Khuat Oanh T H, Morrow Martha, Nguyen Trang N N, Armstrong Gregory
Center for Supporting Community Development Initiatives (SCDI), Hanoi, Vietnam.
Centre for Mental Health, University of Melbourne, 3010, Victoria, Australia.
Harm Reduct J. 2015 Oct 16;12:35. doi: 10.1186/s12954-015-0067-9.
Women who inject drugs (WWID) are neglected globally in research and programming yet may be likelier than males to practise sexual and injecting risks and be infected with HIV and more stigmatised but seek fewer services. Little is known about characteristics, practices and nexus between drugs and sex work of WWID in Vietnam, where unsafe injecting has driven HIV transmission, and commercial sex and inconsistent condom use are prevalent. This was the first quantitative investigation of Vietnamese WWID recruited as injecting drug users. This article summarises descriptive findings.
A cross-sectional survey was conducted among WWID in Hanoi (n = 203) and Ho Chi Minh City (HCMC) (n = 200) recruited using respondent-driven sampling. Characteristics varied within and between sites. Twenty-two percent in Hanoi and 47.5 % in HCMC had never sold sex. Almost all commenced with smoking heroin, some as children. Most injected frequently, usually alone, although 8 % (Hanoi) and 18 % (HCMC) shared equipment in the previous month. Some had sex--and sold it--as children; most had multiple partners. Condom use was high with clients but very low with intimate partners, often injecting drug users. HIV knowledge was uneven, and large minorities were not tested recently (or ever) for HIV. Nearly all perceived intense gender-related stigma, especially for drug use.
This ground-breaking study challenges assumptions about characteristics and risks based on anecdotal evidence and studies among men. Most WWID were vulnerable to sexual HIV transmission from intimate partners. Interventions should incorporate broader sociocultural context to protect this highly stigmatised population.
在全球范围内，注射吸毒女性在研究和项目规划中受到忽视。然而，她们可能比男性更有可能从事性和注射相关的危险行为，感染艾滋病毒的几率更高，受到的污名化更严重，但寻求的服务却更少。在越南，不安全注射导致了艾滋病毒的传播，商业性行为和不坚持使用避孕套的情况很普遍，关于该国注射吸毒女性的特征、行为以及毒品与性工作之间的联系，人们所知甚少。这是首次对招募为注射吸毒者的越南注射吸毒女性进行的定量调查。本文总结了描述性研究结果。
采用应答驱动抽样法，对河内（n = 203）和胡志明市（n = 200）的注射吸毒女性进行了横断面调查。不同地点内部和之间的特征存在差异。河内22%的女性和胡志明市47.5%的女性从未从事过性交易。几乎所有人都从吸食海洛因开始，有些人还是儿童时就开始了。大多数人频繁注射，通常是独自注射，不过上个月有8%（河内）和18%（胡志明市）的人共用注射器具。有些人在儿童时期就有过性行为并从事性交易；大多数人有多个性伴侣。与嫖客使用避孕套的比例较高，但与亲密伴侣（通常是注射吸毒者）使用避孕套的比例非常低。艾滋病毒知识参差不齐，很大一部分少数群体最近（或从未）接受过艾滋病毒检测。几乎所有人都感受到了强烈的与性别相关的污名，尤其是在吸毒方面。
这项开创性研究对基于轶事证据和针对男性的研究所作的关于特征和风险的假设提出了挑战。大多数注射吸毒女性容易通过亲密伴侣感染性传播艾滋病毒。干预措施应纳入更广泛的社会文化背景，以保护这一受到高度污名化的群体。
