Righting the Misperceptions of Men Having Sex with Men: A Pre-Requisite for Protecting and Understanding Gender Incongruence in Vietnam

Adaptation of the U.S.-oriented evidence-based intervention TransAction for transgender women in Vietnam

Background: Trans women in Vietnam are among the most vulnerable groups with high HIV risk and limited access to care. TransAction is an evidence-based intervention to reduce trans women's HIV risks and increase social support and access to care.Aims: The aim of this study was to adapt TransAction to the specific needs of trans women in Vietnam. Methods: This study was conducted in Ho Chi Minh City from November 2020 through June 2021 Using the ADAPT-ITT framework, interviews, focus groups, and community advisory board meetings were conducted with trans women, service providers, and community members to better understand Vietnamese contexts of gender transition, HIV risks, and service gaps. Feedback was solicited on TransAction content and format adaptation. Results: Trans women in Vietnam faced unique challenges related to family norms, policy and regulatory constraints, and limited transgender-specific or gender-inclusive services. TransAction was modified to accommodate identified challenges and needs, and intervention components to enhance family support were added. Strategies to cope with stigma and seek support and services were adapted to Vietnamese culture and policies. Discussion: Post-adaptation interviews and focus groups demonstrated strong feasibility and acceptability for the adapted intervention, which can potentially be used to reduce Vietnamese trans women's HIV risks and increase their social support.

Stigma, coping strategies, and their impact on treatment and health outcomes among young men living with HIV in Vietnam: A qualitative study

BACKGROUND

Stigma affects persons living with HIV in myriad ways, including mental health, adherence to antiretroviral therapy, and retention in care, and may manifest at inter- and intra-personal levels. Youth are particularly vulnerable; those in vulnerable groups may experience multiple stigmas. In Vietnam, new HIV infections are rising among men in young age groups. To better understand the facets of stigma experienced by young men living with HIV in Vietnam, we conducted a qualitative study with youth and clinicians.

METHODS

We conducted in-depth interviews with ten youth and two clinicians in Hanoi, querying experiences of inter- and intra-personal stigma, coping strategies, and disclosure. As a framework for further research, we developed a conceptual model based on our findings and the published evidence base which portrays interactions among HIV-related stigma, coping strategies, and ART adherence, care engagement, and health outcomes.

RESULTS

Common themes that emerged from interviews with youth included extensive internalized/self-stigma and perceived stigma, yet limited experienced interpersonal stigma due to non-disclosure and avoidant coping strategies. Within different types of relationships or contexts, youth used different strategies. Non-disclosure with family, friends, and workplaces/school, and avoidance of romantic relationships and health care were common. Mental health and social support appeared to be mediating factors between coping strategies and health outcomes.

CONCLUSIONS

Validation of this model of mechanisms of the impact of stigma for youth will require further research with larger samples. In the meantime, public campaigns to increase public awareness related to HIV should be implemented in Vietnam. Critical support for youth and their mental health should involve approaches tailored to the individual, taking into account context and personal capacity, including adequate time to prepare psychologically for disclosure. Some strategies for safe and effective disclosure are suggested.

Attitudes and Knowledge of Medical Students in Hanoi regarding Lesbian and Gay People

The LGBT community faces disproportionate healthcare disparities; poorly trained providers and stigma are likely contributors. Objectives: To evaluate the attitudes, opinions, and knowledge level of medical students regarding LGBT people and to examine which demographic variables are associated with more negative attitudes toward LGBT people. A cross-sectional study surveyed 561 medical students at Hanoi Medical University. Students held positive or very positive attitudes of both lesbians (96.3%) and gay men (88.1%). Students who were younger, female, and those with close relationships to LGBT people tended to have more positive attitudes toward gays and lesbians. The average score for the knowledge scale was 12.5 (total 32 questions) with a standard deviation of 4.7. Knowledge scores and positives attitudes were significantly, directly associated. Most students responded that there should be more LGBT-related content added in the curriculum. More research is needed regarding students in other health professions and at other institutions.

Promoting Sexual Health Knowledge through a Social Workers' Mentorship Programme: A Study of Gay Young Adults

Mentorship of counselling for men who have sex with other men and gay youths is understudied. The purpose of this study was to explore the effectiveness of how the Mentor Modelling Programme may increase the sexual health knowledge and practices of gay youths. As an expansion of a previous study with the application of the conceptual framework, this study mapped a sexual health promotion plan and the six-month-long Mentor Modelling Programme with the coordination of eight health and social care professionals and 40 gay youths. The researcher found positive and supportive feedback of how the Mentor Modelling Programme could increase sexual health knowledge, promote long-term relationships, and encourage referral of other vulnerable people. The results indicated two directions. The first solicited the perspectives of health and social care professionals and gay youths on how they would describe the relationship, application to, and experience of the Mentor Modelling Programme and second, assessed how this Mentor Modelling Programme influenced and changed the ideas and senses about counselling services and mentorship. This study reflected the current limited sexual promotion between traditional and inclusive sexual health materials. It further indicated the necessary concerns and areas of attention needed to upgrade the materials and host inclusive sexual health materials for both youths and adults in the communities.

I Teach Nursing as a Male Nursing Educator: The East Asian Perspective, Context, and Social Cognitive Career Experiences

Social and cultural backgrounds, as well as understanding, play key roles in workforce development and human resource shortages, which are associated with the transition to nursing education and teaching from frontline nursing practices. A qualitative method, with the direction of the general inductive approach, was employed in this study. The researcher collected information from 18 male nursing educators who switched their senior roles (from the frontline and practicing fields to nursing education) at nursing schools in South Korea, Japan, Taiwan, China, and Malaysia. Three interview sessions were used to collect information. Three themes were merged from the information: (i) gender-oriented knowledge, teaching and learning; (ii) respect; and (iii) health promotion. More importantly, participants advocated that their male roles and identities provided uniqueness to patients, students, parents, and the general public concerning Asian customs and practices. Based on the social cognitive career theory, personal goals and achievements of career satisfaction took important roles. Although the general public may not agree with these career decisions, due to gender and social biases, participants continued to contribute their energy and knowledge in the health and social caring professions.

I Am a Nursing Student but Hate Nursing: The East Asian Perspectives between Social Expectation and Social Context

From the East Asian social and cultural perspectives and contexts, this study aimed to understand the relationships and behaviors between nursing students’ sense of filial piety and their decision-making behind selecting nursing education as their major. Forty-two traditional-age nursing students (i.e., six men and 36 women) at their final year of a bachelor’s degree program in nursing were invited. The findings indicated that many nursing students disliked their university major and the potential career pathway as a nursing professional, as none of them selected the major based on their choice and interest. The environmental context and family’s recommendations were the major impacts to influence the decision-making process of the participants. The result also indicated that filial piety, parents’ recommendations, and elderly people’s suggestions were the key factors to influence the selections and decisions of university major and career development pathways. The study provided a blueprint for related staff and professionals to create and design career counselling and services for East Asian youths to enable life investment and development.

Policy Response, Social Media and Science Journalism for the Sustainability of the Public Health System Amid the COVID-19 Outbreak: The Vietnam Lessons

Having geographical proximity and a high volume of trade with China, the first country to record an outbreak of the new Coronavirus disease (COVID-19), Vietnam was expected to have a high risk of transmission. However, as of 4 April 2020, in comparison to attempts to containing the disease around the world, responses from Vietnam are seen as prompt and effective in protecting the interests of its citizens, with 239 confirmed cases and no fatalities. This study analyzes the situation in terms of Vietnam’s policy response, social media and science journalism. A self-made web crawl engine was used to scan and collect official media news related to COVID-19 between the beginning of January and April 4, yielding a comprehensive dataset of 14,952 news items. The findings shed light on how Vietnam—despite being under-resourced—has demonstrated political readiness to combat the emerging pandemic since the earliest days. Timely communication on any developments of the outbreak from the government and the media, combined with up-to-date research on the new virus by the Vietnamese science community, have altogether provided reliable sources of information. By emphasizing the need for immediate and genuine cooperation between government, civil society and private individuals, the case study offers valuable lessons for other nations concerning not only the concurrent fight against the COVID-19 pandemic but also the overall responses to a public health crisis.