Urbanisation and sexual health: Understanding bisexually active men in Hanoi, Vietnam

Background: Men who have sex with men (MSM) in Vietnam are receiving increased attention in recognition of their high-risk behaviours and potential for human immunodeficiency virus(HIV) infection and transmission. Due to societal pressures, many MSM in Vietnam are also bisexually active, which ultimately increases the transmission risks beyond the MSM population. Evidence is emerging that indicates a greater proportion of women in Asia with low-risk sexual activities are contracting HIV from their male partners who have become HIV infected through male–male sex. Methodology: Fourteen focus group discussions exploring sexual and social networks were conducted in Hanoi between July 2010 and September 2010. A total of 96 individuals participated in these sessions. Findings: A risk environment approach was used to analyse the focus group themes of social stigma and marriage, sex with other men in closed settings and transactional sex in Hanoi, an increasingly urbanising and westernising city. Implications: Despite limited evidence globally that bisexual men act as a bridge for sexually transmitted diseases, there is particular concern in Vietnam about this potential risk. HIV rates amongst MSM are rapidly rising and there are reports of women contracting HIV from their male partners who are bisexually active

Can rights stop the wrongs? Exploring the connections between framings of sex workers’ rights and sexual and reproductive health

<p>Abstract</p> <p>Background</p> <p>There is growing interest in the ways in which legal and human rights issues related to sex work affect sex workers’ vulnerability to HIV and abuses including human trafficking and sexual exploitation. International agencies, such as UNAIDS, have called for decriminalisation of sex work because the delivery of sexual and reproductive health services is affected by criminalisation and social exclusion as experienced by sex workers. The paper reflects on the connections in various actors’ framings between sex workers sexual and reproductive health and rights (SRHR) and the ways that international law is interpreted in policing and regulatory practices.</p> <p>Methods</p> <p>The literature review that informs this paper was carried out by the authors in the course of their work within the Paulo Longo Research Initiative. The review covered academic and grey literature such as resources generated by sex worker rights activists, UN policy positions and print and online media. The argument in this paper has been developed reflectively through long term involvement with key actors in the field of sex workers’ rights.</p> <p>Results</p> <p>International legislation characterises sex work in various ways which do not always accord with moves toward decriminalisation. Law, policy and regulation at national level and law enforcement vary between settings. The demands of sex worker rights activists do relate to sexual and reproductive health but they place greater emphasis on efforts to remove the structural barriers that limit sex workers’ ability to participate in society on an equal footing with other citizens.</p> <p>Discussion and conclusion</p> <p>There is a tension between those who wish to uphold the rights of sex workers in order to reduce vulnerability to ill-health and those who insist that sex work is itself a violation of rights. This is reflected in contemporary narratives about sex workers’ rights and the ways in which different actors interpret human rights law. The creation of regulatory frameworks around sex work that support health, safety and freedom from abuse requires a better understanding of the broad scope of laws, policies and enforcement practices in different cultural contexts and economic settings, alongside reviews of UN policies and human rights conventions.</p

Antiretroviral Therapy Initiation Following Policy Changes

China's HIV/AIDS treatment policies have been evolving over the preceding decade. This study describes patterns of antiretroviral therapy (ART) initiation for a sample of people living with HIV/AIDS (PLHIV) in rural Anhui, China, where most PLHIV were infected via paid plasma donation during the 1990s. A total of 481 PLHIV who were receiving ART were included in our analyses. Times between HIV diagnosis and the initiation of ART were examined relative to the time points when major ART-related policies changed in China. More than half (53%) of PLHIV who had been diagnosed by 2003 received ART within 6 months, whereas 93% of PLHIV who had been diagnosed in 2010 or later received ART within 6 months. The study results provide additional support that the "Four Frees and One Care" policy in 2003 and the relaxation of ART eligibility in 2010 have facilitated the initiation of treatment for PLHIV in China

Caregiving to persons living with HIV/AIDS: experiences of Vietnamese family members

AIMS AND OBJECTIVES:To examine the experiences of caregiving among Vietnamese family members of persons living with HIV/AIDS.BACKGROUND:As the number of persons living with HIV/AIDS increases, the need of family caregivers who can take responsibility for the home care of these persons increases. Vietnam has one of the fastest growing HIV epidemics in Asia.DESIGN:A descriptive cross-sectional study with quantitative and qualitative methods was used.METHODS:A purposive sample of 104 family caregivers, both male and female, participated voluntarily by answering a questionnaire of caregiver burden, and 20 of them participated in in-depth interview.RESULTS:Female caregivers were mainly mothers and wives while male caregivers were mainly husbands, fathers and siblings. The largest group of family caregivers reported moderate to severe burden. There was no difference between genders in total caregiver burden, but there were several differences between older and younger caregivers in some items of caregiver burden. Five categories of experiences emerged: Different types of caregiving to persons living with HIV/AIDS, cultural and religious issues associated with caregiving, keeping secret to avoid stigma and discrimination, lack of knowledge about disease and provision of care, and fear, anxiety and frustration.CONCLUSIONS:Stigma and discrimination should be decreased by providing knowledge to the general public about HIV/AIDS, in particular about ways of transmission and protection. Special knowledge should be given to family caregivers to enable them to give care to persons living with HIV/AIDS at home. This could be done through culturally appropriate training/intervention programmes in which coping methods should be included. Support group interventions should also be carried through. The results obtained can be used as baseline information.RELEVANCE TO CLINICAL PRACTICE:Health care providers should consider gender, age and culture of family members of persons living with HIV/AIDS. Knowledge about HIV/AIDS, provision of care at home and in hospital, and support groups should be developed and implemented.</p