Substance use among male sex workers in Vietnam: Prevalence, onset, and interactions with sexual risk

Abstract

Background HIV research in Vietnam has focused primarily on its large heroin injector population. Data on men who have sex with men [MSM], particularly the large and growing population of men who exchange sex for money or other material rewards, male sex workers [MSWs], is very limited. Methods Data derive from a cross-sectional study of MSW, age 16-35, recruited using community sampling methods in three cities in 2010-2011, including Hanoi, Ho Chi Minh City [HCMC], and Nha Trang City (n=710). Assessments included demographic characteristics, substance use, sexual risk, and use of health services. A series of “event” questions were used to assess the influence of alcohol and drugs on sexual risk. Results Both tobacco and alcohol are initiated at a young age and most participants currently use both substances overall across all three cities. While alcohol and tobacco use precede the initiation of sex work, stimulant and opiate use are initiated following the initiation of sex work. There was substantial overlap between substance use and sexual risk, and this overlap was strongest in sexual events involving male and female elective partners rather than sex work clients. Conclusion Although rates of HIV infection in this group are low, this may be an artifact of the young age of the sample. High rates of drug use, including alcohol, tobacco and illicit drugs, coupled with high rates of ulcerative STIs such as HPV, suggest the potential for rapid amplification of STI/HIV risk among MSW and their complex sex partnering networks.

High hepatitis C virus (HCV) prevalence among men who have sex with men (MSM) in Vietnam and associated risk factors: 2010 Vietnam Integrated Behavioural and Biologic Cross-Sectional Survey

“…This analysis also highlights that the risk of HCV is not limited to these risk factors given that an estimated one out of five HIV-uninfected, non-injection drug users were HCV Ag/Ab+, which may indicate sexual transmission of HCV in Vietnam that may be supported by the findings that a high proportion of enrolled MSM reported recently having sex with a man for money or with a female sex worker, respectively. High rates of previous or current illicit drug use among these MSM are consistent with recent studies among MSM in select locations in Vietnam 14 15…”

“…High rates of behaviours that increase risk for HIV, HCV and HBV infection have been reported among Vietnamese MSM, including injection and non-injection drug use, multiple concurrent partners and unprotected anal intercourse 14 15. To date, no data on the prevalence and profile of HCV or HBV among MSM in Vietnam have been published.…”

Sexual Initiation and Complex Recent Polydrug Use Patterns Among Male Sex Workers in Vietnam: A Preliminary Epidemiological Trajectory

“…The trajectory data show that the timing of negative events occurs in a relatively consistent order of first alcohol and tobacco use followed by first sexual encounters with female and male partners, then first cannabis use before initiation of sexual activity with male clients (Yu et al, 2015b). Across all three groups, the data show a consistent temporal pattern (Fig 1) in which a constellation of life events occur, such as drug use and sexual encounters with male and female elective partners and migration to the host city before initiation of sex work.…”

“…Relatively little is known about the relationship between age of onset of sexual and drug use risks and current patterns of combined complex drug use among MSW in Vietnam, as most research has focused on the use of specific individual drugs or classes of drugs (Yu et al, 2015a, Yu et al, 2015b). Based on data collected in a controlled comparison, epidemiological study of young MSW in Vietnam, this paper describes the prevalence of current use for a wide range of drugs.…”

Sexual Health Promotion Intervention for Male Sex Workers in Vietnam Increases Knowledge of STI/HIV Transmission Risk

“…Since that time, the prevalence rate among MSM has increased rapidly, from an initial estimate of 3.7% to a current estimate of 16% [1]. Epidemiological studies also show high rates of HIV risk among MSM in Vietnam, including among Male Sex Workers (MSWs) [2][3][4][5][6][7].…”