HIV risk and access to prevention services among male sex workers in Ho Chi Minh city, Vietnam
D. Colby1,2, N.N.N. Trang3, H.T.X. Lan3, D.D. Thien3
1Harvard University, Harvard Medical School AIDS Initiative in Vietnam, Ho Chi Minh, Viet Nam, 2Beth Israel Deaconess Medical Center, Boston, United States, 3Life Centre, Ho Chi Minh City, Viet Nam
Background: Male sex workers (MSW) are a subset of MSM who are at very high risk of HIV infection. The Life Centre conducted a baseline assessment of MSW in Ho Chi Minh City (HCMC) prior to implementing an HIV prevention intervention. This is the first project specifically targeting MSW in Vietnam.
Methods: Qualitative interviews and a quantitative questionnaire were completed by 227 MSW. Recruitment was stratified by geographic location (7 districts) and type of MSW (street/park, massage, brothel/callboy, and bar/disco/café).
Results: Median age was 25 (range 15-47). Sexual orientation was 52% bisexual, 47% homosexual and 1% heterosexual. All MSW reported financial need and lack of other work as the reason for entering sex work. All had male clients, 59% had anal sex with male clients, 41% had casual female sex partners, and 13% had female clients. Condom use was highest for anal sex with male clients (79-81%) and with other MSW (70%); lower with female casual partners and clients (56%) and with female sex workers (45%). Unprotected sex in the previous month was reported by 42.5% of the MSW: 36% had unprotected anal intercourse (UAI), 22% had UAI with male clients, and 3.5% had unprotected intercourse with female clients. Younger MSW had poorer knowledge and less access to HIV prevention services. Five questions on HIV transmission were answered correctly by 39.5% of MSW < 20 years old and 67.4% of MSW >25 years old (p=0.006). Only 9% of MSW < 20 years but 48% of MSW > 25 years had received HIV prevention materials (p< 0.001). Self-reported HIV prevalence was 5.6%.
Conclusions: The majority of MSW in HCMC have good knowledge about HIV prevention and practice safe sex, but almost one-quarter had unprotected sex with clients in the previous month. Interventions need to target young MSW and more widely distribute condoms and lubricant.