Drug use among men who have sex with men in Vietnam: implications for HIV prevention
B. Vu Ngoc1, P. Girault2, K. Mulvey3, S. Nguyen Thanh1, U. Phan Thi1, L. Tran Thi Bich4, S. Dinh Thai5, D. Le Cao6, T. Le Nhan7
1Family Health Internationa/lVietnam, HIV, Hanoi, Viet Nam, 2Family Health International/Asia Pacific Regional Office, HIV, Bangkok, Thailand, 3Substance Abuse and Mental Health Services Association, HIV, Hanoi, Viet Nam, 4Ho Chi Minh City National University, Sociology, Ho Chi Minh City, Viet Nam, 5Family Health Internationa/lVietnam, HIV, Ho Chi Minh City, Viet Nam, 6Ho Chi Minh City AIDS Committee, Harm Reduction, Ho Chi Minh City, Viet Nam, 7Hanoi HIV/AIDS Center, HIV, Hanoi, Viet Nam
Background: There is a growing evidence of drug use among men who have sex with men (MSM) across many cultures in Asia. The association between HIV infection and both injecting drug and using non-injected drugs among MSM and male sex workers (MSWs) in Vietnam have been already described, but there is a lack of understanding about its contexts and meanings to inform the design of targeted interventions.
Methods: Qualitative information was collected about the contexts and meanings of drug use, and its relationships with sexual risk-taking behaviour for HIV infection among MSM and MSWs living in Hanoi and Ho Chi Minh City (HCMC) in Vietnam. Sixty five in-depth interviews and four focus group discussions with MSM and MSWs aged of 18 years or older and who reported the use of any kind of drugs in the past month were conducted in July and August 2009.
Results: The majority of respondents reported using different kinds of drugs either in combination (polydrug use) or sequentially, including heroin, methamphetamine, ecstasy, ketamine, marijuana, and glue. Peer pressure is the most common reason for initiation and continuation of drug use besides depression release, entertainment, energy enhancement, masculinity, self-confidence, weight control, sexual meanings, and sexual partnership. Sexual meanings of drug use include stimulating sexual desire, prolonging sex act, facilitating anal sex, and practicing male sex work. There is a link between drug use and sex work: MSWs sold sex to purchase drugs, or used drugs to reduce inhibition when negotiating with male clients and performing sex acts. Most MSM and MSWs reported having unprotected anal sex while under influence of drugs.
Conclusions: This study highlights the need for addressing drug use and sexual risk taking behaviour in the current HIV interventions targeting MSM and MSWs in these cities.