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越南北部山区美沙酮维持治疗患者的性行为。

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

机构信息

Berkeley School of Public Health, University of California, Berkeley, California, USA.

Institute for Global Health Innovations, Duy Tan University, Da Nang, 550000, Vietnam.

出版信息

Subst Abuse Treat Prev Policy. 2017 Aug 25;12(1):39. doi: 10.1186/s13011-017-0123-4.

Abstract

BACKGROUND

Methadone 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.

METHODS

We 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.

RESULTS

Most 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.

CONCLUSION

This 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.

摘要

背景

美沙酮维持治疗(MMT)可提高患者获得与艾滋病相关服务的能力,并减少针具共用和其他危险的与艾滋病相关行为。然而,患者可能继续从事危险的性行为。在这项研究中,我们评估了越南北部山区省份 MMT 患者的性行为。

方法

我们对 241 名男性 MMT 患者在宣光省的健康状况、MMT 和药物使用史以及性行为进行了调查。使用 EuroQOL-5 维度-5 级量表(EQ-5D-5L)评估健康状况。采用多变量逻辑回归分析评估相关因素。

结果

大多数患者(66.4%)报告在过去 12 个月内至少有一名性伴侣。这些伴侣中大多数是配偶或主要伴侣(72.6%)。约 8.3%的患者有偶然伴侣,5.8%的患者曾光顾性工作者;在从事偶然性行为的患者中,90.9%的患者报告使用了避孕套。当前的药物使用和居住在偏远地区与拥有两个或更多性伴侣的可能性增加有关,而焦虑或抑郁则与可能性降低有关。

结论

本研究表明,在越南山区环境中,MMT 患者中存在性风险行为的比例较低。将关于安全性行为的教育纳入 MMT 服务中,同时提供医疗护理并确保美沙酮治疗的依从性,是减少这些存在不安全性行为风险的患者感染艾滋病风险的重要组成部分。

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