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 PIJAAl I III VAN CONSISTENT CONDOM USE AND CORRELATES AMONG MEN WHO HAVE SEX WITH MEN RECRUITED BY INTERNET-BASED SAMPLING IN HANOI THESIS OF GRADUATION MEDICAL DOCTOR COI RSE 2015-2021 HANOI-2021 «s> ■> MINISTRY OF EDUCATION AND TRAINING MINISTRY OF HEALTH HANOI MEDICAL UNIVERSITY PHAM Till VAN CONSISTENT CONDOM USE AND CORRELATES AMONG MEN WHO HAVE SEX WITH MEN RECRUITED BY INTERNET-BASED SAMPLING IN HANOI Major : Doctor 01 Preventive Medicine Code : D720302 THESIS OF GRADUATION MEDICAL DOCTOR COURSE 2015-2021 Supervisor MD PhD Holing I hi llai Van HANOI - 2021 «s> ■> 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 (hanks of my gratitude to my supervisor Mrs Hoang Thi Hat Van MD Ph D for her enthusiastic guidance, great patient, and strong support since the beginning I came to know about w many new things and I Mil really thankful to them I am very grateful to all the study participants who agreed to spend their time completing the questionnaire and all staff members at SHP clinic Hanoi Medical University who contributed Their conuibution plays a crucial role m the success of this thesis Besides, many thanks to Nguyen Thi Hoang Ha Tran hl Thao Anh Nguy en Huy Hoang Tran Hoan and all my classmates, who were always ready to share their knowledge and skills, and helped me lot throughout the process I would like to thank my close friends Trinh Thuy Duong Bui Thu Hien Quach Luih Giang, who always support me and give me a hand whenever need Last but not least also would like to express my deepest gratitude towaids my family, who always Slay by my side and encourage me to finalize this study Hanoi May 2021 Pham Thu Van II DECLARATION I declare that this thesis represents my own work and has not been submitted for any detree 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 I hu Van -w ã* CN ôG ill CONTENT ACKNOWLEDGEMENT DECLARATION I 1ST OF abbreviation I 1ST 01 TABU S 11ST OF FIGURES INTRODUCTION _ CHAPTER LITERATURE REVIEW 1.1 Definitions 1.2 The situation of HIVTSTIs among MSN ••••■•••••••••••••••'••••••••■••(••••••a* «••••••••••••••• 13 Researches on consistent condom use among MSM 14 Researches on factors associated with consistent condom use among MSM 1.5 Researches on using the internet-based sampling to recruit MSM 1.6 Information about MSM in Hanoi CHAPTER METHODOLOGY 10 MUUMUMU4 12 2.1 Subjects 12 2 Location and tune 12 2.3 Study Design •• 2.4 Sampling 13 2.5 Vaiiables 13 2.6 Dau collection Statistical analysis •I ••• •• • ••• Research ethics 17 CHAPTER RESULTS 3.1 General information 18 3.2 Consistent condom use with different types of paitncrs 26 IV 3.3 Conchies of consistent condom use among MSM recruited by IBS in Hanoi 31 CHAPTER DISCUSSION _ 4.1 General information 37 37 4.2 Consistent condom use SSI th different types of partners 40 4.3 Correlates of consistent condom use 41 CONCLUSION'^, RECOMMENDATION _ REFERENCES 47 APPENDIX _ TWM*M«K> *4: V LIST OF ABBREVIATION AIDS Acquired Immunodeficiency Syndrome CDC Centers for Disease Control and Presention HIM The Hanoi MSM Colton Study HIV Human Immunodeficiency Virus HS54 HIV Sentinel Surveillance plus behaviors IBBS Integrated Biological and Behavioral Surveillance IBS Internet-based sampling SUP Sexual Health Promotion STI Sexuall} Transmitted Infection USAID United State Agency for International Development VAI Unprotected anal jnlCfcoursc VAAC Vietnam Authority of HIV/A1DS Control VND Vietnamese Dong TWM*M«K> *4: vi LIST OF TABLES Table Socio-demographic characteristics of participants 18 Table 3.2 Self-reported HIV/STIs status 19 Table 3.3 Drug use to enhance sexual performance 20 Table3 Having sexual intercourse with male partners met online 23 Table 3.5 Sexual behaviors among MSM with noncommercial male partner 25 Table 3.6 Sexual behaviors among MSN with non-commercial female partner 26 Table 3.7 Consistent condom use with different types of male partners 26 Table 3.8 Consistent condom use with different types of female partners 27 Table 3.9 Factors associated with consistent condom use among MSM in Hanoi reel tilt ed b\ IIỈS ■■ 31 Table 3.10 Factors associated With consistent condom use among MSM recruited by IBS in Hanoi 34 VII LIST OF FIGURES Figure I The percentage of using the Internet to seek male partners 21 Figure Percentage of social apps and websites used to seek male partners 22 Figure 3.3 Distribution (>pes of sexual partners during the last Ó months 24 Figure Main reasons for not using condom when having sexual intercourse with male partners Figure 3-5 Main reasons for not using condom when having se.xual in I ei course with female partners -w ã* CN ôG Vlil ABSTRACT Tc: Consistent condom use and conclaics among men who have sex with men recruited by Internet-based sampling in Hanoi Obftiiive: This study was conducted IO examine the consistent condom use (CCƯ) with different tvpes of partners and correlates among MSM recruited by internet­ based sampling (IBS) in Hanoi Methods: Data for this analysis were from a cohort study IIIM-Hanor conducted from 2017 tô 2019 in Hanoi MSM aged from 16 jeais were recruited ÍỒI the survey using IBS Univariate and multivariate logistic regression were used to assess the association of ecu with selected socio-detnographic characteristics and other factors Results: Among 802 MSM interviewed CCƯ with non-coinmctcial male partner, male client, male sex worker, and female tiansgender was 39.8° Ơ 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 inc I eased odds for ecu Willi non -cormnerc al male partner were being aged from 25 years ot older (OR: 1.27.95%CI: 0.82 - 96) having tertiary education level (OH 1.63.95%CI: 1.01 64) never getting married (OR 2.22 95%CI: 101 -4 88) and using the Internet to seek male partner* (OR OS 95*«CI: 117 3.60) Factors associated with decreased odds of ecu with non­ commercial male partner was spending the night at hotel guesthouse frequently (OR 49 9$%CI: 25 - 97) never being tested HIV (OR: 043 95%CI 19 - 096) and using ATS to enhance sexual performance (OR: 0.44.95%CI 0.21 90) CớnchutMĩ ecu with different types of partners among Hanoi MSM surveyed remains low HIV interventions for MSM should take associated factors found 111 the study into consideration to increase ecu among MSM therebv contnbuting to the reduction of HIV and STI infections AcTM-wcfr Men who have sex with men MSM Consistent condom use Sexual partners Internet-based sampling Hanoi *4: No Coding of answers Questions Skip to assemblers and machine operators Unskilled workers ] Armed forces Sex w ork Illegal work Currently unemployed Others (specify! 2 Including all sources of income and family AS 1 1 [Millions VND1 support, how much Don’t know 999 money did you cam in the last month? My own home Rented House Family relative’s home Sex partner’s home In the last 30 days, where A6 Other (non-relative, non-sex partner) person $ home ha'e you slept (spent the night) most frequently’’ Hotel/guesthouse/other temporary 100(11 School doim Public places Other -w ã* CN ôG No Coding of answers Questions Skip to (speci fy ) Exclusively attracted to men Mostly attracted to men, sometimes women Which of the following sentences most exactly A7 Equally attracted IO both men and women characterizes the types of people that you arc Mostly attracted IO women sexually9 attracted to? sometimes men Exclusively attracted to women B InternH usage and other factors No Bl Coding of answers Questions Skip to Yes No Don’t Know Have you ever been tested for HIV? Positive Negative B2 B3 What was the result of your last lest? Unclear / neither positive or negative Have you ever been diagnosed for any of the following diseases at a TWM*M«K> «“ *4: Did not receive result Don’t know Herpes Syphilis Gonorrhea health clinic? (check all Chlamydia that apply) HPV'wans on your mouth'penis/anus Hepatitis Đ Hepatitis c How often in the Iasi six months have VƠU use • Never amphetamine ty pc Occasionally Slimulani (ATS >10 B4 Otten enhance sexual NA - No regular partners performance with (any of) Refusal youi non-regular male Don't know partnerts)? How often in the last six months has e you use B5 amphetamine type Never stimulant (ATS) to Occasionally Often enhance sexual NA - No regular partners performance with (any of) Refusal your regular male Don't know partncr(s)? Grinder B6 What are some websites, applications, or forums Jack'd Hornet you have used through a Sciuir Smartphone or computer Facebook Zalo Blue to find male sex partners'* Choose all that apply thcgioithuS com TWM*M«K> *4: daugau oct Other (specify: ) 10 B7 Never Occasionally Have sex with someone you met online on A Often website (eg.daugau.com, NA No regular partners lAộxanh net etc ) Refusal Doni know B8 Never Have sex with someone you met through mobile app (Grindr Blue Jack'd, Occasionally Often facebook, etc.) NA - No regular partners Refusal Don ’t know c Sc\u.il behavior* with different tvpe.t of partner* No CI02 Questions Coding of answers Skip to For each of lite kinds of the following partners, have you ever had sex with them (manual, oral, vaginal or anal)? appropri (Ye$y 2(No) Noncommercial male partners ate pans for each type of sexual partners Interviewer must rend the follow mg; Male partners who pay you for sex Non-commcrciiil Mak/Tcmalc partners arc those you have sex w Ith where there was no exchange of money or goods -w ã* CN ôG Skip to Male sex workers *4: C3O1 was in u hun led Other (specify ) No response 10 Always a gìvvr CJ Mak sex worker A giver Dur ng the last months, About half a giver and half a when having anal sex with male sex workers, are you a C30Ỉ give!, receiver or both? receiver A receiver Always a receiver Givinc you insert penis into other man s anus Had not anal sex with a male sex worker in the last 12 Receiving: Other man inserts months penis into your anus Y N Street, park or lakeside Pmw ÚK 13114 nittidis where have you met the male Internet Bat or disco sex worker partners'’ Cinema Swimming pool (Do not read choices aloud, 002 only probe and circle all that apply ) Through an intcrmediaty/pimp Sauna/massagc parlor At home Hotel, guesthouse Other (specify*) CM3 In the last 30 days among the men male sex worker partners, how TWM*M«K> *4: many have you had nnal sex with? Don’t remember 999 If none, record 000 Include both giving and receiving IÍ other than I Always Duung the last monrhs of all the tunes yộu have had anal sex with male sex workers, C3M Occasionally Never how frequently did you and Do not apply, no male sex yOui partners use condoms'* worker partners during the last month Don’t remember C’ondotn use reduces pleasure Condoms IS not available My partners look healths If not always, v-hat is the main reason you did NOT always use a condom during anal sex C305 with this partner'’ Condoms are too expensive My partner didn’t want to trust my partners (Circle one appropriate answer only) C4 Male client -w ã* CN ôG feel embarrassed to buy condoms was III fl hull led Other (specify*) No response 10 or skip to C40I Always a giver A giver During the last months, when having anal sex with C401 male client arc you giver, receiver or both’’ About half a giver and half a receiver A receiver Giving you insert penis into Always a receiver other man’s anus Had not anal sex with a male Receiving: Other man inserts client 111 the last 12 months penis into your anus YN Street, paik or lakeside During the last months, Internet where have you met the male Bar Of disco clients? Cinema Swimming pool it>0 not read choices aloud, C402 I lirough an only probe and circle all that apply intermediary pimp Sauna massage parlor At home Hotel, guesthouse Other (specify 1 In the last 30 davs among the male clients, how mans have \ou had anal sex With? 1 men Don’t remember 999 C403 If none, record 000 Include both giving and receiving During the last month, of all C404 Always the tunes you have had anal sex with male clients, how frequently did you and your partners use condoms? TWM*M«K> Occasionally Never If other than or skip to (501 *4: Do not apply, no male client during the last month Don’t remember Ộ Condoin use reduces pleasure Condoms IS not availablc My partners look healthy If not always what is the main Condoms arc loo expensive reason you did NOT always use a condom during anal sex C405 My partner didn’t want IO with this partner9 trust my partners (Circle one appropriate answer only) Ồ I feel embarrassed to buy condoms WAS in a hurried Otbei I Specify) No response 10 Always a giver c$ Female transgender A giver During the last months, when having anal sex with a About half a giver and half a receiver female transgender, arc you a C50I A receiver giver, receiver or both9 Always a receiver Giving you insert penis into othei man s anus Receiving Other man inserts Had not anal sex with a female transgender in the last 12 months penis into your anus TWM*M«K> *4: YN Street, park or lakeside During the last months, Imemei where have you met the female Bar or disco transgender partners? Cinema Swimming pool (Do IIOĨ read choices aloud, C502 Through an intermediary pimp only probe and circle all that nppls ) Sauna massage pai lot At home Hotel, guesthouse I Other (specify) In the last 30 days, among the female transgender partners, C503 how many have you had anal sex with? 1 persons Don’t remember 999 If none, record 000 Include both giving and receiving If other than Dunng the last month, of all C5O4 Always or 8, skip to C601 the times you have had anal sex with female transgender Occasionally (Mirtncrs how frequently did Never >ou mid your partners use No response H condoms? Don’t remember C505 Condom use reduces If not always, what is the main pleasure reason you did NOT always TWM*M«K> *4: use a condom during anal sex Condoms IS not available w iih this partner'* My partners look healthy (Circle one appropriate answer only) Condoms arc too expensive My partner didn’t want to trust my partners feel embarrassed to buy condoms was in a hurried s Other (specify! .No response 10 C6 Noncommercial female partner C601 Dilling the last 30 day $ have you kid vaginal or anal sex Yes If No with a non-cotninercial sex No skip CO next Don’t remember section partner? During the last 30 days, how many non-commercial female C602 partners have you had sex with (vaginal or anal J? women Don’t remember 999 If none, record 000 -w ã* CN ôG If other During the last 30 days, of all Always rhe nines you have liad anal or C60.3 Occasionally vaginal sex with non­ commercial female partners, how frequently did you use Never (hun skip to Q70I Don't remember condoms? Condom use reduces pleasure Condoms IS not available •2 My partners look healthy If not always, what IS rhe main Condoms are too expensive reason you did NOT always use a condom dunng anal sex C604 My partner didn't want to with this partner9 trust my partners (Circle one appropriate answer feel embarrassed to buy only) condoins was in a hurried Othei (specify) No response 10 (7 Female sex worker C70I C702 Dun ng the last 30 dnys have Yes If No, you had vaginal c*r anal sex with a female sex worker? No skip to next Don't remember section During the last 30 days, I1Oô manv ã female sex workers have TWM*MôK> *4: women Don’t remember 999 you had sex with (vaginal IV anal»? C703 If none, record 000 During the Iasi 30 days, of all Always the times you hAve had Anal or Occasionally vaginal sex with a female sex Never worker how frequently did you use condoms? Don't remember Condom use reduces pleasure Condoms IS not available My partners look healthy If not always, what is Ilie main Condoms are loo expensive reason you did NOT always use a condom during anal sex 0704 My partner didn ’t want to w nh this partner? I trust my partners (Circle one appropriate answer I feel embarrassed to buy only) C8 Female client TWM*M«K> *4: condoms was in a hun led Other (specify) No response 10 If other than skip to Q8OI C80I During the last JO days have you had vaginal Of anal sex with a female client? During the last 30 day s, how C8D2 many female clients Iw'.e you had sex With (vaginal or anal)'* Yes No Don't remember C803 vaginal sex with a female client, how frequently did you use condoms? question nairc women Don’t remember 999 If none, record 000 Always During the last 30 days, of all the times you have had anal or If No end of Occasionally Never If other thân end of Don't remember question nairc Condom use reduces If not always, what it the main pleasure Condoms is not available My partners look healthy Condoms arc too expensive reason you did NOT always use condom during anal sex C8W with this partner'’ My partner didn't want to trust my partners (Circle one appropriate answer only) feel embd massed to buy condoms -w •* CN «G WAS in a hurried Other (specify) No response 10 ...MINISTRY OF EDUCATION AND TRAINING MINISTRY OF HEALTH HANOI MEDICAL UNIVERSITY PHAM Till VAN CONSISTENT CONDOM USE AND CORRELATES AMONG MEN WHO HAVE SEX WITH MEN RECRUITED BY INTERNET- BASED SAMPLING. .. Từĩc: Consistent condom use and conclaics among men who have sex with men recruited by Internet- based sampling in Hanoi Obftiiive: This study was conducted IO examine the consistent condom use. .. have sex with men recruited by internet- based sampling in Hanoi' * Willi the aim: I To describe consistent condom use w ith different types of partners among men who have sex with incn recruited by