title: Substance use among male sex workers in Vietnam: prevalence, onset, and interactions with sexual risk.
abstract: BACKGROUND
  HIV research in Vietnam has focused primarily on its large heroin injector population. Data on men who have sex with men [MSM], particularly the large and growing population of men who exchange sex for money or other material rewards, male sex workers [MSWs], is very limited.
  
  
  METHODS
  Data derive from a cross-sectional study of MSW, age 16-35, recruited using community sampling methods in three cities in 2010-2011, including Hanoi, Ho Chi Minh City [HCMC], and Nha Trang City (n=710). Assessments included demographic characteristics, substance use, sexual risk, and use of health services. A series of "event" questions were used to assess the influence of alcohol and drugs on sexual risk.
  
  
  RESULTS
  Both tobacco and alcohol are initiated at a young age and most participants currently use both substances overall across all three cities. While alcohol and tobacco use precede the initiation of sex work, stimulant and opiate use are initiated following the initiation of sex work. There was substantial overlap between substance use and sexual risk, and this overlap was strongest in sexual events involving male and female elective partners rather than sex work clients.
  
  
  CONCLUSIONS
  Although rates of HIV infection in this group are low, this may be an artifact of the young age of the sample. High rates of drug use, including alcohol, tobacco and illicit drugs, coupled with high rates of ulcerative STIs such as HPV, suggest the potential for rapid amplification of STI/HIV risk among MSW and their complex sex partnering networks.
authors.affiliation: New York University College of Nursing, 726 Broadway, 10th Floor, New York, NY 10003, United States. Electronic address: gy9@nyu.edu.
authors.forename: Gary
authors.initials: G
authors.lastname: Yu
authors.affiliation: School of Public Health, University of Puerto Rico Medical Science Center, San Juan, PR, United States.
authors.forename: Michael C
authors.initials: MC
authors.lastname: Clatts
authors.affiliation: New York University College of Nursing, 726 Broadway, 10th Floor, New York, NY 10003, United States.
authors.forename: Lloyd A
authors.initials: LA
authors.lastname: Goldsamt
authors.affiliation: Center for Research and Training on HIV/AIDS, Hanoi Medical University, 1 Ton That Tung Street, Room 601, Building A1, Hanoi, Viet Nam.
authors.forename: Le M
authors.initials: le M
authors.lastname: Giang
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000428:Alcohol Drinking / Q000453:epidemiology; D018451:Homosexuality, Male / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D015995:Prevalence; D060386:Sex Workers / Q000523:psychology / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000453:epidemiology*; D064424:Tobacco Use / Q000453:epidemiology; D047568:Unsafe Sex / Q000523:psychology / Q000706:statistics & numerical data; D014744:Vietnam / Q000453:epidemiology; D055815:Young Adult
keywords: Male sex work; Onset of drug and sexual risk; Vietnam