Mental health in HIV prevention and care: A qualitative study of challenges and facilitators to integration in Vietnam

Trang, Kathy; Ly, An Thanh; Lam, Le Xuan; Brown, Carolyn; To, Margaret Q; Sullivan, Patrick S.; Worthman, Carol M.; Giang, Lê Minh; Jovanović, Tanja

doi:10.1016/j.socscimed.2021.113978

Cited by 7 publications

(18 citation statements)

References 53 publications

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“…Our concern that mental health stigma may lead participants to underreport experiences of mental health and psychosocial distress was largely unfounded [ 81 - 83 ]. For some participants, mental health stigma may have even enhanced the perceived attractiveness of the app, as it provided them an outlet to share details they otherwise could not.…”

Section: Discussionmentioning

confidence: 99%

“…Concomitantly, all our participants owned a smartphone and, therefore, may represent a subpopulation that is more comfortable using mobile apps than their counterparts. This is unlikely to be representative of older Vietnamese MSM in urban settings and those in the country more generally among whom HIV risk and mental health burden may be both more stigmatized and pronounced [ 83 , 97 , 98 ]. Thus, the generalizability of these findings to other MSM should be taken with caution.…”

Section: Discussionmentioning

confidence: 99%

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Feasibility, Acceptability, and Design of a Mobile Ecological Momentary Assessment for High-Risk Men Who Have Sex With Men in Hanoi, Vietnam: Qualitative Study

Trang¹,

Le²,

Brown³

et al. 2022

JMIR Form Res

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Background Men who have sex with men (MSM) are at a disproportionate risk for HIV infection and common mental disorders worldwide. In the context of HIV, common mental disorders are important and are frequent drivers of suboptimal prevention and treatment outcomes. Mobile ecological momentary assessments (EMAs), or the repeated sampling of people’s behaviors and psychological states in their daily lives using mobile phones, can clarify the triggers and HIV-related sequelae of depressive-anxious symptoms and contribute toward the design of ecological momentary interventions (EMIs) that cater to the contextually varying needs of individuals to optimize prevention and treatment outcomes. Objective This study aims to characterize the feasibility and acceptability of mobile EMA among high-risk MSM in Hanoi, Vietnam. It aims to evaluate the perceived relevance, usability, and concerns of this group with regard to the content and delivery of mobile EMA and the potential of leveraging such platforms in the future to deliver EMIs. Methods Between January and April 2018, a total of 46 participants were recruited. The participants completed 6 to 8 mobile EMA surveys daily for 7 days. Surveys occurred once upon waking, 4 to 6 times throughout the day, and once before sleeping. All surveys queried participants’ perceived safety, social interactions, psychological state, and mental health symptoms. The morning survey further queried on sleep and medication use within the past 24 hours, whereas the night survey queried on sexual activity and substance use and allowed participants to share an audio recording of a stressful experience they had that day. At the end of the week, participants were interviewed about their experiences with using the app. Results Participants completed an average of 21.7 (SD 12.7) prompts over the 7-day period. Excluding nonresponders, the average compliance rate was 61.8% (SD 26.6%). A thematic analysis of qualitative interviews suggested an overall positive reception of the app and 5 recurring themes, which were centered on the relevance of psychological and behavioral items to daily experiences (eg, mental health symptoms and audio recording), benefits of using the app (eg, increased self-understanding), worries and concerns (eg, privacy), usability (eg, confusion about the interface), and recommendations for future design (eg, integrating more open-ended questions). Conclusions Mobile EMA is feasible and acceptable among young MSM in Vietnam; however, more research is needed to adapt EMA protocols to this context and enhance compliance. Most participants eagerly provided information about their mental health status and daily activities. As several participants looked toward the app for further mental health and psychosocial support, EMIs have the potential to reduce HIV and mental health comorbidity among MSM.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Feasibility, Acceptability, and Design of a Mobile Ecological Momentary Assessment for High-Risk Men Who Have Sex With Men in Hanoi, Vietnam: Qualitative Study

Trang¹,

Le²,

Brown³

et al. 2022

JMIR Form Res

Self Cite

View full text Add to dashboard Cite

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“…A study showed that only 70.3% of MSM were willing to seek medical help for sexual health problems, and 79.4% of respondents were not willing to disclose their sexual behavior when seeking medical attention [15]. A study in Vietnam found similar results, with sexual stigma contributing to MSM's reluctance to actively access health services [25]. The second challenge is weak health systems.…”

Section: Text Of Reviewmentioning

confidence: 99%

“…In Shenyang, China, 59.3% had a single infection, 19.2% had dual infections, and 4.5% had multiple (i.e., more than two) infections among the 177 MSM [ 24 ▪ ]. Additionally, the majority ( n = 17/20) participants reported experiencing significant psychological distress either in the past or in the present, approximately one-third also reported a history of suicidal ideation or self-harm, and more depressive-anxious symptoms in a Vietnamese qualitative study [ 25 ]. Operario et al [ 26 ▪▪ ] showed that repeated exposure to anti-MSM stigma can produce emotional distress, pressure to conceal one's identity, social isolation, maladaptive coping, and physiological reactivity.…”

Section: Text Of Reviewmentioning

confidence: 99%

Advances and challenges in sexually transmitted infections prevention among men who have sex with men in Asia

Chen

Niu

2022

Current Opinion in Infectious Diseases

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Purpose of review This review summarizes recently published research on sexually transmitted infections (STIs) and sexually transmitted diseases (STDs) among men who have sex with men (MSM) in Asia, covering four main areas: prevalence and consequences of STIs/STDs, factors associated with STI risk, strategies and measures of STI prevention, challenges in the prevention of SITs. Recent findings Studies show that STIs among Asian MSM are still prevalent, with the prevalence of STIs varying slightly from country to country. In addition to the number of sexual partners, frequency of condom use, high-risk sexual behaviors, the influence of Confucianism, law, and COVID-19 are also related to STI risk. Social stigma, weak health systems, lack of funding and policy support are the current challenges for STIs prevention. Summary In the future, new media technologies are encouraged to be used to enhance education and reduce stigma and discrimination against MSM and STIs. Expanding STI screening, strengthening STI knowledge propaganda and education among MSM population, and providing necessary counseling and medical services are main strategies in STI prevention. It is also important to strengthen STI awareness and policy support at the national level.

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“…Poor health literacy, especially a lack of understanding about mental health, was reported in six studies (Hall et al, 2019;Nguyen et al, 2019;Parry et al, 2020;Putri et al, 2021;Subramaniam et al, 2021;Trang et al, 2021;Zay Hta et al, 2021). Hall et al (2019) and Zay Hta et al ( 2021) reported that the lack of available information contributed to the poor knowledge held by the SEA population, while Subramaniam et al (2021) identified that mental health education was a low priority in schools and workplaces.…”

Section: Poor Health Literacymentioning

confidence: 99%

Barriers and enablers to access and utilization of mental health care services across Southeast Asia: A preliminary scoping review

Andary,

Bassani,

Burrell

et al. 2023

Asia-Pacific Psychiatry

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While the importance of mental health and its impact on overall health and well‐being has been widely recognized, there continue to be ongoing barriers to accessing mental health services. This is particularly poignant in countries in Southeast Asia (SEA) where there may be further stigma in accessing mental health services. As no reviews have been undertaken on this topic, this review aims to outline the barriers and enablers to access and utilization of mental health care services in SEA. Searches were undertaken in commercially produced and gray literature sources. Two independent reviewers screened the results. The data were then independently extracted, which was then collated and synthesized, using the Health Belief Model (HMB) as a framework. Twelve studies were included in the review. Under the HBM, barriers were grouped into: stigma, poor health literacy, internalized reasons, cultural beliefs, lack of training of health professionals, quality of service, and poor distribution of resources. Enablers included: social support, outreach services, structural stigma, self‐awareness, resources and information, accessibility and affordability, and positive attitudes and beliefs about health professionals. Those accessing mental health care in SEA are confronted by complex barriers and few enablers. Ongoing stigma and a distinct lack of resources pose the greatest challenges, which are even more amplified for those in rural areas and minority groups. A multifaceted strategy that improves the structures, processes, and outcomes of mental health is required within these communities.

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Mental health in HIV prevention and care: A qualitative study of challenges and facilitators to integration in Vietnam

Cited by 7 publications

References 53 publications

Feasibility, Acceptability, and Design of a Mobile Ecological Momentary Assessment for High-Risk Men Who Have Sex With Men in Hanoi, Vietnam: Qualitative Study

Feasibility, Acceptability, and Design of a Mobile Ecological Momentary Assessment for High-Risk Men Who Have Sex With Men in Hanoi, Vietnam: Qualitative Study

Advances and challenges in sexually transmitted infections prevention among men who have sex with men in Asia

Barriers and enablers to access and utilization of mental health care services across Southeast Asia: A preliminary scoping review

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