Prevalence of Drug Use in Pnbd Before Intervention

tl %

100

81.2

71.7

56.6

56.1

57.1

17.5

Shared

for guests

MDDP

MDNH

because of acquaintance with husband/lover

Chart 3.9. Rate of regular condom use in 2005-2006

Figure 3.9 shows that the rate of female sex workers in Hanoi who regularly use condoms with strangers is 76%, higher than with regular customers (56.6%) and higher than with husbands/boyfriends (17.5%). The rate of regular condom use with strangers in the BDNH group is higher than that of the BDĐP group (81.2% vs. 71.7%, p= 0.02), the rate of regular condom use with regular customers in the BDNH group is similar to that of the BDĐP group (57.1% vs. 56.1%, p= 0.82). The rate of condom use with husbands/boyfriends in the BDNH and BDĐP groups is similar (17% vs. 18%, p= 0.72, Chi-square test).

3.1.3.5. Drug use behavior

% 30

24.4

16.7

10.3

Already registered

SDMT

Already registered

TCMT

MDDP MDNH General

Figure 3.10. Drug use rate among PWID before intervention

According to chart 3.10, BDNH used drugs less than BDDP (10.3% vs. 24.4%, p=0.0001). The rate of IDU in the BDDP group was higher than that of the BDNH group (16.7% vs. 4%, p=0.0001). Among those who had ever used drugs, up to 61.1% had IDU (in the BDDP group it was 68.7% and in the BDNH group it was 39.1%).

TCMT behavior	Shared (n=55)		BDDP (n=46)		BDNH (n=9)		p*
TCMT behavior	SL	%	SL	%	SL	%
Share BKT	27	49.1	21	45.7	6	66.7	0.29
Use BKT that someone else has used	23	41.8	18	39.1	5	55.6	0.46
Use clean BKT TCMT times nearest	50	90.9	41	89.1	9	100	-

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Table 3.11. Drug injection behavior among PWID with IDU

* Fisher Exact test According to table 3.11, the rate of shared condom use among PWUD is quite high: 45.7%

in the BDDP group and 66.7% in the BDNH group. Notably, 41.8% of PNBD used needles that others had used within 1 month before being interviewed. However, the rate of using clean needles (sterilized needles) in the last TCMT was quite high (89.1% of the BDDP group and 100% of the BDNH group). There was no difference between the BDNH and BDDP groups in these behaviors because p>0.05 (Fisher exact test).

3.1.3.6. Association between behaviors and HIV status

Table 3.12. Relationship between age, amount of money received from prostitution, number of customers and HIV infection status of female sex workers in Hanoi in 2005-2006

Features

HIV status		p
(+)	(-)	p
Average age	27.7	28.4	0.37
Average time in practice (years)	4.8	4.0	0.07
Age of starting prostitution	22.9	24.5	0.03
Age at first sexual intercourse	19.0	19.5	0.12
Amount received for 1 sexual intercourse	116,000	143,000	0.16
Amount received for 1 overnight stay	320,000	359,000	0.12
Average number of customers in the past month	21.2	21.8	0.84

Table 3.12 shows that age, duration of prostitution, age of initiation of sexual intercourse, amount of money received from prostitution and number of clients were not related to HIV status (p>0.05). However, the HIV-infected group started prostitution earlier (at 22.9 years old) than the HIV-uninfected group (at 24.5 years old) in a significant way (p=0.03).

Table 3.13. Relationship between characteristics of target groups and groups

age, education, marital status and HIV status

Feature

HIV (+)		HIV (-)		OR	95% CI	p
SL	%	SL	%	OR	95% CI	p
Target group
BDDP	62	22.5	213	77.5	2.8	1.7 – 4.8	0.0001
BDNH	21	9.4	203	90.6	1
Age group
≤ 20	6	12.8	41	87.2	1
21-30	50	16.9	245	83.1	1.4	0.6 – 3.5	0.47
≥ 31	27	17.2	130	82.8	1.4	0.6 – 3.7	0.47
Education level
Illiterate + small	17	15.2	95	84.8	1
learn
Secondary School	38	15.1	213	84.9	0.9	0.5 – 1.9	0.99
High School	28	20.6	108	79.4	1.4	0.8 – 2.8	0.27
Marital status
Never ended	33	15.8	176	84.2	1
kiss
Married	19	18.3	85	81.7	1.2	0.6 – 2.2	0.58
Had a husband	31	16.7	155	83.3	1.1	0.6 – 1.8	0.81

According to table 3.13: the BDDP group has a 2.8 times higher risk of HIV infection.

compared with the BDNH group (OR=2.8; 95% CI: 1.7 – 4.8). Age group, education level

marital status and marital status were not risk factors for HIV infection (as the 95% CI contained the value 1).

Table 3.14. Some SDMT behaviors and HIV infection risk among PWID before intervention

HIV (+)		HIV (-)		OR	95% CI	p
SL	%	SL	%	OR	95% CI	p
Drug use
Have	31	34.4	59	65.6	3.6	2.1 – 6.1	0.0001
Are not	52	12.7	357	87.3	1
Ever TCMT
Have	22	40	33	60	4.2	2.3 – 7.6	0.0001
Are not	61	13.7	383	86.3	1
Use BKT already
other people use in
1 month ago
Have	13	56.5	10	43.5	7.5	3.2 – 17.9	0.0001
Are not	70	14.7	406	85.3	1

Table 3.14 shows that injecting drug use behavior increases the risk of HIV infection in PWID by 3.6 times (OR = 3.6; 95% CI: 2.1 - 6.1). People who use injecting drugs have a 4.2 times higher risk of HIV infection than those who do not use injecting drugs (OR = 4.2; 95% CI: 2.3 - 7.6). In particular, in the month before the survey, people who have used needles that have been used by others have a 7.5 times higher risk of HIV infection (OR = 7.5; 95% CI: 3.2 - 17.9).

Table 3.15. Clients' sexual health behaviors and HIV infection risk of PWID

HIV (+)		HIV (-)		OR	95% CI	p
SL	%	SL	%	OR	95% CI	p
Stranger with TCMT
Have	11	25.6	32	74.4	2.2	1.0 – 4.9	0.047
Don't know	31	17.2	149	82.8	1.3	0.8 – 2.3	0.31
Are not	28	13.5	179	86.5	1
Regular customers have TCMT
Have	9	23.1	30	76.9	1.6	0.7 – 3.7	0.23
Don't know	12	23.5	39	76.5	1.7	0.8 – 3.4	0.15
Are not	51	15.5	2.78	84.5	1
Husband/boyfriend has
TCMT
Have	15	38.5	24	61.5	4.1	1.9 – 8.9	0.0001
Are not	25	13.2	165	86.8	1

According to table 3.15, the PNBD in the month before the interview had

Strangers to IDUs had a 2.2-fold higher risk of HIV infection (OR = 2.2; 95% CI: 1

– 4.9). Those whose husband/boyfriend had IDU in the past month had a 4.1 times higher risk of HIV infection (OR= 4.1; 95% CI: 1.9 – 8.9). IDU behavior of regular clients was not associated with HIV infection status of FSWs in Hanoi (OR= 1.6; 95% CI: 0.7 – 3.7).

Inadequate basic knowledge about HIV was also not associated with HIV infection status of FSWs (OR=0.7; 95% CI: 0.4 - 1.1).

Table 3.16. Associations between condom use, STI history, and HIV infection

in the pre-intervention PNBD group (n=499)

Characteristic

HIV (+)		HIV (-)		OR	95% CI	p
SL	%	SL	%	OR	95% CI	p
Use condom with strangers
in the past month
Frequent	47	14.4	280	85.6	1
Not often	23	22.3	80	77.7	1.7	1.0 – 3.0	0.05
Use condoms with regular customers
in the past month
Frequent	40	16.9	197	83.1	1
Not often	32	17.6	150	82.4	1.1	0.6 – 1.8	0.85
Use condom with husband/friend
boys in the past year
Frequent	8	19.5	33	80.5	1
Not often	32	16.6	161	83.4	0.8	0.4 – 1.9	0.65
History of STI infection in
last year
Have	49	20.0	196	80.0	1.6	1.0 – 2.6	0.047
Are not	34	13.4	220	86.6	1

Table 3.16 shows that people who did not use condoms regularly when having sex with strangers were 1.7 times more likely to be infected with HIV than those who used them regularly (OR= 1.7; 95% CI: 1.0 – 3.0). People with a history of STIs in the past year were 1.6 times more likely to be infected with HIV (OR= 1.6; 95% CI: 1.0 – 2.6). Condom use with regular clients in the past month or with a husband/lover in the past year was not associated with HIV infection.

Table 3.17. Multivariate analysis of factors increasing the risk of HIV infection

in the group of PNBD in Hanoi in 2005 - 2006.

Risk factors

OR	95% CI	p
BDDP group vs BDNH	3.5	1 – 12.7	0.05
With SDMT vs. without SDMT	5.2	0.2 – 149.4	0.33
With TCMT vs. without TCMT	0.1	0.01 – 3.0	0.15
Using someone else's BKT in the past month vs. not using someone else's BKT	87.8	2.8 – 2770.3	0.01
Strangers with TCMT vs. Strangers no TCMT	0.9	0.3 – 3.9	0.98
Husband/boyfriend with IDU vs. husband/boyfriend without IDU	1.6	0.5 – 5.5	0.47
Use condoms regularly with strangers vs. non-regular use	0.3	0.1 – 0.9	0.04
History of STI infection within the past year vs. no history of STI infection	3.3	0.9 – 11.7	0.06
Age of starting prostitution	0.9	0.8 – 1.1	0.4

After univariate analysis, the risk factors were entered into a multivariate logistic regression model to find the true risk factors. Table 3.17 shows that only 3 factors remained independently associated with HIV infection. The BDDP group had a 3.5 times higher risk of HIV infection than the BDNH group (OR= 3.5; 95% CI: 1 – 12.7). People who used needles that had been used by others had an 87.8 times higher risk of HIV infection than others (OR= 87.8; 95% CI: 2.8 – 2770.3). People who always used condoms when having sex with strangers

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