1. Exposure to HIV risks among young people who use drugs (YPUD) in three cities in Vietnam: time to develop targeted interventions
- Author
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Linh T. Nguyen, An K. Nguyen, Nicolas Nagot, Oanh T. H. Khuat, John Paul Ekwaru, Olivier Phan, Laurent Michel, Didier Laureillard, Salvy-Córdoba, Nathalie, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Supporting Community Development Initiatives [Hanoï, Vietnam], University of Alberta, Hôpital Universitaire Carémeau [Nîmes] (CHU Nîmes), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Etablissement Français du Sang [Occitanie] (EFS Occitanie), and Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)
- Subjects
Male ,Urban Population ,Psychological intervention ,Methamphetamines ,Medicine (miscellaneous) ,MESH: Comorbidity ,HIV Infections ,Comorbidity ,law.invention ,Heroin ,0302 clinical medicine ,Unsafe Sex ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,law ,Transgender ,Cluster Analysis ,Needle Sharing ,030212 general & internal medicine ,Drug use ,education.field_of_study ,biology ,lcsh:Public aspects of medicine ,MESH: HIV Infections ,MESH: Urban Population ,Psychiatry and Mental health ,MESH: Risk-Taking ,Vietnam ,MESH: Young Adult ,MESH: Substance-Related Disorders ,[SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Female ,Young people ,Mental health ,medicine.drug ,Sexual risk ,Adult ,Adolescent ,MESH: Unsafe Sex ,Substance-Related Disorders ,Population ,Young Adult ,03 medical and health sciences ,Risk-Taking ,Condom ,Environmental health ,medicine ,Humans ,MESH: Needle Sharing ,education ,MESH: Adolescent ,MESH: Humans ,business.industry ,Research ,Public Health, Environmental and Occupational Health ,HIV ,MESH: Adult ,lcsh:RA1-1270 ,biology.organism_classification ,MESH: Cluster Analysis ,MESH: Male ,[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,Cannabis ,MESH: Vietnam ,business ,MESH: Female ,030217 neurology & neurosurgery - Abstract
Introduction The aim of this study is to identify the profiles of young people who use drugs (YPUD) and their exposure to HIV risks in the 3 main cities of Vietnam, Haiphong, Hanoi, and Ho Chi Minh City (HCMC), in order to design a community-based intervention to prevent HIV. Methods A survey using respondent-driven sampling (RDS) was conducted among YPUD aged 16–24. Participants were eligible if they reported drug use, confirmed by a urine test. After obtaining informed consent, they were screened for HIV/HCV and assessed using face-to-face questionnaires and self-report. A cluster analysis was conducted, taking into account risk behaviors and confirmed HIV-positive status. Results Seven hundred and three YPUD aged 16–24 were recruited between October 2016 and February 2017, 584 of whom were included in the final analysis. Median age was 21 (17.7, 23.0); 79% were male, 18% female, and 2% transgender. Methamphetamines use was reported by 77%, followed by cannabis (51%) and heroin (17%); polydrug use was common; 15% had “ever” injected drugs. HIV prevalence was 7%. Among all participants, 48% reported non-consistent condom use and 1% reported needle/syringe sharing during the previous month. Four distinct profiles of HIV risk behaviors were identified: The high multiple-risk group mixed unsafe drug use with unsafe sexual practices and had higher prevalence of HIV; the second group practiced high-risk sex with non-consistent condom combined with methamphetamine use; the third group was a moderate-risk group with limited unsafe sexual practices; and the fourth was considered at “low-risk” as reportedly, most never had sex and never injected. The highest risk group included more female YPUD, living in HCMC, who used heroin and had unsafe sex with their regular partners. The second high-risk group included most of the MSM and all transgender people and frequently reported mental health disorders. Conclusions The profiles of YPUD who are at risk of HIV vary according to age, location, and population group. Injecting YPUD are the most exposed to risk and need immediate attention. Sexual exposure to HIV is very common. Mental health is a major concern. Interventions need to be integrated in a differentiated but holistic approach.
- Published
- 2020