NghiSn ciiu Gia d i n h va Gicii SS; -2013 Tong quan ve sir iiy thi va phan biet 6Q\ XUI ddi vAI nam GO quan he tinli due ddng gidi tai Viet Nam Mai Xuan Thu, Le CiT Linh Oai hoc Y te Cong cong Tom tat: Tinh due dong gi6i nam la mot van de nhay cam da ton tai xa hoi tfl lau, nhUng nhijng hieu bie't ve no sd sai va chua ro rang O Viet Nam, tinh due dong gi6i nam ducic coi la dieu trai v6i tU nhien, di ngUdc lai vfli thuin phong mi tuc NhOng chuan mUc xa hoi da khien nam co quan he tinh due dong gi6i tu ky thi ban than va chiu sU miet thi va phan biet do'i xfl tfl phia gia dinh va cong dong xa hoi, dieu ban che kha nang tiep can v6i quyen !di va dich vu xa hoi cua ho Bai viet trinh bay cac dac diem xa hoi va tinh due cua nam co quan he tinh due dong gi6i c' Viet Nam, thUc trang ky thi va phan biet do'i xfl ma ho dang phai chiu diing, cung nhiJ nhan manh t6i sU tham gia cua chinh quyen cung nhiT vai tro cua truyen thong viec thay doi each nhin cua cong dong do'i vdi van de nhay cam TCf khoa: Tinh due; Dong gifii nam; Tinh due dong gidi Dat van de Ngay nay, tinh due dong gidi nam la mot vA'n di xa hOi nhay cam chua dugc chap nhan nhieu nin van boa (Winder, R 2006), tren the gi6i noi chung va dac biet la a Viet Nam ndi rieng 82 Nghien clhi Gia dinh va Gidi Quyen 23, so 1, tr 81-90 Thuat ngff "nam c6 quan he tinh due d6ng gidi" (Men who have sex with men - MSM) la thuflt ngO chi hdnh vi chiJ kh6ng phai mfit dac tinh (Vien Nghien cd^i Ph^t trie^n Xa h6i, 2010) V^o cu6i nhihig nflm 40 d^n diu nhung nam 50 cua the' ky trudc, Afred Kinsey qua trmh phat trit^n thang Kinsey, - la thang dung d^ xac dinh thien hadtig tinh due ciJa mat ngu&i, da chi rang dan 6ng "IS mfit th^ lifin tuc trfin moi khia canh" "tDy thudc vao nhirng giai doan khac cuflc dcri m6i ngudi" (The Kinsey hislilule of Research in Sex-Gender and Reproduction 2007) Do dd, nhiJng ngudi nam cd quan he tinh due (QHTD) ddng gidi khOng chi bao gdm nhirng ngudi tir nhan la ngudi ddng tinh (gay) va ngudi ludng tinh (bisexual), ma bao gdm ca nhijtig ngudi dan dng tu nhan la dj tfnh (heterosexual) nhung co QHTD cung gidi (Jenkins R.A., 2005) Noi each khac, thuat ngir diing de chi ta't ca nam cd QHTD vdi nam khong can quan tam de'n hoan canh hay khuynh hirdng Iinh due cua ho (Vu Ngoc Bao va P Girault, 2005) Tinh due ddng gidi nam xua't hiSn d ta't ca cac xa hdi nhung vi nhieu ly khac nhau, nhung hanh vi thudng bi xa hdi ky thi Hie'u bie't ve tinh due dong gidi nam d mdi qudc gia lai rS't khac va cd the' nhirng hieu biet qua ban che' su ky thi qua nang n^ Di^u da dua de'n nhung quan mem sai Mm v^ tinh due ddng gidi nam Tuy nhien, khSng phai ngudi dan cb kie'n thi'tc khdng diing ve va'n d^ ma hp thudng gia dmh tren co sd nhiing tudng tuong dugc dua la su that, dira tren cac thdng diep ciia truyen thong dai chiing va cac nghien cuxi khdng cd tinh khoa hoc Nhieu ngudi du lam tudng rang chi cd nhimg ngudi nam lit nhan la "ddng ti'nh/gay" mdi cd QHTD vdi nam gidi Trai lai, thUc techo tha'y, phan Idn nhiing ngudi dan ong cd QHTD ddng gidi thudng khdng tu nhan minh la ngudi ddng tinh Ho van sdng \:i lam viec binh thudng, tham chi hp ket hon va cd cai Cd the' cac chulin mue van hda, ndi sg bi cpng dong ky thi cung vdi su thieu hieu bie't da khien hp phai che dau gidi tfnh thirc su ciia ban than (Vu Manh Lgi va cpng su 2009) Bai viet xem xet cac dac diem xa hdi va dac diem tinh due cua nam cd quan he tinh due ddng gidi a Viet Nam, su ky thi va phan biet ddi xCt ma MSM phai chiu dung, dac biet la ddi vdi nhimg MSM cdng khai xu hudng tinh due ciia minh, va mdt sd khuyen nghi ti'ch cue de giiip cho MSM cd cupc sdng td't hon Mai X u a n T h u va Le Cvt Linh 83 Noi dung 2.1 Dac diemi xa hpi ciia nam cd quan he tinh due dong gidi tai Viet Nam Hien tai, tren Ihe'gidi cung nhu d Viet Nam van chua co thdng tin chi'nh xac v^ ty le nam cd QHTD ddng gidi (MSM) c6ng ddng, vi nam gidi thudng khdng tu nhan minh la d6ng ti'nh hay luong ti'nh hoac co hanh vi QHTD vdi nam gidi khac Tuy nhien, theo udc tfnh thi sd lupng MSM d Viet Nam cd the la vai tram ngan, chiem 11^-3% - 8% tong sd nam gidi (Vu Ngoc Bao va F Girault, 2005) Con sd tuong duong vdi cac nudc khu vuc nhu Thai Lan cb 3.4'?v nam gidi dieu tra loan qudc nam 1990, Hong K6ng la 4,1% nam gidi theo dieu tra qua dien thoai nam 2000, va d Philippin la 3% nam gidi theo dieu tra cua ngan hang mau nam 2000 (Griensven, F., 2005) Quan he tinh due ddng gidi giua nam vdi nam la mpt hanh vi xay d mpi Ma tudi Dd tudi ciia MSM cac nghien cuu thudng khdng co sir khac biet nhau, tir 14-70 tudi (Koe S., 2010), tap trung phan Idn vao nhdm 20-30 tudi (Bd Y te, 2009) vdi dp tuoi trung binh la 27 (Vu Manh Lgi va cpng sir, 2009) Cd su khac ve dp tuoi trung binh ciia MSM cac nghien ciiu theo tijng khu vuc cu the nhu d Thanh phd Hd Chf Minh la 27 tuoi (Nguyen Anh Tuan, 2004), d Khanh Hda la 24 ludi (T6n Tha't Toan va D Colby, 2005) Trinh dp hpc van cua MSM cb sir khac biet giira cac nghien cun tai cac khu vuc khac Nam cb QHTD ddng gidi d Khanh Hoa cd sd nam di hpc trung binh la nam (Ton That Toan va D Colby, 2005) O Can Tho va Thanh phd Hd Chf Minh phan Idn MSM da hpc xong Trung hpc ca sdva Trung hpc phd thong (Hang Thi Xuan Lan va cac tac gia 2005; Bg Y te, 2006) Ha Nbi va Thai Nguyen MSM cd trinb dp Trung hpc phd thong hoac Cao dang - Dai hpc iai chiem da sd (Bp Y te, 2006; Vu Manh Lpi va cpng su, 2009) Nam cb QHTD ddng gidi dugc cho la cb kha nang cac ITnh vuc nghe thuat cung nhu cb ky nang giao tiep tdt, nen nbieu ngudi sd hg thudng lam cac nghe nhu chuyen vien trang diem, kinh doanh hoac nhan vien tai cac dich vu giai trf Ngoai ra, mpt sd MSM cQng lam can bp nha nudc, luat su cong nhan, r^t ft trudng hop MSM lam nghe nPng hoac san xuat nong nghiep Ben canh do, ky thi til phfa cong ddng, cung nhu trinh dd hoc va'n cd han che' nen nhieu MSM la lao dong tu hoac roi vao tinh trang tha't nghiep Dang luu y mot bp phan khbng nhd MSM tham gia 64 Nghien CLTu Gia dinli va Gidi Quyen 23, so 1, tr 81.90 vSo cdc hoal d6ng bSt hop phap nhu ban dam, bu6n ban ma tliy, trom cSp gay t^c d6ng khOng tO't dO'i v6i dir luSn vd'n da co nhihig dinh ki^n vdi MSM (Bfl Y 16', 2006) Di^u kien kinh te'cua MSM co cai Ihien nhung chua ro rel: nam 2006, Ihu nhap binh quSn cua MSM mire Irung binh tha'p, dao dflng tCr 500.000 de'n 2.000.000 ddng (lifl Y te', 2006) Tuy nhien, de'n nam 2009, mfc thu nhilp binh quSn ciia MSM nang len de'n 1.000.000 d«n hon 2.000.000 ddng nhung vJn ft mile tha'p, ducSi 3.000.000 dong/thang (Bfl Y te', 2009) Do va'n d^ tinh due ciia MSM ia mdi va'n d^ nhay cam chua dugc xa hfli cha'p nhan lai Viet Nam nen da sfl' cac MSM sfing dflc than va khflng ke't hfln, chie'm khoang 90%, xa'p xl vfli ty le chung ciia chau A la 86% (Koe, S., 2010) Tuy nhien, iinh huong bai quan niem truyen thfl'ng va ap luc lir phi'a gia dinh nen mfll so MSM v8n ke't hon Nam 2006, ty le MSM Ha Nfli va Thanh phfl H6 Chf Minh ke't hfln ISn luot la 8,1 % va 5% (Bfl Y le, 2006) De'n nam 2009 thi ly le da co sir thay dfli la khoang 16% va 10%, ty le cr cac khu vuc khac nhu Hai Phong la khoang 25% va Ciin Tho la khoang hon 9% (86 Y te, 2009) PhSn 16n MSM sfl'ng cung vdi gia dinh, dac biel la v6i cha me, chie'm khoang 80% - 90% (Vu Manh Lgi va eflng su, 2009) Ben canh do, nhifa MSM eiing sfl'ng doc than mac cam ca nhan ve gidi tinh va su phan iJng lir phia gia dinh, ngudi than Mfll so lugng nho MSM co ban be than thi^l, cung canh ngfl hoac co ban linh thi lua chon sfl'ng chung cung vdi hg (Bg Y te, 2006) 2.2 D^c di