As of April 2003, 64,801 HIV cases have been documented in Vietnam (Policy Project 2003), 53.9 % of which are among individuals 20-29 years of age. Although HIV education efforts have increased, there remains a need for proven effective programs. We present findings from a randomized-controlled effectiveness trial of an HIV prevention program for adolescents 15-20 years. Four hundred eighty adolescents were randomized into control and intervention groups. Evaluation data were collected using the Vietnamese Youth Health Risk Behavior Instrument, including scales based on the protection motivation theory (PMT). Findings presented show significant differences in knowledge of severity and vulnerability of HIV/AIDS ( p < .05), perceptions of self-efficacy ( p < .001), and response efficacy for condom use ( p < .05) between control and intervention youth at immediate and 6-month postintervention. A significant difference was also found for response cost of condom use ( p < .05) at immediate postintervention. No significant difference was found for the construct of response cost at 6 months, and there were no significant differences for the constructs external and internal rewards. Reported engagement in vaginal sex (1.7%), or anal and/or oral sex (3.1%) was extremely low, and therefore changes in actual behaviors could not be accurately measured. However, intention to use condoms in possible future sexual encounters increased significantly ( p < .05) for the intervention youth compared to control youth between baseline (74/240, 30.8%) and both immediate postintervention (132/230, 57.4%), and six month follow-up (123/228: 53.9%). These data suggest the potential applicability of the PMT for HIV program development with non-Western adolescents but also point to the need for further studies on how constructs within behavioral theories might need to be modified in different sociocultural settings.

As rates of HIV increase in Viet Nam, there is a need for data on social relations and sexual risk and protective behaviors among Vietnamese adolescents in a context of rapid social and economic changes. We report findings from our qualitative interviews with 159 Vietnamese adolescents living in Ha Noi, Nha Trang City and Ninh Hoa District and survey of 886 adolescents in these same three sites. In the qualitative interviews, youth report a strong adherence to ideals and values regarding abstinence outside of marriage. Youth reported low rates of engagement in vaginal, anal, and/or oral sex with a significant difference in reported behaviors between males (29/469, 6.2%) and females (7/416, 1.7%) [p=.000]. 15/32 (46.9%) sexually active youth reported "rarely" or "never" using condoms. Females had significantly higher scores for perceived sexual stigma than males [t=−10.22 (95% CI −3.72 to −2.52), p=.000] while males scored significantly lower than females on a scale of perceived self-efficacy for abstinence [t=5.31 (95% CI 0.27 to 0.59), p=.000]. The stigmatization of sexual relations outside of marriage particularly for young women reinforces abstinence, however these same values decrease adolescents' abilities to obtain accurate information about sexuality and HIV/STIs, and engage in safer sex.

Corresponding Author: Linda M. Kaljee, Ph.D., Associate Professor, Wayne State University, Pediatric Prevention Research Center, Hutzel Building, Suite W534, 4707 St. Antoine, Detroit, MI, 48201, Phone: 301 873-1203, Fax: 313 745-4993, lkaljee@med.wayne.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Methods-185 randomly selected parent-youth dyads in four communes in Ha Noi and Khanh Hoa Province. Descriptive and comparative analysis included chi-square tests, independent samples t-tests, and ANOVA. Linear regression analysis was utilized to assess relationships between parental knowledge, level of comfort, frequency of talk, and discordancy. NIH Public AccessResults-Seventy-six percent of parents and 44% of youth were female. Youth mean age was 17.2 years. For parental "reproductive health knowledge" mean score was 24.74 (SD 3.84: range 15-34). Lower parental reproductive health knowledge was positively associated with lower levels of education [F=2.983, df 184: p=0.014]. Data indicate a linear model in which knowledge is related to "comfort" (β =0.17; p=0.048) and "comfort" to frequency of "talk" (β =0.6; p<0.0001).Frequency of "talk" is not related to parents' discordant perceptions regarding their child's reported involvement in relationships (β =0.002; p=0.79) or sexual touching (β =0.57; p=0.60).Conclusions-Parent and youth in Viet Nam are engaged in limited communication about reproductive health. There is need for more data to assess the impact of these communication patterns on youths' engagement in sexual behaviors and for development of family-centered interventions to increase parental knowledge and skills for positive communication.

A randomly selected cross-sectional survey was conducted with 880 youth (16 to 24 years) in Nha Trang City to assess relationships between alcohol consumption and sexual behaviors. A timeline followback method was employed. Chi-square, generalized logit modeling and logistic regression analyses were performed. Of the sample, 78.2% male and 56.1% female respondents ever consumed alcohol. Males reporting sexual behaviors (vaginal, anal, oral sex) had a significantly higher calculated peak BAC of 0.151 compared to 0.082 for males reporting no sexual intimacy (p < .0001). Females reporting sexual behaviors had a peak BAC of 0.072 compared to 0.027 for those reporting no sexual intimacy (p = .016). Fifty percent of (33/66) males and 30.4% (7/23) females report event specific drinking and engagement in sexual behaviors. Males reporting 11+ drinks in 30 days had more sexual partners than those reporting 1 to 10 drinks (p = .037). Data suggest different physical and psychosocial mediators between alcohol consumption and sexual behaviors by gender.