Strategies for Developing Gender–Specific HIV Prevention for Adolescents in Vietnam

Abstract

In Vietnam, between 2000 and 2006, HIV rates among 15- to 49-year-olds in the general population have increased from 27% to 53%. The HIV epidemic is occuring in a context of rapid socioeconomic changes, which have brought about conflicting ideals and norms between "traditional" and "modern" gender roles. We discuss the processes for developing the Exploring the World of Adolescents gender-specific HIV prevention curricula for 15- to 21-year-old adolescents living in both rural and urban Vietnam. The curricula are modeled after an existing HIV prevention program previously adapted and evaluated in Vietnam (Vietnamese Focus on Kids) and based in social learning theory (prevention motivation theory) contextualized within socioeconomic changes. The overall capacity building and participatory strategies for program development included (a) review of the HIV/AIDS and socioeconomic conditions in Vietnam, (b) review of the Vietnamese Focus on Kids curriculum themes and the theoretical constructs from the protection motivation theory, () analysis of qualitative and quantitative needs assessment data to incorporate culturally significant issues of gender and sexuality, and (d) a review of themes and activities from existing evidence-based adolescent reproductive health curricula.

Respecting the circle of life: one year outcomes from a randomized controlled comparison of an HIV risk reduction intervention for American Indian adolescents

“…Our evaluation shows that a behavioral health intervention rooted in PMT and adapted for an AI community can improve condom use self-efficacy, but it does not provide evidence of long-term intervention impact on high-risk behaviors. Attenuation of initially strong intervention effects is consistent with past evaluations of the original EBI, FOY (Gong et al, 2009;Kaljee et al, 2005;Lerdboon et al, 2008;Li, Stanton, Feigelman, & Galbraith, 2002;Lwin et al, 2010;Stanton et al, 1996Stanton et al, , 1997.…”

“…The EBI "Focus on Youth" (FOY), developed for African-American adolescents and successfully implemented in various populations around the world, was selected for adaptation (Gong et al, 2009;Kaljee et al, 2005;Lerdboon et al, 2008;Lwin, Stanaland, & Chan, 2010). The Protection Motivation Theory (PMT) underpinning FOY posits that the perceived threat of HIV infection initiates two cognitive pathways: (1) threat-appraisal (risk) balances the threat of contracting HIV including intrinsic/extrinsic rewards vs. the severity of HIV and one's perceived vulnerability; (2) coping-appraisal (protective) balances one's ability to avoid the threat through self-efficacy and response efficacy vs. the relative cost of the adaptive behavior.…”

Gender, Alcohol Consumption Patterns, and Engagement in Sexually Intimate Behaviors Among Adolescents and Young Adults in Nha Trang, Viet Nam

“…While many of these economic changes have been received with enthusiasm by the government and the local populace, resultant social changes associated with the “open door” policies have come under scrutiny and criticism (Kaljee, Tho, Hung, & Diep, 2008; Lerdboon et al, 2008). In particular, the current generation of adolescents and young adults has become more independent with increasing access to goods and services, for example, mobile phones, motorbikes, and information through the Internet and satellite television.…”

Looking at complicating non-biological issues in women with HIV

“…[48] Such gender norms are different in various societies and subject to change with time. [49] Yet, in many countries, especially in the developing world where HIV is spreading fast, females serve a subservient role to men as dictated by gender norms and culture. [5051] These traditional norms place women at an increased risk as they have less freedom in choosing their partners, initiating and pacing sexual activity and negotiating on safer sex.…”