title: Drug users in Hanoi, Vietnam: factors associated with membership in community-based drug user groups.
abstract: BACKGROUND
  A syndemic conjoins injection drug use, incarceration, and HIV in Vietnam, where there is a need for programs that empower people who use drugs to minimize the harms thereby produced. Here we present a post-hoc evaluation of the organizing efforts of the Centre for Supporting Community Development Initiatives (SCDI) with two community-based drug user groups (CBGs) in Hanoi.
  
  
  METHODS
  Members (n = 188) of the CBGs were compared to non-member peers (n = 184) on demographic, psychosocial, behavioral and knowledge variables using a face-to-face structured interview that focused on issues of quality of life and harm reduction. Bivariate analyses were conducted, and variables significantly associated with membership at p < 0.10 were included in a multivariate model.
  
  
  RESULTS
  Variables associated with membership in the CBGs in the multivariate model included increased self-efficacy to get drug-related health care (OR 1.59, 1.24-2.04), increased quality of life in the psychological (OR 2.04, 1.07-3.93) and environmental (OR 2.54, 1.31-4.93) domains, and greater history of interactions with police about drugs (OR 3.15, 1.79-5.52). There was little difference between members and non-members on injection-related harms except in the domain of knowledge about opioid overdose. Among the 114 current injectors (30.6% of the sample), low rates of unsafe injection practices were reported, and low statistical power limited the ability to conclusively assess association with membership.
  
  
  CONCLUSIONS
  Although the CBG members displayed higher levels of well-being and access to healthcare than non-members, further longitudinal study is required to determine if these are a result of membership. The CBGs should pay more attention towards meeting challenges in responding to specific health issues of those who continue to use drugs including HIV, hepatitis, and drug overdose.
authors.affiliation: Yale School of Public Health, 60 College Street, New Haven, CT 06511, USA. robert.heimer@yale.edu.
authors.forename: Eleanor
authors.initials: E
authors.lastname: Hayes-Larson
authors.forename: Lauretta E
authors.initials: LE
authors.lastname: Grau
authors.forename: Kaveh
authors.initials: K
authors.lastname: Khoshnood
authors.forename: Russell
authors.initials: R
authors.lastname: Barbour
authors.forename: Oanh Thi Hai
authors.initials: OT
authors.lastname: Khuat
authors.forename: Robert
authors.initials: R
authors.lastname: Heimer
mesh_terms: D000328:Adult; D003415:Crime / Q000523:psychology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D018671:Needle-Exchange Programs / Q000706:statistics & numerical data; D011788:Quality of Life; D012309:Risk-Taking; D020377:Self Efficacy; D012657:Self-Help Groups; D015819:Substance Abuse, Intravenous / Q000517:prevention & control* / Q000523:psychology; D014744:Vietnam