Prevalence and correlates of alcohol tobacco and substances use among men who have sex with men in hanoi vietnam

1 MINISTRY OF EDUCATION AND TRAINING MINISTRY OF HEA LTH HANOI MEDICAL UNIVERSITY *** NGUYEN Till IIOANG HA PREVALENC E AND CORRELATES OF ALCOHOL, TOBACCO, AND SUBSTANCE USE AMONG NIEN WHO HAVE SEX WITH NIEN IN HANOI, VIETNAM Major : Doctor of Preventive Medicine Code : D 720302 THESIS OF GRADUATION MEDIC.YL DOCTOR COURSE 2015-2021 Supervisor: MD Phi) Hoang Thl Hal Van HANOI - 2021 «s> «> *4: ACKNOM LED G EM ENT Throughout thí writing of this graduation thesis [ have received a great deal of support and assistance I would first like to express my gratitude and appreciation for my supervisor \ÍD Ph D Hoang Thi Hai Van who has given me dedicated support and insightiul comments on mv work I am extremely grateful for being under her guidance in this research, as well as other projects and for my career development would like to acknowledge the Department of Global Health and Training Scientific management, and International Cooperation Departnent for their support thrcughoul various stages of my thesis would like to thank the School of Preventive Medicine and Public Health for giving me the chance to meet inspiring teachers and friends, and all the opportunities to comprehend the priceless value of my major Preventive mediche I would like to thank my friends who have been with me for the past years gone throu^i lots of ups and downs together, argued a lot yet still maintained our precious friendship They unexpectedly made my university lift? enjoyable and unforgettable Last but not least, am would like to express my sincere thank to my family for their unconditional love and support Without them I definitely would not be the person I am today Thank mom for being my greatest role model -w •* CN «G ii CONFIRMATION To - Management Board of Hanoi Medical University - Training Scientific management and International Cooperation Department - School of Preventive Medicine and Public Health, Hanoi Medical University - Department of Global Health Hanoi Medical University - Examination Committee for Graduation Blew 2020-2021 hereby declare that this research was originally done by myself The data handling and analysis were objectively completed with honesty The results of this study have not been published in any docvanent Hanoi June 2021 Student Ngin err Thi Ho inji Ha -w ã* CN ôG iii TABLE OF CONTENT ABBREVIATION* Ỉ LIST OF TABLES _ I LIST OFFICERES iii ABSTRACT • «■••••• Mae •MaaaaaeaaaaaeMaMeaaMMMaM 1^ m»»— INTROD ECTION _ CHAPTER LITERATE-RE REVIEW - 1.1 Concepts and definitions — .3 — _ 1.1.1 -Sex and gender 112 Men who have sex with men 1.2 HIV situation in MSM worldwide and in Vietnam 13 Substance use as a riskofHIV infection in MSM _ 1.4 Substance use iu MSM _ _ 14 Tobaccouse — — _ ãIMIIIKMUIIillMtllll ã!ããããã !ããããã! aiaoaOOM !ããã MM i ãtããôããããããIããã>s I 42 Alcohol use I ATS and other drug use 13 MSM population in Hanoi — —.— —.— — — —.10 CHAPTE R R ESE ARC H s IBJECTS A ND MET HODOLOGY — - 12 2.1 Datasource - - 12 2.2 Study population •nmtvvamrtowwftaawm* J Study design — —— — namHfwawtimttmv 12 13 2.4 Sampling met hod _ 13 23 Sample size — —.— .13 2.6 Research sariables and indicators - - 14 2.7 Studs* instrument _ 15 23 Data collection process - - — — 16 2.9 Data analysis _ 18 2.10 Ethical consideration TWM*M«K> *4: 18 iv CHAPTER3 RESULTS- _ _ — _ — 19 3.1 General characteristics of the study participants - - -— - —19 3.2 Prevalence of tobacco, alcohoL ATS and other drug use and related issues — 22 J Correlates of tobacco, alcohol ATS and other drug use - 29 51 Correlates of tobacco use 29 3 Correlates of alcohol use 34 3.33 Correlates of ATS use 39 Correlates of other drugs use 42 CH.APTER DISCUSSION - -46 4.1 General characteristics of the study participants — 46 4.2 Prevalence of tobacco, alcohol ATS and other drug use —— 47 42.1 Prevalence of tobacco use _ _ _ _ _ 47 2.2 Prevalence of alcohol use 48 4-2-3 Prevalence of ATS use 49 4.2.4 Prevalence of other drug use - - - 50 4A Correlates of tobacco, alcohol, and other substance use 50 4.3.1 Correlates of tobacco use - 50 4.3 Correlates of alcohol use 3 Correlates of AT s use 4-3.4 Correlates of other drug use - _ 52 53 CONCLUSION 54 The prevalence of tobacco, alcohol, ATS and other drug use in MS.M tn Hanoi Vietnam and related issues to their substance use 54 Correlates of tobacco, alcohol ATS and other drug use in MSN in Hanoi, Vietnam _ 55 RECOMMENDATION _ _ 56 RE FERE NCE APPEND IX i ABBREVIATION aOR Adjusted odds ratio ATS /Xmphetamine-ụpe stimulants Ci Confidence interval HIV Human immunodeficiency virus IBBS Integrated BiologC’.al and Behavioral Surveillance IBS Internet Based Sampling MSM Men who have sex with men MSW Male sex workers OR Odds ratio PL1ITV People living with HIV RDS Respondent Driven Sampling STI Sexual transmitted infections TLS Time-Location (or time-space) sampling WHO World Health Organization -w ã* CN ôG ii LIST OF TABLES Table 3.1 Participants' sodo-demographic characteristics 19 Table 3.2 Life style and sex-related characteristics 21 Table 3.4 Correlates of lifetime tobacco use Table Correlates of tobacco use in the past months 29 32 Table Correlates of lifetime alcohol use IMIIIIIMIIIIIItXlllllrMIIIII MllllttiHIHIIIIIIIIIIIII 34 Table 3.7 Correlates of alcohol use in the past months — —.37 Table Í Correlates of lifetime ATS use 39 Table Correlates of ATS use in the past months 41 Table 3.10 Correlates of lifetime other drugs use 42 Table 11 Con elates of other drugs use in the past months 44 -w ã* CN ôG iii LIST Of FI GV RES Figure 2.1 Recruitment and data collection process 17 Figure Pattern of tobacco use alcohol use and substance use in life tune and the pasi3xuomhs _ „ — — — 22 Figure Participants’ choices of substance use in lifetime in the past months 23 Figure 3 Frequency of substance use in the past months 24 Figure Issues related to tobacco use in the past months 25 Figure 3.5 Issues related to alcohol use in the past 11)0nibs 26 Figure Issues related to ATS use in die past months 27 Figure 3.7 Receiving concern about the use of drug from a friend or relative 28 Figure Tried and failed to control cut down or stop using the drug 28 -w •* CN «G iv ABSTRACT Title; Prevalence and correlates of alcohol tobacco, and substances use among men who have sex with men in Hanot Vietnam Objectives: The aim of this study was to describe the prevalence and correlates of tobacco, alcohol and ATS use among MSM in Hanoi Vietnam and lelates issues to their use of substances Methods: We used the baseline survey data collected by internet-based sampling method of the HLM Hanoi study to estimate prevalence and correlates of substances use among MSM in Hanoi The WHO ASSIST questionnaire was used to collect substance use data Descriptive statistics and logistics regression techniques were used tor analysis Results: The prevalence of lifetime tobacco, alcohol and ATS use was 19.08% S3.54% 6.98% Tile prevalence of tobacco, alcohol and ATS use in the past months was 15.21%, 77.18% 11% Lifetime prevalence of other drug use ranged from 1.00% to 85% Age monthly income sexual orientation, group sex and drug use to enhance sex performance were correlated with the use of tobacco, alcohol ATS and other drugs in theu life and in the past Ĩ months Conclusions: Substance use was prevalent in MSM in Hanoi Socio-demographic and sex-related characteristics were correlated with the consumption of substances These findings highlight that substance use hanu reduction programs should be considered in MSM sexual health services Keywords: tobacco, alcohol, ATS, di ug substance, US.M H anoi, Viet Ill ID V Tiêu dỉ: Tv lè liên quan cùa việc sứ dụng rượu bia thuỏc vả chàt gáy nghiện o nhóm nam quan tình dục dóng giới tụi Ha Nội Viet Nam Mục tiêu: Nghiên cứu thục đê mo tã ty lệ va liên quan cua việc sư dung rượu bia thuốc lã vã chát gây nghiên nhỏm MSM tai Hâ Nội Việt Nam vã cãc vãn đe liên quan tới vice sư dựng chất Phirung pháp nghiên cứu: Nghiên cữu sư dụng số liệu điều tra ban dầu báng phương pháp chya mảu trực tuyên cửa nghiổn cưu HIM Hanoi dê udc linh lỹ lê sử dụng vá yéu tố liên quan tới cãc chat gáy nghiện nhòm MSM tội Hà Nội Bộ câu hoi WHO ASSIST dược sư dụng đe thu thàp thòng tin sư dụng chát gãy nghiên Phân tich két quabâng thống ké mó tá vá hói quy logistic Kầ qua nghiên cửu: Ty lệ sư đ|mg thuốc nrợu bu ATS đời lã 19.08% 83.54% ó 98% Tỷ lệ sử dụng thuốc rượu bia va ATS tháng gằn dãy lã 15.21%; 77.18%, 11% Ty lé su dưng chẩt gày nghiên khic dời từ 1.00% tứi 85% Tuói thu nháp hàng tháng., xu hưung tinh dục quan he tinh dục tẠp thê sư dụng chat kicb thích quan hệ tinh dục liên quan tỏi việc dựng ch.it V nhccn MSMtựiHãNội Krt luận: chut gày nghiên Sư dung phơ biên ị nhem MSM tụi Hà Nội Các yểu tó nhàn khâu học vá ycu tó 1ien quan tói tinh dưc va lót sóng lien quan vởi việc sư dụng chất Nhùng kết qua cho thây ràng chunng trinh giám thiêu tie hại cua su dụng chát gãy nghiên cằn dược cản nhác dưa vào dịch vụ chàm sõc súc khoe cho nhóm MSM Từ kboa: thuốc lả, rưọu bia, ATS, chất gây nghiện, MSM Ha Nội Việt Nam TWM*M«K> «“ *4: 8I Odukoya oo, Sekoni AO Alagbe so Odeyemi K Tobacco and Alcohol Use among a Sample of Men who have Sex with Men m Lagos state Nigeria Anna's ofMedical and Health Sciences Research 20L7;7(l) 30-38 82 Vietnam's growing alcohol and salt addiction The ASEAN Post Accessed May 24,2021 https theaseanpostcom article Vietnams-growing-alcohol-andsaM addiction 83 VIỌC DÀN so VÀ CÁC VÀN DẼ XÀ HỌI TIẼir DÙNG Rượu BU ó VIỆT NA M Một số kẻt qua Điã» tra quÁc gia 64 84 Nguyen TV Van Khuu N, Nguyen PD, et al Sociodemographic Factors Sexual Behaviors and Alcohol and Recreational Drug Use Associated with HIX' Among Men Who Have Sex with Men in Southern Vietnam AIDS Behai 2016.20(10)2357-2371 doi 10.1007 510461-015-1265-x 85 Bui H KorthuisT Le G Amphetamine-tvpe stimulant use and unprotected sex in men who have sex with men in Vietnam Drug and Alcohol Dependence 2014,140 e23 doi:10 1016-J dru^lcdep 2014 02 0&4 86 Gerend MA Newcomb ME Mustanski B Prevalence and correlates of smoking and e-cigarette use among young men who have sex with men and transgender women Drug and Alcohol Dependence 2017;179:395-399 doi 10 1016 j drugakdep 2017 07.022 8' Xu w Tang w Zhang J Shi X Zheng Y Kaufman MR Cigarette Smoking and Its Associations with Substance Use and HIX’-Related Sexual Risks among Chinese Men Who Have Sex with Men Int J Environ Res Public Health 2020,17(5) doi 10 3390 Ijerph 170516S3 88 Yada' D Chakrapam V Oosvami p el al Associatkxx Between Alcohol Use and HIX’ Related Sexual Risk Behaviors Among Men Who Have Sex with Men (MSM): Findings from a Multi site Bio Behavioral Survey tn India AJDSBeha* 2014 18(7) 1330-1338 doi 10.1007 SHN61-014-0699-X -w ã* CN ôG ãằ* S9 Kelly BC Parsens JT Prevalence and predictors of non medical prescription drug use among men who have sex with men Addícríie Behaviors 2010.35(4) 312-317 doiioiciỗ iaddbeh.2009.11.002 90 Wei c Guadamuz TE Lim SH Huang Y Koe s Patterns and levels of illicit drug use among men who have sex with men in Asia Drug and Alcohol Dependence 2012;120(l >246-249 doi 10.1016 j drugalcdep 2011.07 016 91 Tomkins A Ahmad s Cannon L, et al Prevalence of recreational drug use reported bv men who have sex with men attending sexual health clinics in Manchester, VK /nr J dci 10 1177 095646241772S638 -w ã* CN ôG STD AIDS 2018;29(4):35O-356 APPEND IX Quest ion II lire A SOCIO-ECONOMIC DEMOGRAPHICS No Questions Coding of answers Skip IO Al What is your dale of birth'1 dd mmlyyyy! Hanoi I Where were you born0 Other place A2 Specify Don't know Year [] How long have you been Month living in Hanoi? If less than month record 01 ( i J A3 Don't remember 99 My own home Rented House Eamily/rdativc's home Sex partner's home Olher (nonrelative, non-sex In the last 30 days, where partner) person’s home A4 have you slept (spent the Hotel guesthouse other temporary night) most frequently? room School dorm Public places s Other (specify' Yes A5 Are you in school now° No TWM*M«K> *4: ) No Coding of answers Questions Skip to l_l_l grade What is the highest gride of (in university college = 13; finished A6 school that you have cohege = 14; finished university = completed9 IS) Have you ever been married Yes to woman? No A7 If you have children, how ] children [ AS many children you have*1 Alone Male partner With friends With wife girlfriend Currently whom are you With family (relatives) A9 living with? Unsettled Others (Specify: ) Yes No Currently what occupations Leaden in all fields and lewis you have to support yourself* Professionals at all fields (high or A10 mid-level) (Probe anything else? Staff, white-collar personnel in all Explain self-employed fields driver, road-side seller, etc.) Skilled -w •* CN «G workers in personal Nol Questions Coding of answers Skip to senices, social safety protection and sales Skilled in workers aquaculture agriculture, and sylviculture Skilled handicraftsmen and other skilled manual workers, assemblers and machine operators Unskilled workers Illegal work 2 Currently unemployed Others (specify) Including all sources Armed forces Sex work 1 2 of [Millions VND1 income and family support, how much money did you Don't know 999 All earn in the last month7 I think of mvself as a man Which of the following I think of myseh* as a woman sentences most exactly I think of MVttlf At A tfAaifender A12 characterizes the way that person w think about •yourself and • Other your gender0 (Specify Not sure -w ã* CN ôG ) Nol Questions Coding of answers Skip to Salary front my works What is your main source of r Supports from family, relatives or income"’ friends A12 (check one only) Subsidy from social programs Other sources Exclusively attracted to men Mostly attracted to men Which of sometimes following the women sentences most exactly Equally attracted to both men and A13 characterizes the types of women people that you are sexually Mostly attracted to women sometimes attracted to° men Exclusively attracted to women "Dong co" (gay.homoscxual) Gav Which words characterize "Bong kin" (who is discreet about you best'1 Write down aỉi bis sexual identity) response options in one aid " Bong Io” (who is open about his give Ũ to the participant for sexual identity) his own selection This "hi-fi" (have sex With both men and A14 question is to confirm the women) sexual ortentaaon Men of the participant and ask him how “Dong tinh’* (Homosexual) he presents himself to other "Chuycn gioi’* (Transgender) s peopiei Other (Specify -w ã* CN ôG ) B ALCO HOL, TOB ACCO AND I>R LG USE Question (if completing follow-up please cross check the patient s answers with the answers given for QI at baseline Any differences on this question should be queried) In your life, which of the following substances have you ever No Yes a Tobacco products (cigarettes chewing tobacco, cigars etc > b Alcoholic beverages (beer wine spirits.etc.) c Cannabis (marijuana, pot grass hash etc ) d Cocaine (coke, crack etc.) e Amphetamine-type stimulants (speed diet pills ecstasy etc) f Inhalants (nitrous, glue, petrol, paint thinner, etc ) g Sedatives or Sleeping Pills (Valium Serepax Rohypnol etc j h Hallucinogens (LSD acid, mushroom PC Special K etc ) i Opioids (heroin, morphine, methadone, codeine etc.) j Other used?(NON-MEDICAL USE ONLY) specify Probe if all answers are negative: "Not even when you were in school?” If "No” to all Items Slop the ASSIST and move to the next section If "Yes” to any of these items, ask Question for each substance ever used -w •* CN «G Question In the past three months, how often have you E < g > used the substances you mentioned (FIRST a W eekly DRUG, s ECOND DRUG ETCỴ? fa w > >• -3 73 /A* r-s w s z Ò —E ■ w ■ ■! b Alcoholic beverages (beer wine spirits, etcỉ c Cannabis (marijuana, pot grass hash etc) d Cocaine (coke, crack etc.) A* e — 4 6 *2 6 a products Tobacco (cigarettes, chewing tobacco cigars, etc ) Amphetamine-type stimulants (speed, diet pills ecstasy, etc) t Inhalants (nitrous, glue, petrol, paint thinner, etc ) g Sedatives or Sleeping Pills (Vahum Serepax, Rohvpnol etc ) h Hallucinogens (LSD acid, mushroom, PC Special K etc ) Opioids (heroin, morphine, methadone, codeine, etc.) j Other specify It "Never” tử dll Items in Question 2, skip to Question If any substances in Question were used in the previous three months continue with Question 3, & for each substance used Question -w ã* CN ôG you failed to what was uonnally expected of D aily During thí- past three months how often have D aily cr Alm ost Question tobacco, cigars, etc.) b Alcoholic beverages (beer wine spirits.etc j ố c Cannabis (marijuana, pot grass hash etc ) s d Cocaine (coke, crack, etc.) e 6 s 6 Amphetamine-t>pe stimulants (speed, diet pills ecstasy etc) f Inhalants (nitrous glue petrol pain: thinner etc) g Sedatives or Sleeping Pills (Valium Serepax, Rohypnol etc ) h Hallucinogens (LSD acid, mushroom PC Special K etc.) i Opioids (heroin, morphine, methadone, codeine, etc.) j Other-specify -w •* CN «G ■s lias a ửienđ or relative or anyone else ever expressed concern about your use of (FIRST DRUG SECOND b z DRUG E TC)? ịI 7£ a Tobacco products (cigarettes chewing tobacco £ = Ị— ? Ĩ s cigars etc) — b Alcoholic beverages (beer wine spirits, etc ) c Cannabis (marijuana, pot, grass hash etc) d Cocaine (coke.crack etc.) e Amphetamine-type stimulants (speed diet pills f Inhalants (nitrous glue petrol paint thinner etc ) g ecstasy, etc) Sedatives or Sleeping Pills (Valium Serepax Rohvpnol etc ) ■ h Hallucinogens (LSD acid mushroom PC special ■■ ■ ■ 6 K etc.) i Opioids (heroin, morphine methadone codeine etc) j Ocher specify -w ã* CN ôG Question rr T c 3G i 5g -ẵ = ~ i i i 1 Has ỹõũẽvẽr tried and failed to control, cut down or stop usưg (FIRST DRUG SECOND DRUG ETC)? X Õ X a Tobacco products (cigarettes, chewing tobacco, i b Alcoholic beverages (beer nine spirits etc) c Cannabis (marijuana, pot grass hash etc.) d Cocaine (coke, crack, etc ) e Amphetamine type stimulants (speed, diet pills, f Inhalants (nitrous, glue, petrol, paint thinner, etc.) g Serepax h Hallucinogens (LSD acid mushroom PC Special 6 3 cigars, etc.) ecstasy etc ) Sedatives or Sleeping Pills (Valium Rohvpnol etc ) K etc.) i Opioids (heroin, morphine methadone, codeine, etc) j Other specify -w ã* CN ôG c SEXI AL HISTORY AND p RACTICES Cl How often in the last six months have you done any of these activities am about to read out With (any of) your regular male partners)? (Since now when we mention about a regular male partner we want to talk about your boyfriend: or a sex partner who are in a relationship with you in a long time) J = Never • OccaiianaUy J - Often • Xi - Vo reglUar partners - Refusal — Don *t A non' J 9 I 9 9 Group sex with your regular partners that included women K Group sex with other men only (including your regular partners) L Vse drugs to enhance sexual performance (Popper and Erectile dysfunction medications, such as Viagra) M Use amphetamine type Slimulant (ATS) to enhance sexual performance used lubricant white having anal sex with my male partner C2 How often in the last six months have you done any of these activities I am about to read out with (any of) your non-regular male partners/* = Never - Occasionally Ì = Often -f- CN «G -4: - X4 - Vđ regular partners - Refusal - Don't know J 9 9 s 9 9 Group sex with your non regular partner $ that included women K Group sex with other men only (including your non-regular partner s) L Use drugs to enhance sexual performance (Popper and Erectile dysfunction medications, such as Viagra) M Use amphetamine type stimulant (ATS) to enhance sexual performance Ư Groi^j sex while using party drugs V Have sex with someone you nret online on a website (e g daugau com taoxanh net etc ) z Have sex with someone you met through mobile app (Gnndr Blue Jack'd Facebook, etc) Y I used lubricant while having anal sex with my male partner w ã* CN ôG