Sexual Stigma, Sexual Behaviors, and Abstinence Among Vietnamese Adolescents: Implications for Risk and Protective Behaviors for HIV, Sexually Transmitted Infections, and Unwanted Pregnancy

Abstract

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.

Determinants of condom use at sexual debut among young Vietnamese

“…This has also been reported among young people from other countries (23,24), a finding that could be explained by intergenerational sexual relations in which female adolescents have sex with older male partners outside the studied age group (24). In Vietnam, stigma associated with premarital sex is seen as a significant hindrance to young women's abilities to negotiate and engage in safer sex (20). The non-condom use at sexual debut among females may also be because females are more likely to have first intercourse with a partner with whom they have intimate relationships (1), but this possibility was ruled out in the multivariate model.…”

“…Similar to other East Asia countries, the low prevalence of safe sex behavior among adolescents and youths in their premarital period may stem from the pervasive social stigma against premarital sex. A qualitative study in Vietnam (20) suggested that this stigma could decrease young people's ability to prepare for the possibility of engaging in sexual behaviors. Despite awareness that condoms can prevent HIV and pregnancy, young people were not only reluctant to prepare for engaging in sex but also had limited social access to both information and condoms (20).…”

“…The major strength is that data were obtained from the first large population-based survey with a nationally representative sample of Vietnamese adolescents and youths that involved comprehensive information on young people's sexual behaviors. As SAVY data were self-reported, problems might arise regarding the accuracy in reporting sexual behaviors, which is still a sensitive issue in Vietnamese society where social norms against premarital sex are still strong (20). Premarital sex might have been under-reported, and this would be a source of bias if condom use among those who did not report actual premarital sex was different from those who reported sexual behavior accurately.…”

Attitudes Toward Premarital Sex in Contemporary Vietnam: Findings from a National Survey

“…Rates of premarital sex in Vietnam are reportedly low (Kaljee et al, 2007;Mensch, Clark, & Dang, 2002Zabin et al, 2009). For example, a 1999 survey of unmarried Vietnamese 15-to 22-year-olds in six provinces found that only 10% of boys and 5% of girls reported ever having had sex, lower than what was reported in some other Asian countries such as the Philippines and Thailand (Mensch et al, 2002(Mensch et al, , 2003.…”

“…prospect for a good marriage and the damage of her social standing as well as that of her whole family (Go et al, 2002;Kaljee et al, 2007;Marr, 1997;Nhan & Hang, 1996;Pham, 1999).…”