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Syndemic conditions for HIV and HCV infections among MSM

Syndemic conditions for HIV and HCV infections among MSM. LE MINH GIANG, BUI MINH HAO, AND VU DUC VIET Center for Research and Training on HIV/AIDS (CREATA) Hanoi Medical University, Vietnam. Outline.

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Syndemic conditions for HIV and HCV infections among MSM

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  1. Syndemic conditions for HIV and HCV infections among MSM LE MINH GIANG, BUI MINH HAO, AND VU DUC VIET Center for Research and Training on HIV/AIDS (CREATA) Hanoi Medical University, Vietnam

  2. Outline Background: Syndemic theory offers a critical approach to examine the conditions that shape the HIV epidemic. Objectives: To describe syndemic conditions of HIV and HCV infections among MSM in Vietnam Methods: Literature review Results & Discussions: High prevalence of syndemic conditions among MSM in Vietnam. Yet little is understood of how these conditions are associated with HIV prevalence and incidence Conclusions: There is a need for a comprehensive and longitudinal study of MSM in Vietnam

  3. HIV epidemic concentrated among KAPs Source: Prepared by www.aidsdatahub.org based on  Viet Nam Global AIDS Response Progress Reporting 2014

  4. HIV prevalence among MSM in three IBSSs % Sources: IBBS 2005, 2009 and 2013

  5. Prevalence of HIV, HCV and other STIs among male sex workers (aged 16 – 29) in Hanoi Source: MSW Study by CREATA of HMU

  6. Syndemic Theory “The term syndemic has been introduced recently….to label synergistic interaction of two or more co-existence of diseases (health conditions) and resultant excess burden of disease” (Singer and Clair, 2003, p. 423) “The presence of conglomerates of psychosocial health conditions of MSM was associated with higher levels of behavioral risk and HIV infection than one would expect in the presence of each of these conditions alone. (Guadazamuz et al, 2014, p. 2089) Associations of syndemic conditions and HIV prevalence and incidence established in the US, Thailand (Bangkok)

  7. Conventional Analysis One-to-One Risk-Disease Association

  8. Syndemic psychosocial conditions and UAI among male sex workers in HCMC Syndemic Conditions: alcohol (Audit risk), amphetamine use, suicide risk (MINI), low self-esteem (Rosenberg scale), PTSD score (Primary Care PTSD Screen), childhood sexual abuse

  9. Syndemic of psychosocial conditions and their assocation Psychosocial Problems: Depressive symptoms; Alcohol dependence; Recent illicit drug; Sexual violence; Childhood sexual abuse

  10. High rates of unprotected intercourse in the last sex among MSM and MSW 1IBBS 2005, 2009, 2013 2 MSW Study at CREATA & Clatts et al, Sexual Health, 2014

  11. Drug use among MSM (IBBS and a 2010 survey in Hanoi) Drug Use in Past 30 Days among MSM2 Proportion of MSM who reported ever having used and injected drugs, 20131 1. MOH IBBS Round III, 2013 2. Courtesy of Nguyen BD (2013)

  12. High prevalence of lifetime and current drug use among male sex workers in three cities (2009 – 2011) • MSW Study at CREATA 2009 - 2011. • Gary Yu et al, International Journal of Drug Policy, 2015

  13. Drinking and sexual risks among MSM in Hanoi(2010) Drinking Level by AUDIT Score among MSM Alcohol Drinking Level (AUDIT) by Condom Use among MSM 1 2 Courtesy of Nguyen BD (2013) 1Giang KB, Subst Use Misuse 2008; 43: 3 2Luchters S, BMC Public Health 2011, 11: 384

  14. Stigma among MSM and sexual risks 1Huy Ha et al, Archives of Sexual Behavior 2015; 44: 2

  15. Stigma among male sex workers in Hanoi and associated risks 1MSW Study at CREATA 2013 – 2015 2 Vu VD, Journal of Preventive Medicine, Special Edition, 2015 3 Nguyen AH, Journal of Preventive Medicine, Special Edition, 2015

  16. Mental health conditions among male sex workers in Vietnam 1 Lloyd A Goldsam et al, International Journal of Sexual Health, 2015 2 Bui HTM et al, Journal of Preventive Medicine, Special Edition, 2015

  17. Mental health conditions and association with sexual risks and drug use 1 Bui HTM et al, Journal of Preventive Medicine, Special Edition, 2015

  18. Guadamuz et al 2014

  19. Context: Growing number of MSM CBOs (278 CBOs from 24 provinces surveyed in 2015)

  20. Thank you for your attention!

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