MINISTRY OF EDUCATION AND TRAINING MINISTRY OF HEALTH
NATIONAL INSTITUTE OF HYGIENE AND EPIDEMIOLOGY
--------------- --------------
TRAN VAN KIEM
HIV RISK BEHAVIORS
AND THE EFFECTIVENESS OF PREVENTIVE INTERVENTIONS ON INJECTION DRUG ADDICTS IN QUANG NAM
DOCTORAL THESIS IN MEDICINE
HANOI - 2014
MINISTRY OF EDUCATION AND TRAINING MINISTRY OF HEALTH
NATIONAL INSTITUTE OF HYGIENE AND EPIDEMIOLOGY
--------------------------
TRAN VAN KIEM
HIV RISK BEHAVIORS
AND THE EFFECTIVENESS OF PREVENTIVE INTERVENTIONS ON INJECTION DRUG ADDICTS IN QUANG NAM
Major: Epidemiology Code: 62.72.01.17
DOCTORAL THESIS IN MEDICINE
Scientific instructor:
1. Prof. Dr. Nguyen Thanh Long
2. Associate Professor, Dr. Nguyen Thi Hong Hanh
HANOI - 2014
COMMITMENT
I hereby declare that this is my own research work. The data and results presented in this thesis are true and have never been published in any other work.
Thesis author Tran Van Kiem
ACKNOWLEDGEMENTS
I would like to sincerely thank the Board of Directors, Department of Epidemiology, Faculty of Training and Scientific Management, Department of HIV/AIDS, and related departments of the Central Institute of Hygiene and Epidemiology for creating the most favorable conditions and providing equipment to help me improve my knowledge, and contributing valuable ideas to me throughout the process of studying and completing my thesis.
I would like to express my deep gratitude to Prof. Dr. Nguyen Thanh Long and Assoc. Prof. Dr. Nguyen Thi Hong Hanh, the teachers who have wholeheartedly helped and guided me throughout my study, research and thesis completion.
I am extremely grateful to the Department of HIV/AIDS Prevention and Control - Ministry of Health, Hanoi Medical University, Military Medical Academy, Nha Trang Pasteur Institute for helping me improve my knowledge, providing technical and financial support to complete this thesis.
I would like to sincerely thank the Quang Nam Department of Health and the Quang Nam HIV/AIDS Prevention Center for creating all conditions and encouraging me throughout my studies and thesis completion.
I would like to sincerely thank the leaders and staff of the District/City Health Centers, local government leaders, departments, organizations and research participants for their enthusiasm and support during the field survey and data collection.
I would like to sincerely thank the professors, associate professors, and doctors in the scientific councils that evaluated my thesis for their valuable comments to help me gain more knowledge and improve my thesis to a better quality.
On this occasion, I would like to express my deep gratitude to my family members, parents, wife, children, siblings, friends and close colleagues who have wholeheartedly supported and encouraged me throughout my studies and helped me overcome difficulties to complete my graduation thesis.
Thesis author Tran Van Kiem
INDEX
Page | |
Cover Page Pledge Acknowledgements Table of Contents List of abbreviations List of tables List of charts List of diagrams, images | |
QUESTION STATEMENT | 1 |
CHAPTER 1: OVERVIEW | 4 |
1.1. HIV/AIDS infection situation in the world and Vietnam | 4 |
1.1.1. Some concepts | 4 |
1.1.2. HIV/AIDS infection situation among drug addicts in the world | 6 |
1.1.3. HIV/AIDS infection situation among drug addicts in Vietnam | 11 |
1.2. HIV risk behaviors among IDUs | 16 |
1.2.1. Risky behaviors due to drug injection | 16 |
1.2.2. Risky behaviors due to sexual intercourse | 22 |
1.2.3. Risk of HIV infection from HIV-infected IDUs | 24 |
1.3. HIV infection prevention interventions in drug addicts | 26 |
1.3.1. Behavior change communication program | 26 |
1.3.2. Program to promote condom use | 28 |
1.3.3. Clean needle exchange program | 30 |
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1.3.4. Substance abuse treatment program33 | |
1.3.5. Voluntary counseling and testing program | 35 |
1.3.6. Peer education program | 37 |
1.3.7. Program for management and treatment of sexually transmitted diseases sexual route | 38 |
CHAPTER 2: RESEARCH SUBJECTS AND METHODS | 40 |
2.1. Research subjects, locations and time | 40 |
2.1.1. Research subjects | 40 |
2.1.2. Research location | 40 |
2.1.3. Research time | 42 |
2.2. Research method | 42 |
2.2.1. Research design | 42 |
2.2.2. Research content | 48 |
2.2.3. Data collection techniques | 54 |
2.2.4. Research indicators | 58 |
2.3. Data processing | 59 |
2.4. Error control | 59 |
2.5. Research ethics | 60 |
2.6. Limitations of the topic | 60 |
CHAPTER 3: RESEARCH RESULTS | 62 |
3.1. HIV infection rate and HIV risk behaviors in drug addicts in Quang Nam in 2011 | 62 |
3.1.1. Some characteristics of the research subjects | 62 |
3.1.2. HIV risk behaviors among IDUs | 64 |
3.1.3. HIV infection rate among drug addicts in the province Quang Nam 2011 | 80 |
81 | |
3.2. Effectiveness of HIV prevention in drug addicts Drugs in Quang Nam province after 2 years of intervention | 87 |
3.2.1. Effectiveness of HIV counseling and testing | 87 |
3.2.2. Effectiveness in care and support for drug addicts | 88 |
3.2.3. Effectiveness of HIV prevention intervention approach drug addict | 91 |
3.2.4. Effectiveness in changing risky behaviors of addicts drug injection | 94 |
3.2.5. HIV infection rate among drug addicts before and after after intervention | 99 |
CHAPTER 4: DISCUSSION | 100 |
4.1. HIV infection rates and HIV risk behaviors in drug addicts in Quang Nam in 2011 | 100 |
4.1.1. Some characteristics of the research subjects | 100 |
4.1.2. HIV risk behaviors of injection drug users drugs in Quang Nam province in 2011 | 101 |
4.1.3. HIV prevalence among injecting drug users in Quang Nam province in 2011 | 113 |
4.1.4. Factors associated with HIV risk behaviors | 116 |
4.2. Effectiveness of HIV infection prevention in drug addicts Drugs in Quang Nam after 2 years of intervention | 117 |
4.2.1. Effectiveness of HIV counseling and testing | 117 |
4.2.2. Effectiveness in caring for and supporting drug addicts | 119 |
4.2.3. Effectiveness of service access for drug addicts | 121 |
4.2.4. Effectiveness of changing HIV risk behavior | 124 |