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Int J Drug Policy. 2015 May;26(5):516-21. doi: 10.1016/j.drugpo.2014.10.011. Epub 2014 Nov 8.

Substance use among male sex workers in Vietnam: prevalence, onset, and interactions with sexual risk.

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New York University College of Nursing, 726 Broadway, 10th Floor, New York, NY 10003, United States. Electronic address:
School of Public Health, University of Puerto Rico Medical Science Center, San Juan, PR, United States.
New York University College of Nursing, 726 Broadway, 10th Floor, New York, NY 10003, United States.
Center for Research and Training on HIV/AIDS, Hanoi Medical University, 1 Ton That Tung Street, Room 601, Building A1, Hanoi, Viet Nam.



HIV research in Vietnam has focused primarily on its large heroin injector population. Data on men who have sex with men [MSM], particularly the large and growing population of men who exchange sex for money or other material rewards, male sex workers [MSWs], is very limited.


Data derive from a cross-sectional study of MSW, age 16-35, recruited using community sampling methods in three cities in 2010-2011, including Hanoi, Ho Chi Minh City [HCMC], and Nha Trang City (n=710). Assessments included demographic characteristics, substance use, sexual risk, and use of health services. A series of "event" questions were used to assess the influence of alcohol and drugs on sexual risk.


Both tobacco and alcohol are initiated at a young age and most participants currently use both substances overall across all three cities. While alcohol and tobacco use precede the initiation of sex work, stimulant and opiate use are initiated following the initiation of sex work. There was substantial overlap between substance use and sexual risk, and this overlap was strongest in sexual events involving male and female elective partners rather than sex work clients.


Although rates of HIV infection in this group are low, this may be an artifact of the young age of the sample. High rates of drug use, including alcohol, tobacco and illicit drugs, coupled with high rates of ulcerative STIs such as HPV, suggest the potential for rapid amplification of STI/HIV risk among MSW and their complex sex partnering networks.


Male sex work; Onset of drug and sexual risk; Vietnam

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