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Research Articles
Sexual Risk and Bridging Behaviors Among Young People in Hai Phong, Vietnam
Cong Thanh Duong, Tran Hien Nguyen, Thi Thanh Ha Hoang, Van Vi Nguyen, Thi Minh Nguyet Do, Van Han Pham, Roger Detels
Published online: 18 July 2007
© Springer Science+Business Media, LLC 2007
AIDS Behav (2008) 12:643–651
Abstract: The risk of the HIV epidemic spreading from high-risk groups to the general population in Vietnam depends on sexual risk and bridging behaviors between highand low-risk individuals. A cross-sectional study was used to describe sexual activities of youth aged 18–29 years. Nearly half (41.4%) were sexually active. Premarital sex was reported by 43.3% of them; 78.3% of sexually active males and 13.5% of sexually active females. Multiple sex partners were reported by 31.0%; 56.7% of males and 9.2% of females. Almost 27% of males and 5% of females engaged in sexual bridging behaviors. Being unmarried was significantly associated with having sex with non-regular partners. Being unmarried and early age at first intercourse were associated with having sex with a sex worker. Consistent condom use was high with commercial sex workers but low with regular partners. Education to delay early sexual debut, increased employment, and strategies to inform young sexually active people to adopt safer behaviors are urgently needed.
Keywords: Sexual risk _ Bridging behaviors _ Young people _ Hai Phong _ Vietnam
HIV Risk Behaviours and Determinants Among People Living with HIV/AIDS in Vietnam
Duong Cong Thanh, Nguyen Tran Hien, Nguyen Anh Tuan, Bui Duc Thang, Nguyen Thanh Long, Knut Fylkesnes
© Springer Science+Business Media, LLC 2008
AIDS Behav
Abstract: There is a potentially high risk of HIV spreading from people living with HIV/AIDS. We conducted a cross-sectional study to examine HIV risk behaviours and their determinants among people living with HIV/AIDS. Eighty-two percent had been sexually active. Sex with multiple partners was reported by 20% and consistent condom use by about one third. More than half of the participants (52%) reported having injected drugs during the previous month, and 35% of those had shared needles and syringes. Voluntary HIV testing and having received condoms or injection equipment from the local HIV prevention program, were found to be significantly associated with fewer HIV risk behaviours. Having learned recently about personal HIV status, multiple sex partners, low educational attainment and young age were found to be associated with higher HIV risk behaviours. Giving high priority to targeted preventive and support programmes is likely to be a highly cost-effective strategy.
Keywords: Risk behaviours _ HIV/AIDS _People living with HIV/AIDS _ Vietnam
The Context of HIV Risk Behaviours Among HIV-Positive Injection Drug Users in Viet Nam: Moving Toward Effective Harm Reduction
Duong Cong Thanh, Karen Marie Moland and Knut Fylkesnes
Published: 6 April 2009
BMC Public Health2009, 9:98 doi:10.1186/1471-2458-9-98
Abstract:
Background: Injection drug users represent the largest proportion of all HIV reported cases in Viet Nam. This study aimed to explore the perceptions of risk and risk behaviours among HIV positive injection drug users, and their experiences related to safe injection and safe sex practices.
Methods: This study used multiple qualitative methods in data collection including in-depth interviews, focus group discussions and participant observation with HIV-positive injection drug users.
Results: The informants described a change in the sharing practices among injection drug users towards more precautions and what was considered 'low risk sharing', like sharing among seroconcordant partners and borrowing rather than lending. However risky practices like re-use of injection equipment and 'syringe pulling' i.e. the use of left-over drugs in particular, were frequently described and observed. Needle and syringe distribution programmes were in place but carrying needles and syringes and particularly drugs could result in being arrested and fined. Fear of rejection and of loss of intimacy made disclosure difficult and was perceived as a major obstacle for condom use among recently diagnosed HIV infected individuals.
Conclusion: HIV-positive injection drug users continue to practice HIV risk behaviours. The antidrug law and the police crack-down policy appeared as critical factors hampering ongoing prevention efforts with needle and syringe distribution programmes in Viet Nam. Drastic policy measures are needed to reduce the very high HIV prevalence among injection drug users.
HIV Prevention Service Coverage for Men Having Sex with Men in 4 Provinces in Viet Nam
Duong Cong Thanh1, Keith Sabin2, David Jacka2, Nguyen Thanh Long3, Vo Hai Son3, Bui Hoang Duc3, Nguyen Tran Hien1, and Nguyen Anh Tuan1.
1 National Institute of Hygiene and Epidemiology, Viet Nam;
2 World Health Organization Representative Office in Viet Nam;
3 Viet Nam Administration of HIV/AIDS Control.
Backgrounds
§ HIV sentinel surveillance is conducted annually among 6 key populations in 39 provinces in Vietnam.
§ To obtain trends of key national and global indicators and HIV infection, some behavioral questions were added to the serosurveys in seven provinces in 2010.
§ This aims to determine HIV prevalence, risk behaviors, and coverage of prevention services among men who have sex with men (MSM).
Methods
§ Cross-sectional surveys were conducted. Participants were selected based on geographic mapping exercise and through peer educators.
§ A short questionnaire consists of 23 behavioral questions were added to the serosurveys among MSM in four voluntary provinces including Ha Noi, Hai Duong, Ho Chi Minh city, and An Giang in 2010.
Results
§ 1009 MSM provided blood and interviews.
§ Median HIV prevalence among MSM and drug injecting-MSM were 6.0% (range: 0.0%-16.0%) and 11.1% (0.0%-50.0%), respectively.
§ Median of MSM ever injecting drug was 12.3% (range: 0.0%-20.5%). The proportion of using clean needles in the most recent injection was low, median of 85.7% (range: 73.6%-91.6%).
§ Median of MSM reporting condom use during anal sex with most recently male partner was 73.4% (range: 66.5%-85.8%). Percentage of consistent condom use through anal sex with male partners in the past month in Hanoi the highest (72.0%), other provinces are below 50%, especially in HCMC was only 29.6%.
§ Median of MSM selling sex in the last 12 months was 35% (range: 0.8%-47.3%).
§ Medians of MSM receiving free condoms and syringes in the last month were 55.6% (43.4%-77.7%) and 36.9% (27.8%-86.2%), respectively.
§ Median of MSM receiving sexually transmitted infections screening in the last 3 months was 13.2% (6.2%-31.6%).
§ HIV testing in the past year and knowing the result was a median of 20.7% (4.4%-39.6%).
Conclusions
§ HIV prevalence was high among drug injecting-MSM and varying among provinces.
§ MSM practiced high risk for HIV transmission.
§ Access to HIV prevention services was very low and varied by service and province.
§ Although mapping was recommended, however, this was at core a convenience sample.
§ The integrating a short behavioral questionnaire into current HIV sentinel surveillance program can be done and routinely implemented annually.
Recommendations
§ Access to HIV prevention efforts needs to be broadened with a focus on drug injecting-MSM to prevent further HIV transmission from injection drug users to general MSM and their partners.
§ Investigation of methods to increase accessibility of HIV/STI services to MSM.
§ Increasing services to address needs of MSM selling sex where it is identified as a significant issue.
§ Improvement of the sampling of sentinel surveillance is a key next step to achieve more representative samples.
§ Expand the application of the brief behavioral questionnaire to routine sentinel surveillance.
Poster for ICAAP conference
"The 10th International Congress on AIDS in Asia and the Pacific,
Busan, Korea, 24 August 2011"
Estimating HIV Incidence Among Female Sex Workers: Results from The Pilot of Integrating Short Behavioral Survey into The Routine HIV Sentinel Surveillance in Vietnam
Duong Cong Thanh1, Keith Sabin2, David Jacka2, Nguyen Thanh Long3, Vo Hai Son3, Bui Hoang Duc3, Nguyen Tran Hien1, and Nguyen Anh Tuan1.
1 National Institute of Hygiene and Epidemiology, Viet Nam;
2 World Health Organization Representative Office in Viet Nam;
3 Viet Nam Administration of HIV/AIDS Control.
Backgrounds
§ HIV sentinel surveillance is conducted annually among 6 key populations in 39 provinces in Vietnam.
§ To obtain trends of key national and global indicators and HIV infection, some behavioral questions were added to the serosurveys in seven provinces in 2010.
§ This aims to determine HIV prevalence, estimated incidence, risk behaviors, and coverage of intervention among female sex workers (FSW).
Methods
§ Cross-sectional surveys were conducted. Participants were selected based on geographic mapping exercise and through peer educators.
§ A short questionnaire consists of 18 behavioral questions were added to the serosurveys among FSW in seven voluntary provinces including Ha Noi, Hai Duong, Thanh Hoa, Hue, Da Nang, Ho Chi Minh city, and An Giang in 2010.
§ Assumptions for HIV incidence density: All sex workers were negative before initiation of selling sex, HIV infection occurred midpoint from initiation of selling to the time of the survey, and ignoring the possibility of being infected through other risks.
Results
§ Median HIV prevalence among overall-FSW and less than 25 years-FSW were 4% (range: 0.0%-29.3%) and 2.4% (0.0%-25%), respectively.
§ Median of FSW those less than 3 years duration of selling sex was 2.8% (range: 0.0%-26.3%).
§ Median estimated HIV incidence density among injecting-FSW and non-injecting-FSW was 0.0 (0.0-16.7) and 0.2 (0.0-1.0) per 100 person-months at risk, respectively.
§ Median of FSW reported ever share needle and inconsistent condom use in the last months was 24.7% (range: 0.0%-60%) and 16.1% (range: 4.1%-46.1%).
§ Medians of FSW receiving free sexually transmitted infections screening including testing and physical examination in the last 3 months were 47.3% (18.6%-75.3%).
§ Medians HIV testing in the past year, more than one year, and never were 50.0% (range: 9.3%-68.6%), 18.6% (4.0%-24.6%), and 35.3% (20.6%-72.0%).
Conclusions
§ Estimated HIV incidence suggests that HIV infection occurs quickly among young FSW and new to sex work.
§ HIV transmission among FSW is closely related to drug injection in some provinces.
§ Access to HIV prevention services was very low and varied by service and province.
§ Although mapping was recommended, however, this was at core a convenience sample. This might capture a very high risk population but it is not necessary representative sample.
§ The integrating a short behavioral questionnaire into current HIV sentinel surveillance program can be done and routinely implemented annually.
Recommendations
§ HIV prevention efforts should increase focus on FSW who are young, new to sex work, and injecting drugs.
§ Improvement of the sampling of sentinel surveillance is a key next step to achieve more representative samples.
§ Expand the application of the brief behavioral questionnaire to routine sentinel surveillance.
Poster for ASHM conference
"Australasian HIV/AIDS Conference 2011 (23rd Annual ASHM Conference)
- Canberra, Australia, 20 September 2011"
Vũ Đình Thiểm, Lin FY, Đỗ Gia Cảnh, Nguyễn Hồng Sơn, Đặng Đức Anh, Mao ND, Chu C, Hunt SW, Robbins JB, Schneerson R, Szu SC. The Vi conjugate typhoid vaccine is safe, elicits protective levels of IgG anti-Vi, and is compatible with routine infant vaccines. Clinical and Vaccine Immunology. 2011 May; 18(5): p.730-735. Epub 2011 Mar 16.
The Vi conjugate typhoid vaccine is safe, elicits protective levels of IgG anti-Vi, and is compatible with routine infant vaccines
Thiem VD, Lin FY, Canh do G, Son NH, Anh DD, Mao ND, Chu C, Hunt SW, Robbins JB, Schneerson R, Szu SC.
Abstract
Typhoid fever remains a serious problem in developing countries. Current vaccines are licensed for individuals who are 5 years old or older. A conjugate of the capsular polysaccharide (CP) of Salmonella enterica serovar Typhi (Vi) bound to recombinant exoprotein A of Pseudomonas aeruginosa (Vi-rEPA) enhanced Vi immunogenicity and protected 2- to 5-year-olds in Vietnam. In this study, Vi-rEPA was evaluated for use in infants. A total of 301 full-term Vietnamese infants received Expanded Program on Immunization (EPI) vaccines alone or with Vi-rEPA or Haemophilus influenzae type b-tetanus toxoid conjugate (Hib-TT) at 2, 4, and 6 months and Vi-rEPA or Hib-TT alone at 12 months. Infants were visited 6, 24, and 48 h after each injection to monitor adverse reactions. Maternal, cord, and infant sera were assayed for IgG anti-Vi and for IgG antibodies to Hib CP and the diphtheria, tetanus, and pertussis toxins at 7, 12, and 13 months. No vaccine-related serious adverse reactions occurred. In the Vi-rEPA group, the IgG anti-Vi geometric mean (GM) increased from the cord level of 0.66 to 17.4 enzyme-linked immunosorbent assay units (EU) at 7 months, declined to 4.76 EU at 12 months, and increased to 50.1 EU 1 month after the 4th dose (95% of infants had levels of ≥ 3.5 EU, the estimated protective level). Controls had no increase of the IgG anti-Vi GM. Infants with cord anti-Vi levels of <3.5 EU responded with significantly higher IgG anti-Vi levels than those with levels of ≥ 3.5 EU. Anti-diphtheria, -tetanus, and -pertussis toxin levels were similar in all groups. Vi-rEPA was safe, induced protective anti-Vi levels, and was compatible with EPI vaccines, and it can be used in infants. High cord IgG anti-Vi levels partially suppressed infant responses to Vi-rEPA.
Ngô Tuấn Cường, Nguyễn Đồng Tú, Trần Huy Hoàng, Lê Thanh Hương, Nguyễn Hoài Thu, Nguyễn Bình Minh, Trần Như Dương, Nguyễn Trần Hiển. Imported Dogs as possible vehicles of Vibrio Cholerae 01 causing Cholera Outbreaks in Northern Vietnam. The Open Infectious Diseases Journal 5 (1), pp.127 - 134, 2011-11-02.
Imported Dogs as Possible Vehicles of Vibrio Cholerae O1 Causing Cholera Outbreaks in Northern Vietnam
Tuan Cuong Ngo, Dong Tu Nguyen, Huy Hoang Tran, Thanh Huong Le, Hoai Thu Nguyen, Tai The Diep, Thi Phuong Lan Nguyen, Binh Minh Nguyen, Nhu Duong Tran, Tetsu Yamashiro,Kouichi Morita, Tran Hien Nguyen and Masahiko Ehara
Abstract
Strains of V. cholerae O1 were isolated from the sewage and a pond near the first patient’s house and also from domestic vegetables obtained at a neighboring market. From 24 October 2007 to 25 June 2009, 1,505 cases were confirmed positive for V. cholerae O1 (biotype El Tor, serotype Ogawa) in 22 cities and provinces in northern Vietnam. On May 8 and May 12, 2009, epidemic strains of V. cholerae O1 were isolated from dogs in slaughter houses in Hanoi and from dogs in cages in Thanh Hoa, respectively. Isolates of V. cholerae O1 in Laos and Thailand were found to be the same clone as those isolates from dogs, patients and environmental water samples in northern Vietnam. Although the transmission routes of cholera differed between the northern and southern provinces of Vietnam, the same clonality was observed among isolates from 2007 to 2010.
Nguyễn Đồng Tú, Ngô Tuấn Cường, Trần Huy Hoàng, Lê Thanh Hương, Nguyễn Hoài Thu, Nguyễn Bình Minh, Trần Như Dương, Tetsu Yamashiro and Masahiko Ehara. Characterization of Vibrio cholerae O139 of an Aquatic Isolate in Northern Vietnam. The Open Microbiology Journal. 2012, Vol 6, p.14-21. 1874-2858/12 2012 Bentham Open.
Characterization of Vibrio cholerae O139 of an Aquatic Isolate in Northern Vietnam
Dong Tu Nguyen, Tuan Cuong Ngo, Huy Hoang Tran, Thanh Huong Le, Hoai Thu Nguyen, Binh Minh Nguyen, Nhu Duong Tran, Tetsu Yamashiro and Masahiko Ehara
Abstract
During the cholera survey in Namdinh province (northern Vietnam) in July, 2010, one strain of Vibrio cholerae O139 was isolated from 7 environmental water samples positive for ctxA, toxR, VCO139 genes and named as V. cholerae O139, ND1 strain. This strain was lysogenic harbouring a genome similar to the filamentous phage fs1. The replicativeform DNA of this phage (named as ND1-fs1, 6856 bp) was sequenced and compared with the other filamentous phages.The filamentous phage ND1-fs1 integrates into the region between ctxB and rtxA genes. The genetic organization of theCTX of V. cholerae O139, strain ND1 was determined and the schematic representation of the genetic organization wasshown together with the ND1-fs1 prophage.
Animal livestock and the risk of hospitalized diarrhoea in children under 5 years in Vietnam
Abstract
To investigate the association between environmental exposure to Objective A livestock and incidence of diarrhoea among Vietnamese children. Methods 828 households in 525 individuals, living in 75 population-based cohort of 353 Khanh Hoa Province, Vietnam, with baseline data covering geo-referenced information on demography, socio-economic status and household animals was investigated. Geographic information system was applied to calculate the density of livestock. The data were linked to hospitalized diarrhoea cases of children years recorded at two hospitals treating patients from the area as under 5 Overall, 3116 children with diarrhoea inpatients in the study area. Results were hospitalized during the study period. The incidence of diarrhoea hospitalization was 60.8/1000 child-years. Male gender, age <years, higher 2 number of household members and lack of tap water were significantly associated with an increased risk of diarrhoea. There was no evidence that ownership of livestock increased the risk of diarrhoea. In spatial analysis, we found no evidence that a high density of any animals was associated with an increased risk of diarrhoea. Conclusions Exposure to animals near or in households does not seem to constitute a major risk for diarrhoea in children under the age of 5 in Vietnam. Public health interventions to reduce childhood diarrhoea burden should focus on well-recognized causes such as sanitation, personal hygiene, access to adequate clean water supply and vaccination.
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Journal of Preventive Medicine
Center for Preventive Health Care and Technical Scientific Service (CPHTS)
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