Knowledge about drug use and its association with HIV risk among men who have sex with men is limited. Although the HIV epidemic among this population in Vietnam is increasingly acknowledged, understanding the impact of drug use on the spread of HIV is largely lacking. Using qualitative data from in-depth interviews and focus group discussions with 93 drug users, 15 non-drug users and 9 community stakeholders, this analysis explores emerging patterns of drug use and risk factors for engaging in risk behaviours among drug-using men having sex with men, men selling sex and transgender individuals in Hanoi and Ho Chi Minh City. Findings revealed that drug use is shifting from heroin to ecstasy and ice. Drug users reported unsafe sex associated with drug use and men selling sex were particularly at elevated risk because of using drugs as a tool for sex work and trading sex for drugs. These findings are guiding development of programmes addressing unmet HIV-prevention needs in Vietnam.
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