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

Mobility, risk behavior and HIV/STI rates among female sex workers in Kaiyuan City, Yunnan Province, China

<p>Abstract</p> <p>Background</p> <p>The mobility of female sex workers (FSWs) is a factor in the geographic spread of human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs). This study describes FSW mobility patterns in a high risk area of China to identify factors associated with increased mobility, and to study the incidence and prevalence of HIV/STIs in this group.</p> <p>Methods</p> <p>270 FSWs recruited from a baseline cross-sectional study were invited to participate in a one-year monthly follow-up cohort study in Kaiyuan City, Yunnan Province, China from 2006 to 2007. Laboratory tests were conducted for HIV/STIs at baseline, 6 and 12 months.</p> <p>Results</p> <p>A total of 117 (43.3%) FSWs moved to another city during the year. Risk factors for increased mobility included being from another city within Yunnan (adjusted hazard ratio [AHR] 1.67, 95% confidence interval [CI] 1.09-2.56), being from outside Yunnan (AHR 1.58, 95% CI 1.04-2.54), and working in lower risk entertainment establishments (AHR 1.55, 95% CI 1.03-2.35). HIV-positive subjects, drug users and FSWs in higher risk venue were less likely to change residence, less likely to use condoms with clients, and earned less per client, but had more working locations and more clients each month.</p> <p>Conclusions</p> <p>The least mobile FSWs were from Kaiyuan, worked in higher risk venues, were more likely to use drugs and be HIV-infected. Because FSWs characteristics differ according to the venue at which they work, future prevention work should tailor programs according to venue with a particular focus on FSWs in higher risk venues.</p

The Prevalence of Sexually Transmitted Infections in Papua New Guinea: A Systematic Review and Meta-Analysis

Patellofemoral osteoarthritis (PF OA) is more prevalent than previously thought and contributes to patient's suffering from knee OA. Synthesis of prevalence data can provide estimates of the burden of PF OA

A Multilevel Analysis of the Impact of Socio-Structural and Environmental Influences on Condom Use Among Female Sex Workers

This study uses multilevel analysis to examine individual, organizational and community levels of influence on condom use among female commercial sex workers (FSW) in the Philippines. A randomized controlled study involving 1,382 female commercial sex workers assigned to three intervention groups consisting of peer education, managerial training, combined peer and managerial intervention and a usual care control group was conducted. The results of the multilevel analysis show that FSWs who work in establishments with condom use rules tend to have a higher level of condom use (β = .70, P < 0.01). Among the different intervention groups, the combined peer and managerial intervention had the largest effect on condom use (β = 1.30, P < 0.01) compared with the usual care group. Using a three-level hierarchical model, we found that 62% of the variation lies within individuals, whereas 24% and 14% of the variation lies between establishments, and communities, respectively. Standard errors were underestimated when clustering of the FSWs in the different establishments and communities were not taken into consideration. The results demonstrate the importance of using multilevel analysis for community-based HIV/AIDS intervention programs to examine individual, establishment and community effects

Steep HIV prevalence declines among young people in selected Zambian communities: population-based observations (1995–2003)

BACKGROUND: Understanding the epidemiological HIV context is critical in building effective setting-specific preventive strategies. We examined HIV prevalence patterns in selected communities of men and women aged 15–59 years in Zambia. METHODS: Population-based HIV surveys in 1995 (n = 3158), 1999 (n = 3731) and 2003 (n = 4751) were conducted in selected communities using probability proportional to size stratified random-cluster sampling. Multivariate logistic regression and trend analyses were stratified by residence, sex and age group. Absence, <30% in men and <15% in women in all rounds, was the most important cause of non-response. Saliva was used for HIV testing, and refusal was <10%. RESULTS: Among rural groups aged 15–24 years, prevalence declined by 59.2% (15.7% to 6.4%, P < 0.001) in females and by 44.6% (5.6% to 3.1%, P < 0.001) in males. In age-group 15–49 years, declines were less than 25%. In the urban groups aged 15–24, prevalence declined by 47% (23.4% to 12.4%, P < 0.001) among females and 57.3% (7.5% to 3.2%, P = 0.001) among males but were 32% and 27% in men and women aged 15–49, respectively. Higher educated young people in 2003 had lower odds of infection than in 1995 in both urban [men: AOR 0.29(95%CI 0.14–0.60); women: AOR 0.38(95%CI 0.19–0.79)] and rural groups [men: AOR 0.16(95%CI 0.11–0.25), women: AOR 0.10(95%CI 0.01–7.34)]. Although higher mobility was associated with increased likelihood of infection in men overall, AOR, 1.71(95%CI 1.34–2.19), prevalence declined in mobile groups also (OR 0.52 95%CI 0.31–0.88). In parallel, urban young people with ≥11 school years were more likely to use condoms during the last casual sex (OR 2.96 95%CI 1.93–4.52) and report less number of casual sexual partners (AOR 0.33 95%CI 0.19–0.56) in the last twelve months than lower educated groups. CONCLUSION: Steep HIV prevalence declines in young people, suggesting continuing declining incidence, were masked by modest overall declines. The concentration of declines in higher educated groups suggests a plausible association with behavioural change

Track D Social Science, Human Rights and Political Science

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138414/1/jia218442.pd

Proportion and predictors of loss to follow-up in a longitudinal cohort study of female entertainment and sex workers in Cambodia

We examined the proportion and correlates of loss to follow-up (LTFU) among female entertainment and sex workers (FESWs) in a longitudinal HIV prevention intervention trial in Cambodia. The Cambodia Integrated HIV and Drug Prevention Intervention trial tested a comprehensive package of interventions aimed at reducing amphetamine-type stimulant use and HIV risk among FESWs in ten provinces. The present study estimated the proportion of women LTFU and assessed factors associated with LTFU. Logistic regression analyses were used. Of a total 596 women enrolled, the cumulative proportion of LTFU was 29.5% (n = 176) between zero- and 12-month follow-up. In multivariate analyses, women with no living children (adjusted odds ratio [AOR] 1.6; 95% confidence interval [CI]: 1.1, 2.3) and those who experienced recent food insecurity (AOR 1.7; 95%CI: 1.1, 2.7) were more likely to be LTFU. Women who were members of the SMARTgirl HIV prevention programme for ≥ 6 months compared to non-members were less likely to be LTFU (AOR 0.3; 95%CI: 0.2, 0.6). LTFU was moderately high in this study and similar to other studies, indicating a need for strategies to retain this population in HIV prevention programmes and research. Interventions aimed at stabilizing women’s lives, including reducing food insecurity and creating communities of engagement for FESWs, should be considered