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Reza MM, Rana AKMM, Morshed Khan MN, Safiullah Sarker M, Chowdhury S, Uddin MZ, Rahman L, Chowdhury MEI, Taher MA, Khan SI. Prevalence of HIV, risk behaviours and vulnerabilities of female sex partners of the HIV positive people who inject drugs (PWID) in Dhaka city, Bangladesh. PLoS One 2023; 18:e0286673. [DOI: https:/doi.org/10.1371/journal.pone.0286673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2023] Open
Abstract
Background
The HIV epidemic in Bangladesh is largely being driven by people who inject drugs (PWID) and mainly concentrated in Dhaka city. Intregrated biological and behavioural survey (IBBS) data of 2016 showed that a considerable percentage of the HIV positive PWID had unsafe sex with their female sex partners. Prevalence of HIV, risk behaviorus and vulnerabilities among the female sex partners of the PWID still remain unexplored.
Methods
To measure HIV prevalence, risk behaviours (drugs/injection/sexual) and vulnerabilities (treatment of and knowledge of sexually transmitted infections (STIs) and HIV/uptake of the routine HIV testing and HIV prevention services/physical and sexual violence), a quantitative survey was conducted among 227 female sex partners of the HIV positive PWID in Dhaka city in 2019 by adopting a take-all sampling technique.
Results
The median age of participants was 34.0 years. Prevalence of HIV was 16.7% (95% CI: 12.4–22.2). Only 6.8% to 18.7% of the participants used condoms consistently with different male sex partners; only 6.8%cto 18.7% during last year. Seventy five percent (95% CI: 69.2–80.8) had no knowledge on STI symptoms. Self-reported symptoms of STIs were reported by 26% (95% CI: 20.7–32.1) and half sought treatment during last year. Nineteen percent (95% CI: 14.7–25.1) had comprehensive knowledge of HIV. As part of the routine HIV prevention services by the PWID drop-in-centres (DICs), 42.7% (95% CI: 36.4–49.3) of the participants were tested for HIV and knew their result within the last year. One-third never received HIV prevention services. During the last one year preceding the survey, 46% (95% CI: 39.3–52.6) reported been beaten and 20.2% (95% CI: 15.3–26.1) been raped.
Conclusion
It is urgently necessary to consider the high-risk behaviours and vulnerabilities in designing or to strengthen targeted interventions for female sex partners of the HIV positive PWID in Dhaka city to ensure equality in accessing and utilization of services.
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Reza MM, Rana AKMM, Morshed Khan MN, Safiullah Sarker M, Chowdhury S, Uddin MZ, Rahman L, Chowdhury MEI, Taher MA, Khan SI. Prevalence of HIV, risk behaviours and vulnerabilities of female sex partners of the HIV positive people who inject drugs (PWID) in Dhaka city, Bangladesh. PLoS One 2023; 18:e0286673. [PMID: 37276219 DOI: 10.1371/journal.pone.0286673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 05/21/2023] [Indexed: 06/07/2023] Open
Abstract
BACKGROUND The HIV epidemic in Bangladesh is largely being driven by people who inject drugs (PWID) and mainly concentrated in Dhaka city. Intregrated biological and behavioural survey (IBBS) data of 2016 showed that a considerable percentage of the HIV positive PWID had unsafe sex with their female sex partners. Prevalence of HIV, risk behaviorus and vulnerabilities among the female sex partners of the PWID still remain unexplored. METHODS To measure HIV prevalence, risk behaviours (drugs/injection/sexual) and vulnerabilities (treatment of and knowledge of sexually transmitted infections (STIs) and HIV/uptake of the routine HIV testing and HIV prevention services/physical and sexual violence), a quantitative survey was conducted among 227 female sex partners of the HIV positive PWID in Dhaka city in 2019 by adopting a take-all sampling technique. RESULTS The median age of participants was 34.0 years. Prevalence of HIV was 16.7% (95% CI: 12.4-22.2). Only 6.8% to 18.7% of the participants used condoms consistently with different male sex partners; only 6.8%cto 18.7% during last year. Seventy five percent (95% CI: 69.2-80.8) had no knowledge on STI symptoms. Self-reported symptoms of STIs were reported by 26% (95% CI: 20.7-32.1) and half sought treatment during last year. Nineteen percent (95% CI: 14.7-25.1) had comprehensive knowledge of HIV. As part of the routine HIV prevention services by the PWID drop-in-centres (DICs), 42.7% (95% CI: 36.4-49.3) of the participants were tested for HIV and knew their result within the last year. One-third never received HIV prevention services. During the last one year preceding the survey, 46% (95% CI: 39.3-52.6) reported been beaten and 20.2% (95% CI: 15.3-26.1) been raped. CONCLUSION It is urgently necessary to consider the high-risk behaviours and vulnerabilities in designing or to strengthen targeted interventions for female sex partners of the HIV positive PWID in Dhaka city to ensure equality in accessing and utilization of services.
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Affiliation(s)
- Md Masud Reza
- Programme for HIV and AIDS, Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - A K M Masud Rana
- Programme for HIV and AIDS, Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mohammad Niaz Morshed Khan
- Programme for HIV and AIDS, Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Md Safiullah Sarker
- Programme for HIV and AIDS, Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Sujan Chowdhury
- Programme for HIV and AIDS, Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | | | - Lima Rahman
- Director, Health and Nutrition Sector, Save the Children in Bangladesh, Dhaka, Bangladesh
| | | | - Md Abu Taher
- National Programme Coordinator (Drugs and HIV/AIDS), UNODC, Dhaka, Bangladesh
| | - Sharful Islam Khan
- Programme for HIV and AIDS, Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
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Abstract
Manipur, an international border region has the highest incidence of human immunodeficiency virus (HIV)-1 infection in India. Nevertheless, there have been no analytical reviews of research article published within this region. In this review, the authors aim to draw the attention of policy makers, medical practitioners and researchers in adopting new strategies to limit the expansion of HIV/acquired immunodeficiency syndrome (AIDS) not only in Manipur but also in other international border areas. A systematic search for published literature in last decade was performed based on the keywords 'Manipur' and 'HIV' using the PubMed. Twenty-six articles were selected and reviewed. There were high incidence of drug resistance (53%), emergence of recombinant virus (32%) and increased incidence of co-infection with hepatitis C virus. The prime cause of the HIV is due to the uses of 'heroin' smuggled from the 'South Asia Golden Triangle' and complex patterns of cross-border movement for trade and commerce. The drug abuse, social stigma, geographical location and resource limitation and socio-political problem of the region have contributed strongly on spreading and failure of preventively programme of HIV/AIDS. This review will provide vital knowledge for the policy makers and clinicians for sentinel surveillance of AIDS pandemic in Manipur and other international border regions.
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Abdul Manaf R, Dickson N, Lovell S, Ibrahim F. Consistent condom use and its predictors among female sexual Partners of People who Inject Drugs in Klang Valley, Malaysia. BMC Public Health 2019; 19:1473. [PMID: 31699061 PMCID: PMC6839187 DOI: 10.1186/s12889-019-7855-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 10/28/2019] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Men who inject drugs (MWIDs) comprise the highest percentage of diagnosed HIV cases in Malaysia. Their female partners risk being infected through unprotected sexual contact. This paper reports the prevalence of consistent condom use and its predictors among the wives and regular sexual partners of MWIDs in Klang Valley, Malaysia. METHODS A cross-sectional study using a self-administered questionnaire was conducted among the wives and regular sexual partners of MWIDs in the study location; 221 women were recruited through respondent-driven sampling. Data were analysed descriptively for the prevalence of consistent condom use, HIV status and HIV risk-related behaviour. Subsequently, simple and multiple logistic regressions were undertaken to identify the predictors of consistent condom use. RESULTS The prevalence of consistent condom use among respondents was 19.5%. Slightly more than half (52.5%) of respondents had never used condoms with their partner. Fourteen women (6.3%) reported being HIV positive. While 7.7% had HIV-positive partners, 45.7% were unaware of their partner's HIV status. Consistent condom use was significantly higher among single women (AOR = 4.95; 95% CI: 2.45, 9.99), women who lived in urban areas (AOR = 2.97; 95% CI: 1.30, 6.78), HIV-positive women (AOR = 3.45; 95% CI: 1.13, 10.5) and women involved in sex work (AOR = 3.55, 95% CI: 1.45, 8.67). CONCLUSIONS Inconsistent condom use among the majority of female sexual partners of MWIDs underscores the heightened risk faced by these women and calls for alternative prevention methods that women are able to control.
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Affiliation(s)
- Rosliza Abdul Manaf
- Department of Community Health Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia.
- Department of Preventive & Social Medicine, Dunedin School of Medicine, University of Otago, P.O. Box 56, Dunedin, 9054, New Zealand.
| | - Nigel Dickson
- Department of Preventive & Social Medicine, Dunedin School of Medicine, University of Otago, P.O. Box 56, Dunedin, 9054, New Zealand
| | - Sarah Lovell
- School of Health Sciences, University of Canterbury, Private Bag 4800, Christchurch, 8140, New Zealand
| | - Faisal Ibrahim
- Department of Community Health Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia
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Sexual Risk Behaviors of Patients with HIV/AIDS over the Course of Antiretroviral Treatment in Northern Vietnam. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15061106. [PMID: 29844289 PMCID: PMC6025123 DOI: 10.3390/ijerph15061106] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 05/25/2018] [Accepted: 05/26/2018] [Indexed: 01/18/2023]
Abstract
Antiretroviral therapy (ART) improves the health and well-being of people living with the human immunodeficiency virus (HIV, PLWH), and reduces their risk of transmitting the virus to sexual partners. However, patterns of sexual risk behavior among HIV-positive patients taking ART in Vietnam remain largely unknown. In this study, we sought to examine sexual risk behaviors and their associated factors among HIV-positive patients receiving ART in northern Vietnam. The socio-demographic characteristics, ART use, health status, and sexual behaviors of 1133 patients taking ART in the Hanoi and Nam Dinh provinces were explored through face-to-face interviews. There were 63.5% of patients who had one sex partner, while 3.6% and 5.6% of patients had sexual intercourse with casual partners or sex workers, respectively, in the previous 12 months. Most participants tended to use condoms more often with commercial sex partners (90.2%) and intimate partners (79.7%), and less often with casual partners (60.9%). Higher age (odds ratio, OR = 1.0; 95% CIs = 1.0, 1.1) or suffering pain/discomfort (OR = 1.7; 95% CIs = 1.2, 2.4) were factors more likely to be associated with multiple sex partners. Patients who were self-employed were more likely to have sexual intercourse with casual partners/sex workers (OR = 2.1; 95% CIs = 1.1, 4.0). Meanwhile, a higher score on the EuroQol visual analog scale (EQ-VAS), an unknown HIV stage, and a longer duration of ART were adversely associated with not using condoms with casual partners/sex workers. Patients with longer durations of ART had a lower likelihood of not using a condom with casual partners/sex workers (OR = 0.5; 95% CIs = 0.3, 0.8). Our study underscored a relatively high rate of unsafe sexual behaviors among HIV-positive patients. Continuing to improve the physical and psychological well-being of HIV-positive patients in Vietnam is important in reducing the spread of HIV via risky sexual behaviors. In addition, safe-sex education should be provided to older people, and to those who are self-employed.
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Boggiano VL, Nguyen HLT, Nguyen LH, Tran TD, Van Nguyen H, Le HT, Le HQ, Hoang CD, Nguyen CT, Tran BX, Latkin CA, Zary N, Vu TMT. Sexual behaviors among methadone maintenance patients in a mountainous area in northern Vietnam. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2017; 12:39. [PMID: 28841918 PMCID: PMC5574107 DOI: 10.1186/s13011-017-0123-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 08/21/2017] [Indexed: 11/10/2022]
Abstract
Background Methadone maintenance treatment (MMT) improves patients’ ability to access HIV-related services and reduces needle sharing and other risky HIV-related behaviors. However, patients may continue to engage in risky sexual practices. In this study, we evaluate sexual behaviors of MMT patients in a mountainous province in Northern Vietnam. Methods We explored the health status, MMT and substance use history, and sexual practices of 241 male MMT patients in Tuyen Quang province. Health status was investigated using the EuroQOL-5 Dimensions-5 Levels (EQ-5D-5 L). Multivariate logistic regression was employed to assess associated factors. Results Most patients (66.4%) reported having at least one sexual partner within the previous twelve months. Most of these partners were spouses or primary partners (72.6%). About 8.3% of patients had casual partners, and 5.8% had visited sex workers; of those who engaged in casual sexual relationships, 90.9% reported using condoms. Current drug use and living in a remote area were associated with an increased odd of having two or more sexual partners, while anxiety or depression was associated with lower odds. Conclusion This study highlights a low proportion of having sexual risk behaviors among MMT patients in Vietnamese mountainous settings. Integrating education about safe sexual practices into MMT services, along with providing medical care and ensuring methadone treatment adherence, is an important component in HIV risk reduction for these patients who were at risk of unsafe sexual practices.
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Affiliation(s)
- Victoria L Boggiano
- Berkeley School of Public Health, University of California, Berkeley, California, USA
| | - Huong Lan Thi Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang, 550000, Vietnam.
| | - Long Hoang Nguyen
- School of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam
| | - Tho Dinh Tran
- Department of Hepatobiliary Surgery, Vietnam-Germany Hospital, Hanoi, Vietnam
| | - Hung Van Nguyen
- Authority of HIV/AIDS Control, Ministry of Health, Hanoi, Vietnam
| | - Huong Thi Le
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Hai Quan Le
- Tuyen Quang Provincial AIDS Center, Tuyen Quang, Vietnam
| | - Canh Dinh Hoang
- Authority of HIV/AIDS Control, Ministry of Health, Hanoi, Vietnam
| | - Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang, 550000, Vietnam
| | - Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam.,Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Carl A Latkin
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Nabil Zary
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Thuc Minh Thi Vu
- Department of Immunology and Allergy, National Otolaryngology Hospital, Hanoi, Vietnam
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Shaw SA, Terlikbayeva A, Famouri L, Hunt T, Gilbert L, Rozental Y, Primbetova S, Chang M, Ma X, El-Bassel N. HIV testing and access to HIV medical care among people who inject drugs and their intimate partners in Kazakhstan. JOURNAL OF SUBSTANCE USE 2016; 22:53-59. [PMID: 30220879 DOI: 10.3109/14659891.2016.1143046] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background Growing rates of HIV and high rates of injection drug use in Kazakhstan call for examining access to testing and treatment among people who inject drugs and their intimate partners. Objectives We examine how access to health and drug treatment services as well as risk environment factors are associated with ever being tested for HIV and ever receiving any general HIV medical care among 728 male and female intimate partners where at least one partner injects drugs. Methods Multivariate random effects logistic regression with random effects for couple were conducted to examine associations between access to health and drug treatment services, risk environment factors, and HIV testing and HIV medical care outcomes. Results Analyses indicate that accessing needle exchange services and having a regular physician were associated both with access to HIV testing and HIV medical care. Receiving drug treatment was associated with accessing HIV testing but not HIV medical care. Being arrested and charged with a criminal offense was also associated with accessing HIV testing but not HIV medical care. Conclusions/Importance Study findings highlight the need for increased scale-up of HIV testing efforts, as well as integrated HIV treatment and care in Kazakhstan.
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Affiliation(s)
- Stacey A Shaw
- Global Health Research Center of Central Asia, Columbia University, New York City, 1255 Amsterdam Ave, New York, NY 10027
| | - Assel Terlikbayeva
- Global Health Research Center of Central Asia, Columbia University, Almaty, Kazakhstan, 102 Luganskogo St, ap.1, Medeu district, Almaty, Kazakhstan 050059
| | - Leila Famouri
- School of Medicine, 1 Medical Center Drive, P.O. Box 9100, West Virginia University, Morgantown, WV 26506
| | - Tim Hunt
- Global Health Research Center of Central Asia, Columbia University, New York City, 1255 Amsterdam Ave, New York, NY 10027
| | - Louisa Gilbert
- Global Health Research Center of Central Asia, Columbia University, New York City, 1255 Amsterdam Ave, New York, NY 10027
| | - Yelena Rozental
- Global Health Research Center of Central Asia, Columbia University, Almaty, Kazakhstan, 102 Luganskogo St, ap.1, Medeu district, Almaty, Kazakhstan 050059
| | - Shopan Primbetova
- Global Health Research Center of Central Asia, Columbia University, Almaty, Kazakhstan, 102 Luganskogo St, ap.1, Medeu district, Almaty, Kazakhstan 050059
| | - Mingway Chang
- Global Health Research Center of Central Asia, Columbia University, New York City, 1255 Amsterdam Ave, New York, NY 10027
| | - Xin Ma
- Global Health Research Center of Central Asia, Columbia University, New York City, 1255 Amsterdam Ave, New York, NY 10027
| | - Nabila El-Bassel
- Global Health Research Center of Central Asia, Columbia University, New York City, 1255 Amsterdam Ave, New York, NY 10027
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High HIV Prevalence and Associated Risk Factors Among Female Sexual Partners of Male Injection Drug Users (MWID) in Ho Chi Minh City, Vietnam. AIDS Behav 2016; 20:395-404. [PMID: 26271814 DOI: 10.1007/s10461-015-1156-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Injection drug use is a major factor in acquiring and transmitting HIV in Vietnam. This analysis aims to present estimates of HIV infection and factors associated with HIV infection among female sex partners (FSP) of MWID in Ho Chi Minh City (HCMC), Vietnam. Cross-sectional surveys were conducted in 2011 and 2013 among males who inject drugs (MWID) who then referred their FSP for a behavioral and biologic survey. In total, 445 MWID and FSPs were enrolled. HIV prevalence among MWID was 50 and 35 % among FSPs. Among FSPs, 60.3 % reported ever using illegal drugs and among those, 72.7 % reported ever injecting illicit drugs. Among FSP, injection drug for >1 year [adjusted Odds Ratio (aOR), 95 % CI 2.94, 1.19-7.26), p value = <0.001] and having a male partner infected with HIV [(aOR 3.35: 1.97-5.69), p value = <0.001] were associated with HIV infection. The prevalence of HIV infection is high among FSP of MWID in HCMC and is highly associated with the injection drug use behavior of the FSP. Harm-reduction intervention programs that focus on the MWID-FSP couple or directly on the FSPs are required.
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Female sexual partners of male people who inject drugs in vietnam have poor knowledge of their male partners' HIV status. J Acquir Immune Defic Syndr 2015; 68:562-7. [PMID: 25559591 DOI: 10.1097/qai.0000000000000512] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Vietnam's HIV epidemic is concentrated among male people who inject drugs (PWID), and their female sexual partners (SPs) may be at risk for infection. HIV prevention interventions for SPs were implemented in Hanoi, Dien Bien Province, and Ho Chi Minh City (HCMC), and data from linked surveys used to evaluate these interventions offered an unusual opportunity to assess knowledge of HIV status within couples. METHODS Linked surveys (behavioral interviews and HIV testing) among 200 PWID-SP couples in Hanoi, 300 in Dien Bien, and 249 in HCMC. RESULTS HIV prevalence among male PWID was 53% in Hanoi, 30% in Dien Bien, and 46% in HCMC, and lower among their SPs: 44%, 10%, and 37%, respectively. Comparison of SPs' beliefs regarding male PWID partners' HIV status with the PWIDs' actual test results revealed that 32% of SPs in Dien Bien and 44% in Hanoi and HCMC lacked correct knowledge of their male partners' status. This proportion was slightly lower (21%-33%) among SPs whose PWID partners reported having been previously tested and received HIV+ results. CONCLUSIONS SP interventions reached HIV-negative women in serodiscordant relationships, and some improvements occurred in condom use and relationship characteristics. Nevertheless, our findings suggest that at least 11,000 SPs in Vietnam may be at high risk for HIV infection because of incorrect knowledge of their partners' HIV status. Interventions should be strengthened in HIV testing, disclosure, and treatment, as well as empowerment of SPs as individuals, within couples, and as communities.
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Sawada I, Tanuma J, Do CD, Doan TT, Luu QP, Nguyen LAT, Vu TVT, Nguyen TQ, Tsuchiya N, Shiino T, Yoshida LM, Pham TTT, Ariyoshi K, Oka S. High proportion of HIV serodiscordance among HIV-affected married couples in northern Vietnam. PLoS One 2015; 10:e0125299. [PMID: 25898138 PMCID: PMC4405585 DOI: 10.1371/journal.pone.0125299] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Accepted: 03/12/2015] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Little is known about the state of HIV transmission among married couples in Vietnam. This study aims to clarify HIV serostatus in this group and elucidate risk factors for intra-marital HIV transmission. METHODS In 2012, we enrolled a group of HIV-positive married men registered at the HIV outpatient clinic of a referral hospital in northern Vietnam, along with their wives. Sociodemographic, behavioural and clinical data were collected from men and wives. HIV serodiscordant couples were followed until March 2014 to determine seroconversion rate. A phylogenetic analysis was performed based on env V3 sequence to detail cluster formation among men. RESULTS Of the 163 HIV-positive men enrolled in the study, 101 (62.0%) had wives testing HIV-negative. Half of men reported injecting drug use (IDU) as a likely transmission route. Couples reported a high incidence of unprotected sexual intercourse prior to diagnosis; the median (inter quartile range) was 4 (4-8) times per month. Only 17 couples (10.4%) reported using condoms during at least half these instances. Multivariable analysis revealed IDU history among men was independently associated with HIV-negative wives (adjusted OR 0.31; 95% CI 0.10-0.95, p=0.041). Phylogenetic analysis of 80 samples indicated CRF01_AE. Of these, 69 (86.3%) clustered with IDU-associated viruses from Vietnam. No HIV seroconversion was identified during a follow-up of 61 serodiscordant couples, with 126.5 person-years of observation during which HIV-infected men were on antiretroviral drug therapy (ART). CONCLUSION High HIV serodiscordance was observed among HIV-affected married couples in northern Vietnam. A large number of at-risk wives therefore remain HIV-negative and can be protected with measures including proper use of ART if couples are made aware of the serodiscordance through screening.
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Affiliation(s)
- Ikumi Sawada
- Department of Clinical Tropical Medicine, Institute of Tropical Medicine, Graduate School of Biomedical Science, Nagasaki University, Nagasaki, Japan
- AIDS Clinical Center, National Center of Global Health and Medicine, Tokyo, Japan
| | - Junko Tanuma
- AIDS Clinical Center, National Center of Global Health and Medicine, Tokyo, Japan
| | - Cuong Duy Do
- Department of Infectious Diseases, Bach Mai Hospital, Hanoi, Vietnam
| | - Tra Thu Doan
- Department of Infectious Diseases, Bach Mai Hospital, Hanoi, Vietnam
| | - Quynh Phuong Luu
- Laboratory for Molecular Diagnostics, Department of Immunology and Molecular Biology, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Lan Anh Thi Nguyen
- Laboratory for Molecular Diagnostics, Department of Immunology and Molecular Biology, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | | | - Tuan Quang Nguyen
- Department of Infectious Diseases, Bach Mai Hospital, Hanoi, Vietnam
| | - Naho Tsuchiya
- Department of Clinical Tropical Medicine, Institute of Tropical Medicine, Graduate School of Biomedical Science, Nagasaki University, Nagasaki, Japan
| | - Teiichiro Shiino
- Infectious Diseases Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Lay-Myint Yoshida
- Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | | | - Koya Ariyoshi
- Department of Clinical Tropical Medicine, Institute of Tropical Medicine, Graduate School of Biomedical Science, Nagasaki University, Nagasaki, Japan
- * E-mail:
| | - Shinichi Oka
- AIDS Clinical Center, National Center of Global Health and Medicine, Tokyo, Japan
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Goldsamt LA, Clatts MC, Le G, Yu G. Injection and sexual risk practices among young heroin users in Hanoi, Vietnam. DRUGS (ABINGDON, ENGLAND) 2015; 22:166-172. [PMID: 25995608 PMCID: PMC4435536 DOI: 10.3109/09687637.2014.979765] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Epidemiological data in Vietnam shows high HIV prevalence rates among injection drug users, especially in urban centres. However, there are limited data on specific practices used to prepare and inject drugs or on sexual practices among Vietnamese injectors. A street-based cross-sectional interview was conducted with 862 heroin injectors in Hanoi, Vietnam, to collect such data. Variability was seen in both injection and sexual risk, with 12.9% of current injectors reporting at least one unsafe method of drug sharing and 57.1% reporting unsafe sex in the past 30 days. These risks were strongly associated with those who engaged in unsafe injection significantly more likely to engage in unsafe sex (69.4% vs. 55.3%) and those engaging in unsafe sex significantly more likely to engage in unsafe injection (15.7% vs. 9.2%). These findings highlight the overlap of injection and sexual risk practices among Vietnamese heroin users and suggest the need for strong, broadly targeted HIV prevention activities among this population.
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Affiliation(s)
| | - Michael C. Clatts
- School of Public Health, University of Puerto Rico, San Juan, Puerto Rico
| | - Giang Le
- Center for Research and Training on HIV/AIDS, Hanoi Medical University, Hanoi, Vietnam
| | - Gary Yu
- College of Nursing, New York University, New York, NY, USA
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Dao A, Hirsch JS, Giang LM, Parker RG. Social science research on HIV in Vietnam: a critical review and future directions. Glob Public Health 2013; 8 Suppl 1:S7-29. [PMID: 23906241 DOI: 10.1080/17441692.2013.811532] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Social science research can enhance the response to Vietnam's growing HIV epidemic by capturing the country's rapidly changing social and political context. The present paper reviews the published, peer-reviewed and English-language social science literature on HIV in Vietnam in order to identify critical theoretical and substantive gaps, while laying the groundwork for future research. We found four broad foci for work on the social context of HIV and AIDS in Vietnam: the cultural meanings and social relationships that shape Vietnam's HIV epidemic; stigma and discrimination; social inequality and structural violence as contributors to HIV risk; and, finally, how broader global and social systems shape Vietnam's HIV epidemic. We signal the particular need for additional research on the effects of the media on attitudes towards HIV and AIDS, on social movements, and on health systems, as well as on a number of other key areas. Work along these lines, in addition to more effective communication of policy-relevant findings to those responsible for the development and implementation of policies and programmes, will strengthen Vietnam's response to HIV and AIDS.
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Affiliation(s)
- Amy Dao
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA.
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Go VF, Frangakis C, Le Minh N, Latkin CA, Ha TV, Mo TT, Sripaipan T, Davis W, Zelaya C, Vu PT, Chen Y, Celentano DD, Quan VM. Effects of an HIV peer prevention intervention on sexual and injecting risk behaviors among injecting drug users and their risk partners in Thai Nguyen, Vietnam: a randomized controlled trial. Soc Sci Med 2013; 96:154-64. [PMID: 24034963 DOI: 10.1016/j.socscimed.2013.07.006] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Revised: 05/01/2013] [Accepted: 07/08/2013] [Indexed: 11/15/2022]
Abstract
Globally, 30% of new HIV infections outside sub-Saharan Africa involve injecting drug users (IDU) and in many countries, including Vietnam, HIV epidemics are concentrated among IDU. We conducted a randomized controlled trial in Thai Nguyen, Vietnam, to evaluate whether a peer oriented behavioral intervention could reduce injecting and sexual HIV risk behaviors among IDU and their network members. 419 HIV-negative index IDU aged 18 years or older and 516 injecting and sexual network members were enrolled. Each index participant was randomly assigned to receive a series of six small group peer educator-training sessions and three booster sessions in addition to HIV testing and counseling (HTC) (intervention; n = 210) or HTC only (control; n = 209). Follow-up, including HTC, was conducted at 3, 6, 9 and 12 months post-intervention. The proportion of unprotected sex dropped significantly from 49% to 27% (SE (difference) = 3%, p < 0.01) between baseline and the 3-month visit among all index-network member pairs. However, at 12 months, post-intervention, intervention participants had a 14% greater decline in unprotected sex relative to control participants (Wald test = 10.8, df = 4, p = 0.03). This intervention effect is explained by trial participants assigned to the control arm who missed at least one standardized HTC session during follow-up and subsequently reported increased unprotected sex. The proportion of observed needle/syringe sharing dropped significantly between baseline and the 3-month visit (14% vs. 3%, SE (difference) = 2%, p < 0.01) and persisted until 12 months, but there was no difference across trial arms (Wald test = 3.74, df = 3, p = 0.44).
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Affiliation(s)
- Vivian F Go
- Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, 615 North Wolfe Street, E6610, Baltimore, MD 21205, USA.
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Nitayaphan S, Ngauy V, O'Connell R, Excler JL. HIV epidemic in Asia: optimizing and expanding vaccine development. Expert Rev Vaccines 2012; 11:805-19. [PMID: 22913258 DOI: 10.1586/erv.12.49] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The recent evidence in Thailand for protection from acquisition of HIV through vaccination in a mostly heterosexual population has generated considerable hope. Building upon these results and the analysis of the correlates of risk remains among the highest priorities. Improved vaccine concepts including heterologous prime-boost regimens, improved proteins with potent adjuvants and new vectors expressing mosaic antigens may soon enter clinical development to assess vaccine efficacy in men who have sex with men. Identifying heterosexual populations with sufficient HIV incidence for the conduct of efficacy trials represents perhaps the main challenge in Asia. Fostering translational research efforts in Asian countries may benefit from the development of master strategic plans and program management processes.
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Affiliation(s)
- Sorachai Nitayaphan
- Royal Thai Army Component, Armed Forces Research Institute of Medical Sciences, 315/6 Rajvithi Road, Bangkok 10400, Thailand
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15
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Hammett TM, Des Jarlais DC, Kling R, Kieu BT, McNicholl JM, Wasinrapee P, McDougal JS, Liu W, Chen Y, Meng D, Doan N, Tho HN, Quyen NH, Tren VH. Controlling HIV epidemics among injection drug users: eight years of Cross-Border HIV prevention interventions in Vietnam and China. PLoS One 2012; 7:e43141. [PMID: 22952640 PMCID: PMC3428343 DOI: 10.1371/journal.pone.0043141] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2012] [Accepted: 07/16/2012] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION HIV in Vietnam and Southern China is driven by injection drug use. We have implemented HIV prevention interventions for IDUs since 2002-2003 in Lang Son and Ha Giang Provinces, Vietnam and Ning Ming County (Guangxi), China. METHODS Interventions provide peer education and needle/syringe distribution. Evaluation employed serial cross-sectional surveys of IDUs 26 waves from 2002 to 2011, including interviews and HIV testing. Outcomes were HIV risk behaviors, HIV prevalence and incidence. HIV incidence estimation used two methods: 1) among new injectors from prevalence data; and 2) a capture enzyme immunoassay (BED testing) on all HIV+ samples. RESULTS We found significant declines in drug-related risk behaviors and sharp reductions in HIV prevalence among IDUs (Lang Son from 46% to 23% [p<0.001], Ning Ming: from 17% to 11% [p = 0.003], and Ha Giang: from 51% to 18% [p<0.001]), reductions not experienced in other provinces without such interventions. There were significant declines in HIV incidence to low levels among new injectors through 36-48 months, then some rebound, particularly in Ning Ming, but BED-based estimates revealed significant reductions in incidence through 96 months. DISCUSSION This is one of the longest studies of HIV prevention among IDUs in Asia. The rebound in incidence among new injectors may reflect sexual transmission. BED-based estimates may overstate incidence (because of false-recent results in patients with long-term infection or on ARV treatment) but adjustment for false-recent results and survey responses on duration of infection generally confirm BED-based incidence trends. Combined trends from the two estimation methods show sharp declines in incidence to low levels. The significant downward trends in all primary outcome measures indicate that the Cross-Border interventions played an important role in bringing HIV epidemics among IDUs under control. The Cross-Border project offers a model of HIV prevention for IDUs that should be considered for large-scale replication.
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Affiliation(s)
- Theodore M Hammett
- Abt Associates Inc., Cambridge, Massachusetts, United States of America.
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Hammett TM, Kling R, Van NTH, Son DH, Binh KT, Oanh KTH. HIV prevention interventions for female sexual partners of injection drug users in Hanoi, Vietnam: 24-month evaluation results. AIDS Behav 2012; 16:1164-72. [PMID: 22016330 DOI: 10.1007/s10461-011-0062-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Vietnam's HIV epidemic is driven by injection drug use. Most IDUs are sexually active and may infect their female sexual partners (SPs). We implemented peer-based HIV prevention interventions for SPs in Hanoi. This paper reports on an evaluation of these interventions based on cross-sectional surveys of SPs. Our data show that this population can be reached, relationships improved, and consistent condom use increased (27% at 24 months up from 16% at 12 months: P = 0.002). Self-reported condom use at last sex was 3.5 times higher among participants in the intervention than among non-participants after controlling for selection bias, indicating a possible intervention effect. However, no significant association was found for consistent condom use in the previous 6 months. Many SPs remain at risk for HIV and interventions must promote a range of HIV prevention strategies including consistent condom use, lower risk sexual activity, and ARV treatment as prevention.
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Affiliation(s)
- Theodore M Hammett
- Abt Associates Inc, 72 Xuan Dieu, Floor 3, Tay Ho District, Hanoi, Vietnam.
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