Chlamydia Infection Distribution by Age Group Before Intervention

25 %

22.1

15.3

16.7

12.8

≤ 20 years old

10.2

11.1

10.3

10 8.2 8.2

21-30 years old

≥31 years old

Shared

MDDP

MDNH

Figure 3.6. Distribution of Chlamydia infection by age group before intervention

Figure 3.6 shows that among people ≤ 20 years old, 12.8% were infected with Chlamydia. The infection rate in the age group 21-30 was 15.3% and the age group ≥ 31 years old was 10.2%. In the BDDP group, the infection rate in the age group ≤ 20 years old was 16.7%, in the age group 21-30 was 22.1% and in the age group ≥ 31 years old was 11.1%. In the BDNH group, the infection rate in the age group ≤ 20 years old was 10.3%, and in both the age groups 21-30 and ≥ 31 years old, the infection rate was 8.2%.

25 %

22.8

14.4

13.4

14 14.5

11.5

11.6

10 8.5

6.5

Maiden

Married Married

Shared

MDDP

MDNH

Figure 3.7. Distribution of Chlamydia infection by marital status before intervention (n=499)

Figure 3.7 shows that the Chlamydia infection rate in the never-married group (not married) is 14.4%, the married group is 11.5% and the ever-married group is 13.4%. In the BDNH group, the never-married and the married have an infection rate of less than 10% (6.5% and 8.5%) and the ever-married (including divorced/separated/widowed) have an infection rate of 11.6%. In the BDDP group, the never-married have a higher infection rate (22.8%) than the married (14%) and the ever-married (14.5%).

3.1.2.3. Rates of co-infection with HIV and STIs

Table 3.3. Distribution of STI infection rates by pre-CT HIV status

Infection rate

HIV (-) (n=416)		HIV (+) (n=83)		P
SL	%	SL	%	P
Gonorrhea	9	2.2	0	0	0.17*
Chlamydia	58	13.9	9	10.8	0.45
Syphilis	4	1.0	0	0	0.48*

Maybe you are interested!

* Fisher exact test According to table 3.3, among people infected with HIV, no one was infected with gonorrhea or syphilis. The rate of Chlamydia infection among people infected with HIV was 10.8% while among people not infected with HIV it was 13.9%.

3.1.3. HIV and STI risk behaviors of female sex workers in 4 districts of Hanoi in 2005-2006

3.1.3.1. Age of prostitution, duration of practice and number of sexual partners of female sex workers

Table 3.4. Age of prostitution, duration of practice and number of sexual partners

Feature

General (n=499)	BDDP (n=275)	BDNH (n=224)	p
Age of starting prostitution
Medium	24.2	25.2	22.9	0.0001
Standard deviation	5.9	6.7	4.5
Time of practice
Medium	4.1	4.4	3.7	0.047
Standard deviation	3.9	4.1	3.5
Number of sexual partners/month
Medium	21.7	21.2	22.3	0.59
Standard deviation	20.0	18.9	21.4
Number of new visitors/month
Medium	14.8	15.3	14.2	0.52
Standard deviation	17.6	17.6	17.4
Number of regular customers/month
Medium	5.5	4.9	6.3	0.07
Standard deviation	7.6	5.7	9.4

Table 3.4 shows that when PWID were about 24 years old, they started selling sex. The average age at which PWID started selling sex was higher than that of PWID (25.2 vs. 22.9; p=0.0001, t test). The average duration of selling sex was 4.1 years, the PWID group was 4.4 years, longer than the PWID (3.7 years) (p=0.047, t test). Each month, PWID surveyed before the intervention had 21.7 sexual partners, 14.8 strangers, and 5.5 regular customers. The number of regular customers and monthly strangers of PWID did not differ from that of PWID.

3.1.3.2. HIV knowledge of female sex workers in Hanoi before intervention

Table 3.5. Basic knowledge about HIV of female sex workers in Hanoi in 2005-2006

Knowledge about HIV

%			p
Shared (n=499)	BDDP (n=275)	BDNH (n=224)	p
Ever heard about HIV/AIDS	87.2	85.5	89.3	0.20
Consider yourself at risk high HIV	25.7	29.8	20.5	0.02
Full basic understanding of HIV	43.1	36.4	51.3	0.001
Monogamous sex reduces the risk HIV infection risk	81.6	77.8	86.2	0.02
Always use condoms correctly. reduce the risk of HIV infection	83.8	81.1	87.1	0.07
Share BKT when TCMT works increased risk of HIV infection	80.0	79.6	80.4	0.84
Use public toilets does not transmit HIV	66.3	61.5	72.3	0.01
Mosquito or insect bites not HIV transmission	56.3	50.9	62.9	0.007

Table 3.5 shows that in the pre-intervention survey, 87.2% of PWID had heard about HIV/AIDS. The proportion of PWID who thought they were at high risk of HIV infection was 25.7%. This proportion in the MSM group was 29.8%, significantly higher than that of the MSM group (20.5%) (p=0.02). The proportion of PWID who had basic knowledge about HIV before the survey was not high, accounting for 43.1% of the surveyed PWID. This proportion was higher in the MSM group than in the MSM group (51.3% compared to 36.4%, p=0.001). 81.6% of PWID understood that being faithful to one sexual partner was not

HIV infection and this partner does not have another partner reduces the risk of HIV infection, 83.8% understand the role of condoms in preventing sexually transmitted HIV infection and 80% of PWID know that sharing needles when injecting drugs increases the risk of HIV infection. The awareness of the protective role of condoms in preventing HIV as well as the risks of sharing needles between PWID and PWID groups did not differ significantly (p= 0.07 and p= 0.84). The rate of PWID denying misconceptions about HIV was lower (66.3% understood that using public toilets does not transmit HIV and 56.3% understood that mosquito or insect bites do not transmit HIV). In general, the rate of correct answers to questions about HIV by PWID was higher than that of PWID.

Table 3.6. Percentage of PNBD tested for HIV

Characteristic

Percentage			p
General (n=435)	BDDP (n=235)	BDNH (n=200)	p
Know where to do confidential HIV testing, voluntarily wish	34.9	40.4	28.5	0.01
Ever tested for HIV	43.0	39.6	47.0	0.12
Ever had voluntary HIV testing	32.4	28.5	37.0	0.06

According to Table 3.6, the rate of PWUD knowing where to voluntarily and confidentially test for HIV was 34.9%, this rate was higher in the MSM than in the MSM (40.4% vs. 28.5%, p=0.01). The number of PWUD who had ever tested for HIV was 43%. The rate of ever testing for HIV in the MSM group was similar to that of the MSM group (39.6% vs. 47%, p=0.12). 32.4% of PWUD voluntarily tested for HIV.

3.1.3.3. Knowledge about STIs and attitudes towards handling signs of STI infection of PNBD before intervention

Table 3.7. Proportion of PNBDs who recognized STI symptoms before CT

STI Symptoms

Shared (n=499)		BDDP (n=275)		BDNH (n=224)		p
SL	%	SL	%	SL	%
Symptoms of genital discharge	318	63.7	174	63.3	144	64.3	0.81
Symptoms of painful urination	141	28.3	83	30.2	58	25.9	0.29
Symptoms of genital warts	72	14.4	53	19.3	19	8.5	0.001
Symptoms of lower abdominal pain	101	20.2	54	19.6	47	21	0.71
Don't know what STI symptoms	89	17.8	54	19.6	35	15.6	0.24
Know the 4 STI Symptoms	11	2.2	10	3.6	1	0.4	0.02

According to Table 3.7, 63.7% of PWUD knew that genital discharge was a symptom of STI. Symptoms of painful urination, genital ulcers and lower abdominal pain were less recognized (accounting for 28.3%, 14.4% and 20.2% respectively). 17.8% of PWUD did not know any common STI symptoms, only 3.6% in the PWUD group and 0.4% in the PWUD group knew 4 symptoms.

6 % 0

49.6

46.5

TS ulcer

born

12.8

TS yes

born

Shared

MDDP

MDNH

Figure 3.8. History of STI infection of female sex workers in Hanoi before intervention

cards (n=499)

According to chart 3.8, up to 46.5% of PNBD had a history of genital discharge and 12.8% had a history of genital ulcers within 1 year before being interviewed. The rate of history of genital discharge in the BDDP group was not different from that in the BDNH group (p=0.22). BDNH had a lower history of genital ulcers than BDDP (4% vs. 20%, p=0.0001).

Table 3.8. Attitudes on handling STI symptoms in the most recent time

How to handle

n	%
Go to a state health facility for medical examination and treatment	20	11.0
Go to private medical facility for examination and treatment	50	27.5
Go to the pharmacy yourself to buy medicine	120	65.9
Home remedies	53	29.1
Do nothing	22	12.1
Use condoms during symptoms	24	13.2

Table 3.8 shows that, among those who answered about how they handled STI symptoms, only 11% went to public clinics and 27.5% went to private clinics. 65.9% bought medicine from pharmacies for treatment, 29.1% treated themselves at home and 12.1% did not handle anything. Only 13.2% used condoms during sexual intercourse while they had symptoms.

When infected with STIs, 79.4% of BDDPs bought medicine at the pharmacy to self-treat, higher than this rate in the BDNH group (57.9%). The difference was statistically significant with p=0.003 (Chi-square test)

3.1.3.4. Condom use behavior of female sex workers before intervention

Table 3.9. Condom availability in 2005-2006

Rate of PNBD

%			p
General (n=499)	BDDP (n=275)	BDNH (n=224)	p
Ever used condom	99.0	98.5	99.6	0.39
Can have BCS < 15 minutes	97.8	97.5	98.2	0.82
Know that at the reception condoms available	80.6	78.2	83.5	0.24
Bring condoms when interviewed	2.0	3.3	0.4	0.03

Table 3.9 shows that 99% of FSWs had ever used condoms and 97.8% of FSWs had condoms within 15 minutes (97.5% of the FSW group and 98.2% of the FSW group). About 80% of FSWs' reception facilities had condoms available (78.2% of the FSW group and 83.5% of the FSW group). However, only a very small number (2%) of FSWs had condoms with them when interviewed.

Table 3.10. Percentage of PNBD knowing condom supply locations

Condom supply location

General (n=499)		BDDP (n=275)		BDNH (n=224)		p
SL	%	SL	%	SL	%	p
Pharmacy	456	91.4	254	92.4	202	90.2	0.38
Peer	167	33.5	105	38.2	62	27.7	0.01
Medical facility	62	12.4	43	15.6	19	8.5	0.02
Bar, restaurant, hotel	141	28.3	72	26.2	69	30.8	0.25

According to Table 3.10, 91.4% of FSWs know that they can buy condoms at pharmacies. 33.5% of FSWs know that they can get condoms through peer educators, 28.3% think that they can get condoms at bars, restaurants, hotels and 12.4% at health facilities.

Comment