Health-seeking behaviour for sexually transmitted infections and HIV testing among female sex workers in Vietnam

Abstract

This qualitative study was conducted to explore health-seeking behaviour for sexually transmitted infections (STIs) and HIV testing among female sex workers (FSWs) in the cities of Hanoi and Da Nang, Vietnam. Data were gathered from in-depth interviews, focus groups and participant observation. Results suggest that women's decision to seek STI treatment and HIV testing is influenced by the complex interplay of personal risk perceptions, social relationships and community discourse. The women exhibited adequate knowledge of HIV while their knowledge of STIs was limited. They demonstrated high-risk perceptions of HIV, but they showed little concern for STIs. Most women sought treatment at pharmacies when they noticed symptoms of the genital tract. Their decision to seek care in health facilities and HIV testing was hampered by the high costs of treatment, judgmental attitudes of service providers, and a lack of information on testing services. Future interventions need to focus on strengthening knowledge of STIs and the STI-HIV association, and increasing awareness of HIV counselling and testing services. Training for STI service providers including pharmacies and private practitioners on sex-worker friendly and non-judgmental services and counselling skills should be emphasized to provide timely diagnosis and treatment of STIs, and to refer women to HIV testing.

Protecting, Balancing, and Confronting: Health-Seeking Among Homeless Youth in Ho Chi Minh City, Vietnam

“…As our participants emphasized, many homeless Vietnamese youths avoid engagement with medical facilities for fear of being caught by police or government officials and sent to rehabilitation centers. When youths did take action with regard to their health, it was often through pharmacies that served as primary care centers (Ngo et al, 2007) or via informal networks of peers, members of the community, and social workers.…”

“…To date, while there has been extensive research looking at how pharmacies throughout Vietnam are operated ( Van Duong, Binns, & Van Le, 1997), there has been little research looking at ways to successfully involve pharmacies in public health endeavors. Taking the findings of previous studies a step further (Ngo et al, 2007), pharmacies can play a crucial role in helping homeless youth improve their health and can act as a liaison to other health care services. Throughout Vietnam, locally run pharmacies can be found on each street corner.…”

Treatment 2.0 Pilot in Vietnam—Early Progress and Challenges

“…Stand-a-lone VCT sites have been one major approaches to promote testing. Given low testing rates amongst, key populations at higher risk [11,16,17], however, this has not been enough. Treatment 2.0 plans to institute rapid testing through provider initiated testing and counselling (PITC) in service delivery points as well as widespread anonymous communitybased testing and counselling to better reach , key populations at higher risk.…”

“…WHO supported VAAC in identifying areas in various service delivery systems where testing and counselling as well as ART delivery may occur, such as through methadone maintenance treatment clinics, polyclinics, and at commune level health stations. UNAIDS has been working to address major concerns around confidentiality and ensure that these adapted service delivery systems protect human rights and with services that are "client-oriented" toward, key populations at higher risk who have previously cited fears of stigma and discrimination as major barriers to accessing HIV services [9][10][11]. Due to the unique situation surrounding the history and financing of HIV, Vietnam, similar to many other countries, has developed a vertical HIV system.…”

“…Key populations at higher risk and PLHIV are highly marginalized populations and face high levels of stigma and discrimination. Fears related to protection of confidentiality, stigma, and lack of perceived risk, and fear of HIV diagnosis have been major reasons for low uptake and or late treatment initiation [9][10][11]. Treatment 2.0 has allowed a platform to include the perspectives of PLHIV and, key populations at higher risk in the planning process to design a system that adequately reaches and supports these communities through strengthened HIV prevention and risk reduction, accessible and confidential counselling and testing, and linkages to high quality adherence and care support.…”