Sexual behaviors among methadone maintenance patients in a mountainous area in northern Vietnam

Victoria L Boggiano,Nabil Zary,Hung Van Nguyen,Carl A Latkin,Canh Dinh Hoang,Thuc Minh Thi Vu,Bach Xuan Tran,Long Hoang Nguyen,Hai Quan Le,Cuong Tat Nguyen,Huong Lan Thi Nguyen,Huong Thi Le,Tho Dinh Tran

doi:10.1186/s13011-017-0123-4

Abstract

BackgroundMethadone maintenance treatment (MMT) improves patients’ ability to access HIV-related services and reduces needle sharing and other risky HIV-related behaviors. However, patients may continue to engage in risky sexual practices. In this study, we evaluate sexual behaviors of MMT patients in a mountainous province in Northern Vietnam.MethodsWe explored the health status, MMT and substance use history, and sexual practices of 241 male MMT patients in Tuyen Quang province. Health status was investigated using the EuroQOL-5 Dimensions-5 Levels (EQ-5D-5 L). Multivariate logistic regression was employed to assess associated factors.ResultsMost patients (66.4%) reported having at least one sexual partner within the previous twelve months. Most of these partners were spouses or primary partners (72.6%). About 8.3% of patients had casual partners, and 5.8% had visited sex workers; of those who engaged in casual sexual relationships, 90.9% reported using condoms. Current drug use and living in a remote area were associated with an increased odd of having two or more sexual partners, while anxiety or depression was associated with lower odds.ConclusionThis study highlights a low proportion of having sexual risk behaviors among MMT patients in Vietnamese mountainous settings. Integrating education about safe sexual practices into MMT services, along with providing medical care and ensuring methadone treatment adherence, is an important component in HIV risk reduction for these patients who were at risk of unsafe sexual practices.

Highlights

Methadone maintenance treatment (MMT) improves patients’ ability to access Human Immunodeficiency Virus (HIV)-related services and reduces needle sharing and other risky HIV-related behaviors
Vietnam has seen a rise in injection drug use Boggiano et al Substance Abuse Treatment, Prevention, and Policy (2017) 12:39 over the past decade [11] and the leading cause of new HIV infections is via needle sharing [10]
There is an increasing trend nationwide of HIV being spread by risky sexual behavior in most-at-risk populations such as sex workers, men who have sex with men, and injection drug users [12]

Summary

Introduction

Methadone maintenance treatment (MMT) improves patients’ ability to access HIV-related services and reduces needle sharing and other risky HIV-related behaviors. The impact of methadone maintenance treatment (MMT) on risky sexual behaviors has been debated. Vietnam has seen a rise in injection drug use Boggiano et al Substance Abuse Treatment, Prevention, and Policy (2017) 12:39 over the past decade [11] and the leading cause of new HIV infections is via needle sharing [10]. There is an increasing trend nationwide of HIV being spread by risky sexual behavior in most-at-risk populations such as sex workers, men who have sex with men, and injection drug users [12]. Authors have found that injection drug users are likely to engage in high risk sexual practices such as having sex with sex workers [8, 13] and infrequent condom use [13]. PWID put their female partners at risk of HIV and other STDs [9, 14]

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