Factors associated with substance use and sexual behavior among drug users in three mountainous provinces of Vietnam

Due to their geographical characteristics, the mountainous areas of Vietnam are particularly vulnerable to illicit drug use. Drug users in remote areas are also more likely to engage in risky sexual behaviors. This study aimed to describe the prevalence and characteristics of substance use and sexual behaviors and explored their related factors among newly admitted drug users in three mountainous provinces of Vietnam. A cross-sectional study was conducted on 300 newly-admitted drug users registering for Methadone Maintenance Treatment (MMT) at 6 clinics in three provinces: Dien Bien, Lai Chau and Yen Bai from October 2014 to December 2015. Information about the socio-demographic characteristics, history of substance use, and sexual behaviors were collected. The multivariate logistic regression model was used to identify potential predictors of four outcomes, which included: drug injection, re-use of needles, using condoms during the last time of having sex, and having sexual intercourse with female sex workers. The proportion of injecting drug users was 68.3%; of those 9% never re-used needles. Of note, 69% of those who reported having sex with female sex workers in the last month did not use condoms. Regression models showed that those who injected drugs and had health problems in last 30 days had greater odds of having sex with female sex workers. Drug users in mountainous settings acknowledged the high prevalence of human immunodeficiency virus (HIV)-related risk behaviors and a demand for physical and psychological care. Scaling up MMT services is key to approaching this high-risk group; however, at the same time, comprehensive harm-reduction interventions, counseling, and health care services should also be made accessible and effective in this setting.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

HIV knowledge and risk behaviors among drug users in three Vietnamese mountainous provinces

Background: Globally, people who inject drugs are highly vulnerable to HIV transmission. Methadone maintenance treatment (MMT) programs are one of the most cost-effective mechanisms to substitute opioid use and improve the quality of life of patients. Since the coverage of MMT is still limited and even for those patients who are treated, improving their knowledge on HIV and maintaining healthy behaviors are key to maximizing the outcomes of HIV harm reduction programs. This study examined the knowledge on HIV, perceived risk and HIV testing among drug users accessing methadone maintenance services in three Vietnamese mountainous areas. Methods: A cross-sectional study of 300 people enrolling for MMT services in three provinces in Vietnam was conducted. The factors associated with the knowledge, attitudes, and practices of respondents about HIV/AIDS were exploited using multivariable logistic model. Results: Of the 300-people surveyed, 99% knew of HIV and 60.6% were identified as having good knowledge. While 75.2% identified that injecting drugs was a risk factor for HIV, 52.2% thought they were not at risk of HIV mainly as they did not share needles. 92.6% had undergone HIV testing with 17.4% being positive, a number which was significantly lower than Vietnam's national average for people who inject drugs. Age, ethnicity and education were associated with knowledge of HIV while ART treatment was linked to self-assessed HIV status. Conclusions: This study sheds new light on the knowledge attitudes and practices of people who inject drugs, particularly males in mountainous areas of Vietnam regarding HIV prevention. Overall, knowledge was good with most conducting safe practices towards transmission. Enhanced education and targeting of minority groups could help in increasing the numbers receiving MMT and HIV services.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Methadone maintenance treatment reduces the vulnerability of drug users on hiv/aids in vietnamese remote settings: Assessing the changes in hiv knowledge, perceived risk, and testing uptake after a 12-month follow-up

Methadone Maintenance Treatment (MMT) program has been considered a medium through which human immunodeficiency virus (HIV) risks assessment and prevention on drug use/HIV-infected population can be effectively conducted. Studies concerning the implementation of such idea on patients in remote, under-developed areas, however, have been limited. Having the clinics established in three mountainous provinces of Vietnam, this study aimed to evaluate the changes in knowledge of HIV, perceived risk, and HIV testing uptake of the patients. A longitudinal study was conducted at six MMT clinics in three provinces with a pre-and post-assessments among 300 patients. Outcomes of interest were compared between baseline and after 12 months. The magnitude of changes was extrapolated. The proportion of participants reporting that their HIV knowledge was not good fell by 4.4% (61.3% at the baseline vs. 56.8% at 12 months). The significant improvement seen was in the knowledge that needle sharing was a mode of transmission (82.7% vs. 89.6%). Nevertheless, the majority of participants reportedly considered mosquitoes/insect and eating with the HIV-infected patient were the route of transmission at both time points (84.7% vs. 89.1%, 92.2% vs. 93.3%, respectively). This study found a limited improvement in HIV knowledge and testing uptake among MMT patients following a 12-month period. It also highlighted some shortcomings in the knowledge, attitudes and practices (KAP) of these patients, in particular, incorrect identification of HIV transmission routes, among patients both at program initiation and follow-up. The findings lent support to the argument for enhancing education and counseling efforts at MMT clinics regarding HIV, as well as for improving access to preventive and health care services through the integration of MMT/HIV services.SCOPUS: ar.jinfo:eu-repo/semantics/publishe