importance of understanding the meanings and implications of ART in specific social contexts to understand how social support structures could be established to ensure treatment continuation.