Consistent condom use and correlates among men who have sex with men recruited by internet based sampling in hanoi

MINISTRY OF EDUCATION AND TRAINING MINISTRY OF HEALTH HANOI MEDICAL UNIVERSITY PHAM THU VAN CONSISTENT CONDOM USE AND CORRELATES AMONG MEN WHO HAVE SEX WITH MEN RECRUITED BY INTERNET-BASED SAMPLING IN HANOI THESIS OE GRADUATION MEDICAL DOCTOR COURSE 2015-2021 HANOI - 2021 MINISTRY OF EDUCATION AND TRAINING MINISTRY OF HEALTH r-u -ÍM Qỉ ugc V Hl HANOI MEDICAL UNIVERSITY _ PHAM THU VAN CONSISTENT CONDOM USE AND CORRELATES AMONG MEN WHO HAVE SEX WITH MEN RECRUITED BY INTERNET-BASED SAMPLING IN HANOI Major : Doctor of Preventive Medicine Code : D720302 THESIS OF GRADUATION MEDICAL DOCTOR COURSE 2015-2021 Supervisor: MD PhD Hoang Thi Hai Van HANOI-2021 r-u -ÍM Qỉ ugc V Hl ACKNOWLEDGEMENT To begin with I would like to thank Preventive Medicine and Public Health Institute Board of President and Global Health Department for giving me the opportunity to study and complete this thesis I would like to express my special thanks of my gratitude to my supervisor Mrs Hoang Thi Hai Van MD Ph D for Iter enthusiastic guidance, great patient, and strong support since the beginning 1 came to know about so many new things and I am really thankful to them 1 am very grateful to all the study participants who agreed to spend their time completing the questionnaire and all staff members at SUP clinic Hanoi Medical University who contributed Their contribution plays a crucial role in the success of this thesis Besides, many thanks to Nguyen Thi Hoang Ha Tran Thi Thao Allh Nguyen Huy Hoang Tran Hoan and all my classmates, who were always ready to share their knowledge and skills, and helped me a lot throughout the process 1 would like to thank my close friends Trinh Thuv Duong Bui Thu Hien Quach Linh Giang, who always support me and give me a hand whenever I need Last but not least I also would like to express my deepest gratitude towards my family, who always stay by my side and encourage me to finalize this study Hanoi, May 2021 Pham Thu Van r-u -ÍM «£ ugc V Hl li DECLARATION I declare that this thesis represents, my own work and has not been submitted for any degree in any university previously All the sources of information which have been used in the thesis and external contributions are fully referenced and acknowledged Hanoi, May 2021 Pham Thu Van CONTENT ACKNOWLEDGEMENT i DECLARATION LIST OF ABBREVIATION LIST OF FIGURES V vi INTRODUCTION CHAPTER 1 LITERATURE REVIEW 1.1 Definitions 1.2 The situation of HIV/STls among MSM 6 I 3 Researches on consistent condom use among MSM .7 1.4 Researches on factors associated with consistent condom use among MSM 8 1.5 Researches on using the internet-based sampling to recruit MSM 9 I 6 Information about MSM in Hanoi 10 CHAPTER 2 METHODOLOGY 12 2 I Subjects 12 2.2 Location and time 2.3 Study Design 13 2.4 Sampling 13 2.5 Variables 13 2.6 Data collection 16 2 7 Statistical analysis 17 r-u -ÍM CỊỈ ugc V 17 2 8 Research ethics Hl 3.2 condom use with different types of partners 26 3.1 Consistent General3.information CHAPTER RESULTS 18 3.3 Correlates of consistent condom use among MSM recruited by IBS in Hanoi 31 CHAPTER 4 DISCUSSION 4.1 General information 4 2 Consistent condom use with different types of partners 40 4.3 Correlates of consistent condom use 41 CONCLUSION RECOMMENDATION 46 ••••••••••••• 47 REFERENCES A ppcxiniv 4» I J r-u -ÍM CỊỈ ugc V Hl V LIST OF ABBREVIATION AIDS Acquired Immunodeficiency Syndrome CDC Centers for Disease Control and Prevention HIM The Hanoi MSM Cohort Study HIV Human Immunodeficiency Virus HSS+ HIV Sentinel Surveillance plus behaviors IBBS Integrated Biological and Behavioral Surveillance IBS Internet-based sampling SUP Sexual Health Promotion STI Sexually Transmitted Infection USAID United State Agency for International Development UAI Unprotected anal intercourse VAAC Vietnam Authority' of 11IV/A1DS Control VND Vietnamese Dong r-u -ÍM Qỉ ugc V Hl 7 LIST OF TABLES r-u -ÍM Qỉ ugc V Hl 8 LIST OF FIGURES r-u -ÍM CỊỈ ugc V Hl ABSTRACT Title: Consistent condom use and correlates among men who have sex with men recruited by Internet-based sampling in Hanoi Objective: This study was conducted to examine the consistent condom use (CCU) with different types of partners and correlates among MSM recruited by internetbased sampling (IBS) in Hanoi Methods: Data for this analysis were from a cohort study IÍIM-Ỉ lanoi conducted from 2017 IO 2019 in Hanoi MSM aged from 16 years were recruited for the survey using IBS Univariate and multivariate logistic regression were used to assess the association of ecu with selected socio-demographic characteristics and other factors Results: Among 802 MSN interviewed, ecu with non-commercial male partner, male client, male sex worker, and female transgender was 39.8% 41.5% 40.0% and 20.0% respectively Meanwhile, ecu with non-commcrcial female partner, female client and female sex worker was 43.1% 72.7% and 80.0% respectively Characteristics associated with increased odds for ecu with noncommercial male partner were being aged from 25 years or older (OR: 1.27, 95%CI: 0.82 - I 96) having tertiary education level (OR: 1.63, 95%CI: 1.01 2.64) never getting married (OR: 2.22 95%C1: 1.01 - 4 88) and using the Internet to seek male partners (OR: 2.05,95%C1: 117 3.60) Factors associated with decreased odds of ecu w ith noncommercial male partner was spending the night at hotel guesthouse frequently (OR: 0 49 95%CI: 0 25 0.97) never being tested HIV (OR: 0.43 95%CI 0 19-0 96) and using ATS to enhance sexual performance (OR: 0.44 95%CI: 0.21 - 0.90) Conclusion: ecu with different types of partners among Hanoi MSM sun eyed remains low HIV interventions for MSM should take associated factors found in the study into consideration to increase ecu among MSM thereby contributing to the reduction of HIV and STI infections Keywords: Men who have sex with men MSM Consistent condom use Sexual partners Internet-based sampling Hanoi 10 TÓM TẢT Tên đề tài' Sử dung bao cao su thưởng xuyên vã các yều tồ liên quan ớ nhóm nam quan hệ tinh dục đòng giới thu tháp bởi phương pháp chọn mầu trực tuyển tai Há Nội Mục liêu: Nghiên cửu được thưc hiện nhím niuc tiêu xác đinh ti lệ sử dung bao cao su thưởng xuycn và cãc yếu tố liên quan ơ nhóm MSM được thu thập bởi phương pháp chọn mầu trực tuyền tai Hà Nội (IBS) Phươngpháp: Nghiên cữu sư dụng số liệu tứ nghiên cứu IIIM-tlà Nội với đối tượng MSM tũ 16 tuỏi trớ lẽn được thu thập bảng phương pháp IBS Phương pháp phân tích hồi quy logistic được dùng đề dành giá mói liên quan giừa việc sử dung bao cao su thưởng xuyên (CCƯ) với các yếu tồ liên quan Kct quà: Trong số 802 MSM ti lô CCƯ với ban tinh nam tư nguyện, bạn tinh nam khách hãng, ban tinh nam bán dâm vã nừ chuyền giới lằn lưọt lã 39 8% 41 5% 40.0% và 20.0% Ti lệ ecu với bạn tinh nừ tự nguyện, ban lình nừ khách hàng vá bạn tinh nừ băn dâm lần lượt là 43.1%, 72.7% và 80.0% Cãc vcu tơ lãm tăng khá năng ccu khi quan hộ tinh dục (QIITD) với ban tinh nam tự nguyện gồm; tuồi tú 25 trở len (OR: 1.27.95%CI: 0 82 1.96) trinh độ hoe vần lữ đai hoe trờ lẽn (OR: 1.63.95%CI: 1.01 - 2.64) chưa từng kềt hòn (OR: 2.22 95%C1: 1.01 4 88) vả có sữ dung Internet đê tim kiếm ban tinh nam (OR: 2.05 95%CI: 1.17 - 3.60) Cãc yếu tố lãm giam kha nàng ecu khi ỌHTD với ban tinh nam tư nguyên gôm thướng xuyên qua dẽm tai khách san nhã nghi (OR 0.49 95%CI: 0.25 0.97) chưa từng xét nghiêm HIV (OR 0.43 95%CI: 0.19 0.96) vã sử dụng ATS đè tảng khoái cám tinh dục (OR: 0.44 95%CI: 0.21 - 0.90) Két luận: Ti lệ ecu với các loai ban tinh khác nhau trong nhõm MSM tạt Hã Nội còn thấp Cãc biện pháp can thiệp dư phóng HIV cần chủ trọng đèn các yếu tó liên quan được xác định trong nghiên cứu để làm tâng ti lê ecu trong công đồng MSM tử đõ góp phần giam lây nhiễm HIV và các bênh lây truyền qua đường tinh due Từ Nam quan hê ban tinhtinh, due đồng MSM.tuyến sứ dung bao caokhỏa: Nội su thường xuyên, chongiói mầu trực 1 lã -■c -ÍM CỊỈ ugc V Hl assemblers and machine operators 1 2 I 2 1 2 Sex work 1 2 Illegal work 1 2 Unskilled workers Armed forces Currently unemployed 1 2 Others (specify) 1 2 Including all sources of income and family support, A5 how much money did you 1 1 J 1 (Millions VND1 Don't know 999 earn m the last month? My own home 1 Rented House 2 Family/relative’s home 3 Sex partner's home 4 Other (nonrelative non-sex partner) person’s In the last 30 days, where A6 have you slept (spent the home 5 Hotel/guesthouse/other temporary room 6 night) most frequently? School dorm 7 Public places 8 Other 9 r-u -ÍM CỊỈ ugc V Hl No Questions Coding of answers (specify: Skip to ) Exclusively attracted to men 1 Mostly attracted to men sometimes women 2 Equally attracted to both men and W hich of the following women 3 Mostly attracted to women sentences most exactly A7 characterizes the types of people that you arc sexually sometimes men 4 Exclusively attracted to women 5 attracted to? B Internet usage and other factors No Bl B2 Questions Coding of answ ers Have you ever been tested for HIV? W hat was the result of your last test? Yes 1 No 2 Don’t Know 7 Positive 1 Negative 2 Unclear / neither positive or negative 3 Did not receive result 4 Don’t know 7 Herpes 1 1 lave you ever been B3 Skip to diagnosed for any of the Syphilis 2 Gonorrhea 3 follow ing diseases at a r-u -ÍM CỊỈ ugc V Hl health clinic? (check all that apply) Chlamydia 4 HPV'warts on your mouth 'penis/anus 5 Hepatitis B 6 Hepatitis c 7 How often in the last six months have you use amphetamine type stimulant (ATS) to enhance sexual B4 performance with (any of) Never 1 Occasionally 2 Often 3 NA No regular partners 4 your noil-regular male Refusal 8 partner(s)? Don’t know 9 How often in the last six months have you use amphetamine type stimulant (ATS) to enhance sexual performance with (any of) B5 your regular male parmcrís)? Never 1 Occasionally 2 Often 3 NA No regular partners 4 Refusal 8 Don’t know 9 B6 What are some websites, applications, or forums you have used through a smartphone or computer to find male sex partners? Choose all that apply r-u -ÍM CỊỈ ugc V Hl Grinder 1 Jack’d 2 Hornet 3 Scruff 4 Facebook 5 Zalo 6 Blue 7 thcgioithu3.com 8 daugau net 9 Other (specify: ) 10 B7 Never 1 Occasionally 2 Have sex with someone you Often 3 met online on a website (eg.daugau.com NA No regular partners 4 taoxanh.net etc ) Refusal 8 Don't know 9 B8 Have sex with someone you Never 1 met through mobile app Occasionally 2 (Grindr Blue Jack’d Often 3 Facebook, etc ) NA - No regular partners 4 Refusal 8 Don’t know 9 c Sexual behaviors with different types of partners No Questions Coding of answers For each of the kinds of the following partners, have you ever had sex with them (manual, oral, vaginal or anal)? Skip to appropn 1 (Yes)/2(No) Noncommercial ate parts male partners 1 2 for each C102 Interviewer must read the following: Noncommercial Male/fcmalc partners are those you have sex with where there was no exchange of money or goods r-u -ÍM CỊỈ ugc V Hl Skip to type of sexual Male partners who pay you for sex 1 2 Male sex workers 1 2 partners Malc/femalc sex workers arc those who you have sex with and pay money Female transgender 1 2 Non-commercial female partners Male female partners who pay you for sex (clients): this includes payinent by money or goods Female transgender: a transgender person who was a male at birth but whose current gender identity is a female 1 2 f emale partners who pay you for sex (clients) 1 2 Female sex workers 1 2 C2 Non-commcrcial male partner Always a giver 1 A giver 2 C2OI During the last 6 months, when having anal sex with noncommercial male partners, arc you a giver, receiver or both? Giving you insert penis into other man’s anus Receiving: Other man inserts penis into your anus During the last 6 months, where have you met your noncommercial About half a giver and half a receiver 3 A receiver 4 Always a receiver 5 Had not anal sex with non commercial male partner in the last 6 months 6 YN Street, park or lakeside 1 2 Internet 1 2 male sex partner0 Bar or disco 1 2 (Do not read choices aloud, only C2O2 probe and circle all that apply.) Cinema 1 2 Swimming pool 1 2 Through an intermediary pimp 1 2 Sauna/massagc parlor 1 2 At home 1 2 r-u -ÍM CỊỈ ugc V Hl Hotel, guesthouse 1 2 Other (specify) 1 2 In the last 30 days, among your lion-commercial male partners, how many have you had anal sex 1 1 1 1 men with? Don’t remember 999 C2O3 Include both giving and receiving If none, record 000 If other than 1 or Always 1 During the last 6 months, of all the times you have had anal sex with C204 noncommercial male partners, how frequently did you and your partners use condoms? Occasionally 2 Never 3 Do not apply, no noncommercial sex partners during the last 6 month s Doni remember 9 Condom use reduces pleasure 1 Condoms is not available 2 If not always, what is the main reason you did NOT always use a condom dun ng anal sex with this C205 partner? My partners look healthy 3 Condoms are too expensive 4 (Circle one appropriate answer My partner didn't want to 5 1 trust my partners 6 I feel only) embarrassed to buy condoms 7 r-u -ÍM CỊỈ ugc V Hl 8 skip to C30! 1 was in a hurried s Other (specify) 9 No response 10 C3 Male sex worker Always a giver 1 A giver 2 About During the last 6 months, when having anal sex with male sex workers, are you a giver, receiver or both? C3OI Giving: vou insert Denis into other half a giver and half a receiver 3 A receiver 4 Always a receiver 5 Had not anal sex with a male sex worker in the last 12 months 6 man's anus Receiving: Other man inserts penis into your anus YN Street, park or lakeside 1 2 Purm (1K last -months- where have you met the male sex worker partners0 Internet 1 2 Bar or disco 1 2 Cinema I 2 Swimming pool 1 2 Through an (Do not read choices aloud, only C302 probe and circle all that apply.) intermediary/pimp 1 2 Sauna/massage parlor 1 2 At home 1 2 Hotel, guesthouse 1 2 Other (specify) 1 2 C3O3 In the last 30 davs among the male sex worker partners, how r-u -ÍM CỊỈ ugc V Hl Illi men many have you had anal sex with? Don’t remember 999 If none, record 000 Include both giving and receiving During the last 6 months of all the times you have had anal sex with C304 male sex workers, how frequently did you and your partners use condoms? If other than I or Always 1 8 skip to Occasionally 2 C401 Never 3 Do not apply, no male sex worker partners during the last month 8 Don't remember 9 Condom use reduces pleasure 1 Condoms IS not available 2 My partners look healthy 3 Condoms are too expensive If not always, what is the main reason you did NOT always use a condom during anal sex with this C305 partner? 4 My partner didn’t want to 5 1 mist my partners 6 (Circle one appropriate answer only) 1 feel embarrassed to buy condoms 7 1 was in a hurried 8 Other (specify) 9 No response 10 C4 Male client r-u -ÍM CỊỈ ugc V Hl Always a giver 1 A giver 2 About half a giver and half a receiver 3 A receiver 4 During the last 6 months, when C401 having anal sex with male client, are you a giver, receiver or both? Always a receiver 5 Had not anal sex with a male client in the last 12 months 6 Giving: vou insert Denis into other man's anus Receiving: Other man inserts penis into your anus YN Street, park or lakeside 1 2 During the last 6 months, where have you met the male clients? Internet 1 2 Bar or disco 1 2 Cinema 1 2 (Do not read choices aloud, only probe and circle all that apply.) C402 Swimming pool 1 2 Through an intermediary pimp 1 2 Sauna massage parlor 1 2 At home 1 2 Hotel, guesthouse 1 2 Other (specify) 1 2 In the last 30 days, among the male clients, how many have you had anal sex with? Don’t remember 999 C403 Include both giving and receiving During the last 6 month, of all the times you have had anal sex with C404 Illi men male clients, how frequently did you and your partners use condoms? r-u -ÍM CỊỈ ugc V Hl If none, record 000 If other than 1 Occasionally 2 or 8 Never 3 skip to C501 Always 1 Do not apply, no male client during (he last month 8 Don't remember 9 Condom use reduces pleasure 1 Condoms IS not available 2 My partners look healthy 3 Condoms arc too expensive If not always, what is the main reason you did NOT always use a condom during anal sex with this C405 partner? 4 My partner didn't want to 5 1 trust my partners 6 I feel embarrassed to buy condoms 7 (Circle one appropriate answer only) 1 was in a hurried 8 Other (specify) 9 No response 10 C5 Female transgender Always a giver 1 A giver 2 About During the last 6 months, when having anal sex with a female transgender, arc you a giver, receiver or both? C50I half a giver and half a receiver 3 A receiver 4 Always a receiver 5 Had not anal sex with a female Giving: you insert penis into other transgender in the last 12 months 6 man's anus Receiving: Other man inserts penis into your anus r-u -ÍM CỊỈ ugc V Hl YN Street, park or lakeside 1 2 During the last 6 months, where have you met the female transgender partners? Internet 1 2 Bar or disco 1 2 Cinema 1 2 Swimming pool 1 2 Through an (Do not read choices aloud, only C502 probe and circle all that apply.) intennediary/pimp 1 2 Sauna massage parlor 1 2 At home 1 2 Hotel, guesthouse 1 2 Other (specify ) 1 2 In the last 30 days, among the female transgender partners, how many have you had anal sex with? Don’t remember 999 C503 Include both giving and receiving During the last 6 month, of all the times you have had anal sex with C504 female transgender partners, how frequently did you and your partners use condoms? C5O5 1 1 1 1 persons If none, record 000 If other than 1 or 8 Always 1 skip to Occasionally 2 C601 Never 3 No response 8 Don’t remember 9 If not always, what is the main reason you did NO T always r-u -ÍM CỊỈ ugc V Hl Condom use reduces pleasure 1 use a condom during anal sex with this partner0 Condoms IS not available 2 My partners look healthy 3 Condoms are UK) expensive (Circle one appropriate answer only) 4 My partner didn't want to 5 1 trust my partners 6 1 feel embarrassed to buy condoms 7 1 was in a hurried s Other (specify) 9 .No response 10 C6 Noil-commercial female partner During the last 30 days, have you C601 had vaginal or anal sex with a non-commercial sex partner? Yes 1 No 2 Don't remember 9 During the last 30 days, how many non-commcrcial female painters have you had sex with (vaginal or C6O2 Illi women Don’t remember 999 anal)? If none, record 000 r-u -ÍM CỊỈ ugc V Hl If No skip to next section If other During the last 30 days, of all the times you have had anal or C603 vaginal sex with noncommercial female partners, how frequently did you use condoms? Always 1 Occasionally 2 than 1, skip to Q701 Never 3 Don't remember 9 Condom use reduces pleasure 1 Condoms is not available 2 My partners look healthy 3 Condoms are too expensive C604 If not always, what is the main reason you did NOT always use a condom dunng anal sex with this partner? 4 My partner didn't want to 5 1 trust my partners 6 1 feel (Circle one appropriate answer only) embarrassed to buy condoms 7 1 was in a hunied 8 Other (specify) 9 No response 10 C7 Female sex worker During the last 30 days, have you C70I had vaginal or anal sex with a female sex worker? Yes 1 No 2 Don't remember 9 C7O2 During the last 30 days, how many female sex workers have r-u -ÍM CỊỈ ugc V Hl 1 1 1 1 women If No, skip to next section you had sex with (vaginal or anal)? Don’t remember 999 If none, record 000 If other During the last 30 days, of all the C703 limes you have had anal or vaginal sex with a female sex worker, how frequently did you use condoms? Always 1 Occasionally 2 Never 3 Don't remember 9 Condom use reduces pleasure 1 Condoms IS not available 2 My partners look healthy 3 Condoms are too expensive If not always, what is the main reason you did NOT always use a condom during anal sex with this C704 partner? 4 My partner didn’t want to 5 1 trust my partners 6 I feel (Circle one appropriate answer embarrassed to buy condoms 7 1 was in a hurried s only) Other (specify) 9 No response 10 C8 Female client r-u -ÍM CỊỈ ugc V Hl than 1, skip to Q80I C80I During the last so days, have you had vaginal or anal sex with a female client? Yes 1 No 2 Don't remember 9 During the last so days, how many C802 female clients have you had sex with (vaginal or anal)? IfNo end of question naire women Don't remember 999 If none, record 000 Always 1 During the last so days, of all the times you have had anal or C803 vaginal sex with a female client, how frequently did you use Occasionally 2 Never 3 Don't remember 9 condoms? If other than 1 end of question nairc Condom use reduces pleasure 1 Condoms is not available 2 My partners look healthy 3 Condoms are too expensive 4 If not always, what is the main reason you did NOT always use a condom during anal sex with this C804 My partner didn't want to 5 1 trust my partners 6 partner? 1 feel embarrassed to buy (Circle one appropriate answer condoms 7 1 was in a burned 8 only) Ollier (specify ) 9 No response 10 -■c -ÍM CỊỈ ugc V Hl ... have sex with men recruited by internet- based sampling in Hanoi? ?? with the aim: To describe consistent condom use with different types of partners among men who have sex with men recruited by internet- based. .. Title: Consistent condom use and correlates among men who have sex with men recruited by Internet- based sampling in Hanoi Objective: This study was conducted to examine the consistent condom use. .. men recruited by internet- based sampling in Hanoi To describe of consistent condom use among men whoHanoi in have sexcorrelates with men recruited by internet- based sampling r-u -ÍM Qỉ ugc V Hl