, ^: ^ifU'^x"^ VI THANH NIEN - DI CU - Chi dao, hudng dan to chire thyc hien cac d i an TTXH cac PTTT, gom: Tiep thj xa hdi bao trinh DS-KHHGD/SKSS va phdng chong HIV/AIDS eao su Hello, Yes va mang phim tranh thai Hdi - Hudng din Chi cge DS-KHHGD cae tinh, KHHGD Viet Nam thyc hien; Tiip thj xa hdi thuie phdi hgp vdi cac dan vj cd lien quan vien tranh thai Trung tam nghien ciru phat day manh TTXH cae PTTT trien y t i cdng ding (CCRD) thyc hien; Tiip thj Chi cue DS-KHHGO cac tinh, phi: xa hdi cac PTTT lam sang DKT thyc hien; Lya - Kien toan to chu'C bd may, mang ludi TTXH ehpn dan vj thyc hien TTXH sd lugng PTTT lam tai tinh, phi Thanh lap va xay dyng quy sang UNFPA vien trg giai dpan 2009-2010; che hoat ddng eiia Ban quan ly du an TTXH cac lya ehpn dan vi thyc hien TTXH thudc vien tranh PTTT ciia tinh, phd thai khan cap mua tip ngudn ngan sach nude va tip nguon vien trg - To chiPC thu thap sd lieu ve nhu cau TTXH cac PTTT (bao cao su va thudc vien) theo tipng - Phdi hgp vdi cac dan vj cd lien quan xay nhdm ddi tugng tren toan tinh, tu' dd lap ke dyng va trinh phe duyet sira doi bo sung thdng tu hoach quan ly va diiu phoi chuang trinh TTXH s i 27 TC/VT hudng dan quan ly quay vdng vin tai dja phuang bao dam thyc hien chi tieu Nha TTXH, CO chi sir dgng tiin ban san phim tiip thj nude v i so ngudi thyc hien BPTT, kjp thdi bao xa hdi cac PTTT eao cip cd tham quyin cac vin d i vudng mic, - Tien hanh cac nghien ciPU danh gia phgc vg viec hoach djnh chuang trinh k i hoach diy manh khd khan va tham muu, de xuit cac giai phap khic phuc TTXH thdi gian tdi, bao gdm: Danh gia thyc - Phdi hgp vdi cae ea quan, dan vi cd li§n trang an ninh hang hoa SKSS/KHHGD; danh gia quan danh gia tinh hinh thyc hien edng tac day chuang trinh TTXH hang hoa SKSS/KHHGD; manh TTXH cae phuang tien tranh thai tai cac Tong quan cac nghien ciru ve bao eao su, nghien tinh, phi giai doan 2006-2010, d i xuat Ke ciru phan dpan thj trudng va dy bao tong the nhu hoach thyc hien giai dpan 2011-2015 bao eao ciu bao cao su giai dpan 2011-2020 cho chuang Tong cge DS-KHHGD quy 111/2010 J\y SAVY DEN SAVY 2: NHU'NG P H A T HIEN VE DAY THI SU'C K H E T I N H D U C - su'c KHOE SINH S A N DAO XUAN DONG SAVY ((2003) va SAVY (2009) la cuoc cuoc didu tra cho phdp so sanh su thay ddi vd xu didu tra qudc gia vS vi nien va nien huong phat thdn quan trong kidn thuc, thdi Viet Nam vS nhidu vin dd khac nhau: giao due, do, hanh vi, Idi sdng va didu kien sdng cua lao ddng, vide lam, tinh due va su'c khod sinh san, thieu nidn sue khod tam thin, tai nan, thuang tich va benh SAVY duoc tiin hanh vdi 10.044 vj thdnh tat, hanh vi, uoc mudn, hoai bao Kdt qua cua nidn va nien tudi 14-25 t^i 63 Dan so & Phat trien 7-2010 f v i THANH NIEN - DI CU tinh/thanh (mdu nghidn cifu a SAVY la 7.584 vi Khdng cd the lam tot han ngudi me viec nidn vd nidn tai 42 tfnh/thanh) giiip gai hieu biit v i s y phat trien the chat, Day thi ea c h i kinh nguyet va ca nhO'ng v i n d i v i van Tuoi CO kinh va xuat tinh lan dau hoa irng xu, giao tiip v a ngudi bo cung cd So lieu d SAVY cho t h i y nu" cd kinh l i n dau thuan Igi han ngudi me trai d i n tuoi day sdm han nam ed mong tinh/xuit tinh lan d i u han thi va gap nhCrng v i n d i ve gidi tinh mpt nam, va sdm han SAVY Tuoi trung binh SLPC khde tinh due cd kinh lan dau cua nu' la 14,2 va mong tinh/xuit Ngudn dem lai thdng tin nhiiu nhit v i sire tinh l i n d i u cua cua nam la 15,5 d khoe tinh dgc (SKTD) d SAVY cung v i n la SAVY1 la 14,5 va 15,6 TiVi, tinh chung ea nude chiim ty le 56,3%, ty le Tuoi mong tinh/xuit tinh l i n dau ciia nam d dd d nam la 58,2%, nu 54,5% T i i p theo la sach thj sdm han d nam ndng thdn, va tuoi cd kinh l i n bao, tap chi 47,7%; ban be 39,3% Thay cd giao • d i u ciia nu' d dd thi cung sdm han nu" d ndng edn cd vai trd cao han nhan vien y t i , cdng tac thdn Su khac biet giu'a nien d ndng vien dan so (14,6% so vdi 5,7%), diiu mpt thdn va dd thj phan nao phan anh e h i dp dinh l i n nu'a chirng td moi quan he thay/ed vdi hpc dudng ma nam/ntr nien duge hudng sinh khdng can trd viec cung c i p thdng'tin ve qua trinh trudng Tuoi cd kinh l i n dau cd SKTD the giam di khoang - nam dieu kien kinh te- Ban tinh xa hdi va che dp dinh dudng duae cai thien hon, Phil hgp vdi xu the toan c i u la ngudi tre ed md md tich tu sdm han tren toan ca the Nguon va SLT chia se thong tin Vdi tuoi day thi d SAVY ngudn thdng tin quan trpng nhit doi vdi VTN la TiVi (58,5%), t i i p ban tinh sdm, dd cung sdm cd hoat dpng tinh dgc SAVY ty le ed ban tinh d nam la 31,8%, nu' 30,2%; d SAVY ty le tuang irng la 35,7% va31,3% theo la sach, bao, tap ehi (49,3%); ban be Ngoai quan he tinh dgc (giao hap), (35,4%); me (31,53%) Thay cd giao cung giup thieu nien cung tra Idi cd nhiiu hanh vi khac doi nhieu cho ca VTN nam va nu' (tuang irng la vdi ban tinh nhu hdn (khoang 70%), sd md eo 22,9% va 21,9%), dieu chirng td giao dgc gidi quan sinh dgc cua (khoang 30%) Nhieu tfnh - khoa hpc n h i m xay dyng nhan each cho nghien ciru d nude ngoai v i hanh vi tinh dgc VTN, ed dieu kien thuan lai de dua vao nha cua thiiu nien edn khai thae chi tiet han trudng n h i m phat hien nhO'ng hanh vi cd nguy eo, Gia dinh la mdi trudng ed the manh de hinh khdng an toan (de nhiim cac benh lay truyen nhan each ma xa hdi ky vpng va cung c i p qua dudng tinh due/HIV) va vi pham dao dire, nhO'ng hieu biit v i sinh ly sinh san cho VTN Cae phap luat, vi dg nhiiu ban tinh, tinh dgc theo du' li§u ciia d i i u tra cung da xac nhan ed moi dudng hau mdn, cuang dp tinh dgc quan h$ tich eye, tin cay giu'a cha me - eon cai Dan so & Phat trien - VI THANH NIEN - DI CU Tinh tren toan miu ciia SAVY thi 34% so ngudi duge hdi da tra Idi cd ban tinh nhung so Dp tuoi - : 14,8% nam va 2,1% nu- cho biit da cd quan he tinh due ngudi song chung vdi chi cd 16%; 92% da Dp tuoi 2 - : 29,8% nam va6,1%nu tirng hen hd Tinh hinh d SAVY cung khdng khac nhiiu Quan he tinh due lan dau va truxrc hon nhan so vdi SAVY • Thanh nien ndng thdn cd tuoi quan he tinh • So vdi SAVY tuoi quan he tinh dgc eiia due lan diu la 18 tuoi, sdm han nien d dd nien SAVY ed xu hudng giam thj ddi chiit (thanh nien thj ed quan he tinh SAVY 2, tuoi quan he tinh dgc lin diu trung binh dgc lan diu la 18,4 tuoi) ddi vdi toan miu chi la 18,1 tuoi (18,2 cho nam va 18 cho nu'), giam 1,5 tuoi so vdi SAVY • Tfnh chung cho ea ngudi da kit hdn va • Tuoi ed quan he tinh dgc lin diu cua thiiu nien dan tpc thieu so cung sdm han nien Kinh/Hoa (17,9 tuoi so vdi 18,1 tuoi) chua kit hdn, nien d SAVY da tirng ed Quan he tinh due trwac hon nhan quan he tinh dgc trude hdn nhan chiim ty le Cy SAVY 1, nhan djnh ve quan he tinh due 9,5% (ty le d SAVY la 7,6%) trude hdn nhan td khic nghiet, cho ring cac • Nam nien da tii'ng cd quan he tinh phuang tien thdng tin dai chiing cdng vdi tu due chua lap gia dinh (ke ea nhirng ngudi tudng hay hoang mang cua ngudi Idn ed the la hien da kit hdn) ed ty le la 13,6%, eao hon hai nhO'ng tac nhan gdp phan thoi phong sy thuc (ve lin tinh cho nu' la 5,2% (con sd tuang irng d thiiu nien ed hoat dpng tinh dgc va cac SAVY 11,1% va 4%) - nhu-ng so lieu da ciing hanh vi nguy ca eao han nhiiu so vdi cac so li$u CO them y nghT v i xu hudng tre hoa sinh hoat tinh chinh thuc ciia cupc dieu tra) va ein ed bing dgc d gidi tre chirng xac thuc de bac bd cac thdng tin sal lech • Phin Idn nam va nCr hien da lap gia dinh nhung da tirng cd quan he tinh dgc trude hdn nhan vdi ngudi sau la vg/chong minh » Cy ca cupc diiu tra SAVY va SAVY 1, Thay doi quan niem ve tinh due trwac hon nhan Thanh nien hien td cd quan niem cdi md han v i quan he tinh dgc trude hdn nhan d nam chua vg nhung da tirng ed quan he tinh dgc ca tinh huong dudi day, ty le thiiu nien a cao han rit nhiiu so vdi nO' chua chong SAVY chap nhan tinh dgc trude hdn nhan deu • Thanh nien chua lap gia dinh d dd thj ed ty eao han ty le thiiu nien d SAVY Dieu le quan he tinh dgc cao han nien ndng cho thay xu hudng chap nhan tinh dgc trude thdn hdn nhan dang gia tang nien va du • Ty le nien chua lap gia dinh nhung da cd quan he tinh dgc tang theo dp tuoi ed sy thay doi ve nhan thire so vdi SAVY (sau nam) nhyng vin so ddng chua chap nhSn Dp tuoi 14 - 17: Rat it nien nam va nu" da tii'ng cd quan he tinh dgc 10 • Dan so & Phat trien 7-2010 E vi THANH NIEN - DI cu •mmmmsim Bang Quan niem cua vj nien v i tinh due tripae hon nhan SAVY Tinh due tru'O'c hon nhan Chap nhan Khong chap nhan (%) (%) Khi ngudi t u nguyen 37 47 Khi ngudi yeu 27 56 Khi ngudi s i p k i t hdn 34 47 Khi ngudi da trudng thanh, cd hieu biet ve hau qua 36 45 Khi ngudi phg nu- dugc bao ve 32 48 Ty le nam gidi, ngudi song d dd thj ed "thai dp t i i p ddn ban, iis dd cd d i i u kien thuan Igi hon de hien dai" eao han h i n nip, ngudi song d ndng d i n d i n quan he tinh dgc Quan he tinh due l i n thdn MiPC dp c h i p nhan tinh dgc trude hdn nhan d i u d nu' xay d nha ban tinh ed ty le cao rd d ngudi DTTS lai eao han ngudi Kinh/Hoa Tuy ret, d i i u cd the la sy nhie nhd cd ich cho nhien cung nen biet da cd khao sat xa hdi cho cae bac cha me de dat nhu'ng gidi han cho ring tinh hinh quan he tinh dgc trude va ngoai eon gai hdn nhan eiia VTN (10 - 19 tuoi) d Viet Nam O' ca cupc d i i u tra, hanh vi tinh due l i n dau khdng chl bien d cac Idn, cac khu d thieu nien cd xu hudng trd sy md dd thj ma da x u i t hien cang nhiiu d ndng man ddi song tinh dgc chir khdng phai la hanh vi thdn Viet Nam (Le Thj Nham Tuyit) ngiu hirng Thipa nhan thyc t i la can cip Chap nhan quan he tinh dgc trude hdn nhan quan trpng de ed k i hoach xay dyng hanh trang cung cd xu hudng ty le thuan vdi sy phat trien xa hieu biit v i SKSS cho thiiu nien tip hoi, giong nhu da nhan t h i y d cac nude trude tuoi 18 Ma mpt nhu'ng viec e i n hoan khu vyc va tren the gidi Ke tip ed sy bao sdm la thiit k i chuang trinh giao dgc gidi dpng v i nguy ea ciia dai djeh HIV/AIDS va khai tinh (bao gdm ea kien thu'c v i SKSS) cho cac niem tinh dgc an toan dugc ndi d i n nhiiu thi van bae cha me va nha trudng tu" c i p de quan trpng han la lam ngudi tre ed nhan Mai dam thire dung v i trach nhiem hanh vi tinh Sd ngudi ed quan he tinh dgc vdi ngudi ban due chir khdng phai ban than hanh vi dam d ca cupc khao sat kha hiem, chi cd 3,2% Nai quan he tinh due lan dau (70 ngudi) d SAVY (d SAVY la 79 ngudi, Vdi nhdm chua lap gia dinh, d SAVY 1, quan chiim 5,2%) Ty le quan he tinh dgc l i n d i u vdi h0 tinh dgc lan dau d nha hp hoae nha ban tinh gai mai dam d nien chua k i t hdn da giam chiem ty \d 28%, d SAVY la 76,1% Cd di d SAVY 2, dd la dau hieu thyc sy dang mipng, the sau nam, mire song nang eao, thiiu chirng td gidi tre da cd y thu'c v i tinh due an ni6n phan Idn da cd khdng gian rieng de hpc va toan 87% so ngudi d SAVY da tra Idi ehi cd Dan so & Phat trien - 11 ããiằfiô*ãa4SƠ&-^-"^*lt?/.^ã^;ã.,v^-i;-,'ã^ã"J.>^ V! THANH NI^N - DI CU ban tinh 12 thang vira qua (d SAVY la hdi nhO'ng nam qua da dem den kit qua 85%) Cd ban tinh chi chiem ty le 3,2% Qua Cdng viec tiep theo la nang cao hieu biit de cae sd lieu da neu, thay ro tip SAVY din SAVY thiiu nien nhan thire thyc hanh tinh due 2, ty le quan he tinh dgc vdi gai mai dam da giam an toan la mot gia trj xa hdi di va ty le chi quan he tinh dgc vdi ban tinh da tang len Cd the nhu'ng nd lye tong hgp eiia xa Thanh thiiu nien d ca cupc dieu tra diu ed thai dp kha gidng doi vdi mai dam Bang Thai dp vai viec ban dam SAVY Nam Nu SAVY1 Nam NO- 33% 32% 45% 42% 34% 33% 40% 38% Ban dam la vd dao du-c 56% 57% 57% 58% Tong 5109 4928 3795 3789 Ty If dong y vai y kien Ban dam la khdng tdt nhung ed phai lam hoan canh bit bude Ban dam cd xiu hay khdng thudc vao each nghT eiia tu'ng ngudi ca cupc khao sat, kit qua phan tich cho Ty le biet ve TDDG nhung khdng chip nhan thay mu-c dp chip nhan va dp lugng doi vdi hanh hanh vi tinh dgc cung eao d ca cupc khao vi ban dam phg thudc vao hoan canh eg the chir sat: Cy SAVY la 80,2% va d S A V Y la 84,i% khdng phai mpi hanh ddng ban dam deu dugc NhO'ng du' lieu da cung cap bing chu-ng ve danh gia gidng Cae nha xa hdi hpc ed the sy ky thj ciia cdng ding vdi xu hydng TDDG, trd lam rd han khfa canh nay, dong thdi cung cd the li de nhdm dan so khdng dam lo dy doan ring quan diem edn ed the thay doi dien va nhu vay khdng dugc hudng su quan theo su phat trien van hoa - kinh t i ciia xa hdi, tam cua xa hdi ve mat tiep can hieu biet de bing chirng la d nhiiu nude edng nghiep phat phdng tranh cac nguy ca lay nhiem HIV trien quan diem ve mai dam khac vdi nude ta hien Trong tuang lai, cin mpt khao sat rpng va sau han ve chu de ban sic gidi vdi tinh due nhu Tinh due dong giai (TDDG) nhiiu nude phat trien da lam de ed nhu'ng phan Sau cupc khao sat thi so ngudi tra Idi khdng tich toan dien han ve eon ngudi, dd cd biet ve TDDG vin cao (chung cho ca nude d quyen dugc chuyen gidi SAVY1 la 40%, d SAVY2 la 36,6%) va khdng SiPc khoe sinh san thay doi miy, dieu dd chirng td nhan thu'c ciia Mang thai, nao pha thai edng ddng ve xu hudng tinh dgc khdng dugc Vi so lugng nu' chua cd chong nhung da c6 cai thien bao nhieu 12 quan he tinh dgc va da tirng mang thai, nao thai Dan so & Phat trien 7-2010 VI THANH NIEN - DI CU vao thdi d i i m d i i u tra ciia SAVY va SAVY phat trien han nu'a viec giao dgc thiiu nien qua nhd nen khd ed the binh luan Chi ed the ghi v i SKSS va sinh ly thg thai de biit ty bao ve nhan la khdng thay ed d i i n bien dang lo ngai han "Thdi diem de ed thai chu ky kinh" la mpt d SAVY so vdi SAVY s i nu' chua mang hieu biet c i n thiit, giiip phg nu ed the chii chong dpng tranh thai, la each de phg nu' biet tranh thai Viet Nam la mpt nhO'ng nude cd ty le bing phuang phap ty nhien nao pha thai eao tren n h i t t h i gidi, dd 20% Tranh thai la d lira tuoi VTN, tren ca nude cd 5% em gai Ty le biit ve cae bien phap tranh thai deu rat sinh trude tuoi 18, 15% sinh trude tuoi eao, trung binh tip bien phap trd len Tuy nhien, 20 sir dgng hieu biit v i tranh thai thyc t i nhu Trong Chiin luge Dan so Viet Nam giai doan 2001-2010 ed doan n h i n manh "Viec mang thai t h i nao va cac bien phap tranh thai cd dap irng nhu c i u khdng mdi la d i i u quan trpng nhit ngoai y muon va tinh trang nao pha thai la dang Bao cao su v i n la bien phap hd tra hang d i u lo ngai" (Uy ban Dan so, Gia dinh va Tre em, cho nam (72,7%) nhung vien tranh thai khan c i p 2003:220) Cdn Chien luge qudc gia v i cho nu* lai ed ty le sir dgng khdng eao (chi 4,5%) Cham sdc SKSS giai doan 2001-201CJ cung d i Bien phap tranh thai hien dai dugc sir dung muc tieu "Giam cd thai ngoai y muon va cac tai nhiiu nhit: BCS v i n dipng hang d i u vdi 42,9%, bien nao hiit thai" (Uy ban Dan so, Gia dinh va tiep theo la dgng eg tip cung 26,5%, thuoc uong Tre em, 2003:255) tranh thai 18,8%, x u i t tinh ngoai am dao 7,7%, Hieu biet ve sinh ly thu thai a thieu nien % (nam 67% va nu' 74%) tra "idi "Cd" vdi cau ndi "Lieu mpt ban gai cd the mang thai sau tfnh vdng kinh 2,0%, vien tranh thai khan cap 1,8% (ty le t h i p sir dgng vien tranh thai khan c i p cd the da gdp p h i n lam gia tang so nao pha thai dVTN) lan quan he tinh dgc d i u tien?" cho thay dieu Benh lay truyen theo dirang tinh due quan trpng la cd d i n g i n phan thiiu Cd the cho ring sy hieu biit v i cac benh ni6n da biit danh gia cao nguy ea mang thai sau lan quan he tinh dgc dau tien So ddng thieu nifen (82%) cung da b i i t den va cd n i i m tin vao cae bien phap tranh thai Tuy nhien, ty le phan tram nam nu' nien tra Idi dung cau hdi ve thdi diem d i cd thai chu ky kinh kha thip Cy SAVY 2, chl cd 13% (7% nam va 18% nu) tra Idi dung cau hdi (thdi diem" giu'a ky LTQDTD khdng thay doi sau l i n diiu tra Cdn e i n nhiiu nd lye de nang eao nhan thu'c cdng dong ve cae benh ndi tren Tren thyc t i , d i i u can luu y cac t h i y thuoc thyc hanh la benh phg khoa thudng gap nhit lai chinh la viem am dao (do n i m chiem ty le eao nhit) va sy d i tai d i i n cua benh nay, cd nguyen nhan tip hieu biet han e h i v i ve sinh phg nu' va ddi song tinh dgc kinh") O' SAVY 1, cd 17% ( 1 % nam va 22% nu-) tra Idi diing Dieu cd y nghTa d cho can thiet vg chdng Cung c i n ed chuang trinh kiem soat benh viem am dao virut gay u sui (HPV) d Dan so & Phat trien - 13 ... ciia SAVY thi 34% so ngudi duge hdi da tra Idi cd ban tinh nhung so Dp tuoi - : 14 ,8% nam va 2 ,1% nu- cho biit da cd quan he tinh due ngudi song chung vdi chi cd 16 %; 92% da Dp tuoi 2 - : 29 ,8%... Tre em, cho nam ( 72, 7%) nhung vien tranh thai khan c i p 20 03 :22 0) Cdn Chien luge qudc gia v i cho nu* lai ed ty le sir dgng khdng eao (chi 4,5%) Cham sdc SKSS giai doan 20 01- 20 1CJ cung d i Bien... vdi mai dam Bang Thai dp vai viec ban dam SAVY Nam Nu SAVY1 Nam NO- 33% 32% 45% 42% 34% 33% 40% 38% Ban dam la vd dao du-c 56% 57% 57% 58% Tong 510 9 4 928 3795 3789 Ty If dong y vai y kien Ban