Substance use and high-risk sexual behavior among men who have sex with men in Hanoi

Abstract

Aims: HIV prevalence is increasing among men who have sex with men (MSM) in Vietnam but little is known about their substance use and risky sexual behaviors. We hypothesized that alcohol and illicit drug use is associatedwith risky sexual behaviors in MSM. Methods: We conducted a cross-sectional survey in Hanoi in 2010 in MSM recruited through community-based respondentdriven sampling. Participants reported sociodemographic characteristics, alcohol use (AUDIT 8–15= risky, 16–19=harmful, ≥20=dependence), any illicit drug use, and sex without a condom in the past 30 days. We tested associations between substance use and unprotected sex using multivariable logistic regression. Results: The majority of 451 participants were born outside Hanoi (68.3%), with a mean age of 22.5 (SD 5.3) years. During the past 30days, 27.1%used illicit drugs, andalcohol usewashazardous for 41.5%, harmful for 23.1%, and consistent with alcohol dependence for 19.3%. Participants had a median 3 sexual partners (range 1–54); 83.1% drank alcohol before or during sexual intercourse and 75.2% reported unprotected sex. Inmultivariable analysis, age (aOR 0.96, 95% CI 0.91, 0.99), being born outside Hanoi (aOR 1.94, 95% CI 1.14, 3.30), alcohol dependence (aOR 3.34, 95% CI 1.24, 8.98) and alcohol use before or during sexual intercourse (aOR 3.67, 95% CI 1.94, 6.95) were associated with unprotected sex in the past 30 days, but illicit drug use was not (aOR 1.12; 95% CI 0.61, 2.04), after adjusting for education level and income. Conclusions: Recent alcohol and drug use was common in our sample of Hanoi MSM. Alcohol dependence and drinking prior to sex were associated with unprotected sex, suggesting that tailored interventions to reduce alcohol consumption in MSM may be indicated to reduce behaviors associated with HIV transmission in Hanoi. Financial support: Vietnam HIV Addiction Technology Transfer Center (VHATTC) (SAMSHA TI23603); Fulbright Scholar Award 47422223.