141st APHA Annual Meeting

In This section

282267
Stigma, depression, and sexual risk for HIV infection among men who engage in transactional sex in ho chi minh city, Vietnam

Tuesday, November 5, 2013

Catherine E. Oldenburg, MPH , Department of Epidemiology, Harvard School of Public Health, Boston, MA
Katie Biello, PhD, MPH , The Fenway Institute, Boston, MA
Donn Colby, MD, MPH , Harvard Medical School AIDS Initiative in Vietnam, Ho Chi Minh City, Vietnam
Jason Park, BS , Harvard School of Public Health, Boston, MA
Kenneth Mayer, MD , The Fenway Institute, Fenway Health, Boston, MA
Thi Mai , Harvard Medical School AIDS Initiative in Vietnam, Ho Chi Minh City, Vietnam
Thi Nguyen , Harvard Medical School AIDS Initiative in Vietnam, Ho Chi Minh City, Vietnam
Ngoc Nguyen , Harvard Medical School AIDS Initiative in Vietnam, Ho Chi Minh City, Vietnam
Matthew J. Mimiaga, ScD, MPH , Harvard School of Public Health, Boston, MA
Background: Commercial sex workers experience high levels of stigma in the context of sex work in Vietnam, and are at high risk for HIV transmission/acquisition. Little research has explored sexual risk, sex work-related stigma and other factors among this group. Methods: In 2010, 300 male sex workers (MSWs) completed a behavioral and psychosocial survey. Stigma was assessed by 6 questions on a 4-point Likert scale, with a composite stigma score on a scale of 0 to 18. Associations between demographic and psychosocial factors and stigma were assessed using regression models. Results: Mean age was 22.3 years (SD=5.0); 50.3% identified as homosexual, 31.5% bisexual, and 16.1% heterosexual. In one month, mean number of clients was 11.7 (SD=12.9) and non-commercial male partners 9.0 (SD=10.9). Participants' mean stigma score was 7.1 (SD=4.4; median=7.0; interquartile range=4-10) and 47.3% were depressed. Factors associated with increased stigma included disclosure of sexual orientation to healthcare workers (b=1.83, 95%CI=0.77, 2.88), meeting clients in the street/park (b=1.36, 95%CI=0.26, 2.46), being forced to have unprotected sex (b=2.39, 95%CI=1.30, 3.47), and higher education (b=1.16, 95%CI=0.05, 2.26). Factors associated with decreased stigma included meeting clients on the telephone/internet (b=-1.16, 95%CI=-2.30, -0.023) and financial support from family/friends (b=-1.19, 95%CI=-2.34, -0.043). In an adjusted model, stigma was associated with higher odds of depression (AOR=1.07, 95%CI=1.00, 1.14). Conclusions: Stigma in the context of sex work and depression are relevant among MSWs. Addressing stigma and depression in HIV prevention interventions is crucial for tailoring these programs to MSWs' needs, and may result in decreased HIV spread.

Learning Areas:
Public health or related research
Social and behavioral sciences

Learning Objectives:
Identify factors associated with sex work-related stigma among male sex workers in Vietnam; Describe psychosocial factors that are associated with experienced stigma; Discuss how stigma and associated psychosocial factors can be a barrier to participation in HIV prevention programs.

Keywords: HIV Risk Behavior, Sex Workers

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a doctoral student in epidemiology and am studying psychosocial factors related to HIV prevention among high-risk populations.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.