Transcript HIV RISKS AMONG YOUNG MALE MIGRANTS USING HEROIN IN

HIV RISKS AMONG YOUNG
MALE MIGRANTS USING
HEROIN IN HANOI, VIETNAM
Le Minh Giang†‡; Michael Clatts,†;
Lloyd Goldsamt†, Huso Yi†, Nguyen
Minh Son‡
† Institute for International Research on Youth At Risk
National Development and Research Institutes, Inc.
71 West 23rd Street, 8th Floor
New York, NY 10010
‡ Hanoi Medical University, Hanoi, Vietnam
Background and Objective
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Circular migration and the spread of
HIV/AIDS: A dominant image of migrant
men with unsafe heterosexual relationships
Studies, especially in Southeast Asia,
largely ignore other important sources of
transmission risk
A preliminary analysis of HIV risks among
male, economic migrants in Hanoi to
illustrate the complex set of risk factors
that migrants are facing in growing urban
centers
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Source: The Asia Pacific Economic Center, Hanoi, Vietnam (2004)
Background and Method
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A multi-year study on early social course of
drug injection
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First phase: extensive ethnographic
mapping of all nine wards of Hanoi
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Second phase: a cross-sectional survey
with targeted sampling of young, active
heroin users between the age of 16 and 29
(N = 1270).
In this analysis, comparison of
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Hanoi-based (N=921) vs. economic migrants
(N=132).
Background characteristics
Hanoi- based
Migrant
M
%/SD
M
%/SD
Age
23.2
3.1
23.5
3.3
Number of years of schooling
9.36
2.8
8.95
2.9
Housing Status
Family’s Home*
73.7
5.3
Hostel/Temporary Home*
10.4
65.2
Streets/Public Venues
7.7
17.4
Construction
2.3
8.3
Family support*
31.8
5.3
Porter
2.4
11.4
Stealing/Robbery
18.5
16.7
Street Vending
2.0
10.6
Primary income source last year
Health history and HIV knowledge
Hanoi- based
M
%/SD
Migrant
M
%/SD
Disease History
Hepatitis B and C
8
6.1
Tuberculosis
2
1.5
3.4
6.1
Ever seriously considered
26.7
26.5
Ever attempted
31.8
22.9
HIV testing (ever tested)*
48.3
39.5
Ever incarcerated*
24.6
14.4
Malaria
Suicidal tendency
HIV knowledge (scale of 20)
15.3
3.0
15.2
3.2
Patterns of Drug Use: Current and
Lifetime
Hanoibased
M
Ever used in lifetime
MDMA*
Marijuana
Amphetamine/Methamp
heta-mine
Seduxen/Valium
Opium
Injection alone vs. group
Alone*
%/SD
Migrant
M
%/SD
20.5
39.4
33.3
12.9
33.3
26.5
27.4
38.8
20.5
43.9
34.9
47.3
Onset of HIV risks and migration
Hanoibased
M
SD
Age of migration to work
Age of first use of
Heroin
Years of exposure to
heroin*
Opium
Ever selling sex*
Age of first sex work
Migrant
M
18.0
SD
3.0
18.3
4.8
3.1
2.9
19.3
4.2
3.0
2.5
18.8
3.3
4.6
3.3
19.3
3.2
15.2
1.9
20.1
19.6
Discussion & Conclusion
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Strength & Significance:
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out-of-treatment sample recruited through
extensive ethnographic mapping;
silent issue not only in the country’s response to but
also in global image about HIV risks among young
male migrants
Limitation: lack of qualitative data that
could shed light on the interaction between
migration and risks/resilience
Migration for economic opportunities in
growing urban centers like Hanoi is itself a
hazardous experience.
Discussion & Conclusion
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The confluence of both drug and sexual
risks among young male migrants demands
comprehensive approach to prevention
planning
Further qualitative research is needed to
understand the complex interaction
between migration and risks/resilience
Prevention programming needs to seek
ways to improve migration experience,
rather than just focusing on behavioral
approach to HIV/AIDS prevention.
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Young people who participated in the study.
Young ethnographers from Hanoi Medical
University and the Center for Community Health
Research and Development.
Grant Number DA016188 from U.S. National
Institute on Drug Abuse and Grant Number 325
(03-050) from the World AIDS Foundation