Social context, diversity and risk among women who inject drugs in Vietnam: descriptive findings from a cross-sectional survey

Harm Reduction Journal

Gregory Armstrong³  Trang NN Nguyen¹  Martha Morrow³  Oanh TH Khuat² 

[1] Center for Promotion of Quality of Life (Life Center), Ho Chi Minh City, Vietnam;Center for Supporting Community Development Initiatives (SCDI), Hanoi, Vietnam;Centre for Mental Health, University of Melbourne, Victoria, 3010, Australia

关键词: Cross-sectional survey;    Risk;    HIV;    Gender;    Vietnam;    Women;    PWID;   

Others  :  1230034
DOI  :  10.1186/s12954-015-0067-9

 received in 2015-02-17, accepted in 2015-09-15,  发布年份 2015

【 摘 要 】

Background

Women who inject drugs (WWID) are neglected globally in research and programming yet may be likelier than males to practise sexual and injecting risks and be infected with HIV and more stigmatised but seek fewer services. Little is known about characteristics, practices and nexus between drugs and sex work of WWID in Vietnam, where unsafe injecting has driven HIV transmission, and commercial sex and inconsistent condom use are prevalent. This was the first quantitative investigation of Vietnamese WWID recruited as injecting drug users. This article summarises descriptive findings.

Findings

A cross-sectional survey was conducted among WWID in Hanoi (n = 203) and Ho Chi Minh City (HCMC) (n = 200) recruited using respondent-driven sampling. Characteristics varied within and between sites. Twenty-two percent in Hanoi and 47.5 % in HCMC had never sold sex. Almost all commenced with smoking heroin, some as children. Most injected frequently, usually alone, although 8 % (Hanoi) and 18 % (HCMC) shared equipment in the previous month. Some had sex—and sold it—as children; most had multiple partners. Condom use was high with clients but very low with intimate partners, often injecting drug users. HIV knowledge was uneven, and large minorities were not tested recently (or ever) for HIV. Nearly all perceived intense gender-related stigma, especially for drug use.

Conclusion

This ground-breaking study challenges assumptions about characteristics and risks based on anecdotal evidence and studies among men. Most WWID were vulnerable to sexual HIV transmission from intimate partners. Interventions should incorporate broader sociocultural context to protect this highly stigmatised population.

【 授权许可】

   
2015 Khuat et al.

【 图 表 】

Fig. 1.

Fig. 2.

【 参考文献 】

• [1]Ministry of Health Vietnam. Report on HIV/AIDS situation the first 6 months of 2015 and the priorities for the last 6 months of the year. Official documents 561/BC-BYT. June 18, 2015.
• [2]Nguyen Hoang Long. Optimize HIV response in Vietnam – an investment strategy. Presented at ASEAN Health Ministers’ Meeting on HIV/AIDS. September 14, 2014. Hanoi, Vietnam.
• [3]UNDP, Viet Nam Ministry of Health National AIDS Standing Bureau, Australian Agency for International Development (2002). Evaluation of the National AIDS Program January 1996 – June 2001 in Vietnam. Available at http://www.hivpolicy.org/Library/HPP000337.pdf. Accessed June 18, 2015.
• [4]Harm reduction and global HIV epidemic. 2015.
• [5]Cleland CM, Des Jarlais DC, Perlis TE, Stimson G, Poznyak V. HIV risk behaviors among female IDUs in developing and transitional countries. BMC Public Health. 2007.
• [6]Des Jarlais DC, Feelemyer JP, Modi SN, Arasteh K, Hagan H. Are females who inject drugs at higher risk for HIV infection than males who inject drugs: an international systematic review of high seroprevalence areas. Drug Alcohol Depend. 2012.
• [7]El-Bassel N, Terlikbaeva A, Pinkham S. HIV and women who use drugs: double neglect, double risk. Lancet. 2010; 376:312.
• [8]Pinkham S, Malinowska-Sempruch K. Women, harm reduction, and HIV. International Harm Reduction Development Program of the Open Society Institute, New York; 2007.
• [9]Roberts A, Mathers B, Degenhardt L. Women who inject drugs: a review of their risks, experiences and needs. National Drug and Alcohol Research Centre. University of New South Wales, Sydney; 2010.
• [10]Choi SYP, Cheung YW, Chen K. Gender and HIV risk behavior among intravenous drug users in Sichuan Province. China. Soc Sci Med. 2006; 62:1672-84.
• [11]Nemoto T, Iwamoto M, Colby D, Witt S, Pishori A, Le MN et al.. HIV-related risk behaviours among female sex workers in Ho Chi Minh City. Vietnam. AIDS Educ Prev. 2008; 20:435-53.
• [12]Viet Nam Country progress report, Jan 2008 – Dec 2009. Government of Viet Nam, Hanoi; 2010.
• [13]Thanh DC, Hien NT, Tuan NA, Thang BD, Long NT, Fylkesnes K. HIV risk behaviours and determinants among people living with HIV/AIDS in Vietnam. AIDS and Behavior. 2009; 13:1151-9.
• [14]Nguyen VT, Scannapieco M. Drug abuse in Vietnam: a critical review of the literature and implications for future research. Addiction. 2008; 103:535-43.
• [15]Viet Nam AIDS report 2014: Jan 2012 – Dec 2013. Government of Viet Nam, Hanoi; 2014.
• [16]Viet Nam AIDS report 2012: Jan 2010 – Dec 2011. Government of Viet Nam, Hanoi; 2012.
• [17]Johnston LG, Sabin K, Hien MT, Huong PT. Assessment of respondent-driven sampling for recruiting female sex workers in two Vietnamese cities: reaching the unseen sex worker. J Urban Health. 2006; 83 Suppl i:16-28.
• [18]Heckathorn DD. Respondent-driven sampling: a new approach to the study of hidden populations. Social Problems. 1997; 44:174-99.
• [19]RDS analysis tool v5.6: User manual. RDS Incorporated, Ithaca; 2006.