title: Early sexual initiation and multiple sexual partners among Vietnamese women: analysis from the Multiple Indicator Cluster Survey, 2011.
abstract: BACKGROUND
  Under current HIV transmission mechanisms operating in Vietnam, women are seen as victims of their male partners. Having multiple sexual partners is one of the well-known risk factors for HIV infection. However, little is known about women's risky sexual behaviour and their vulnerability to HIV in Vietnam. This study aims to explore association between early sexual initiation and the number of lifetime sexual partners in Vietnamese women. Although the Vietnamese culture is socially conservative in this area, identifying women's risky sexual behaviour is important for the protection of women at risk of HIV and other sexually transmitted diseases.
  
  
  METHODS
  A total of 8,791 women, who reported having had sexual intercourse, were included in this analysis of data from the 2011 Multiple Indicator Cluster Survey in Vietnam. Data were collected using two-stage strata sampling, first at the national level and second across six geographical regions (n=8,791). Multivariable logistic regressions describe association between early initiation of a sexual activity and lifetime multiple sexual partners.
  
  
  RESULTS
  Early sexual intercourse was significantly associated with having lifetime multiple sexual partners. Women who were aged 19 or younger at first sexual intercourse were over five times more likely to have multiple sexual partners, compared with women whose first sexual intercourse was after marriage; aged 10-14 years (OR=5.9; 95% CI=1.9-18.8) at first intercourse; and aged 15-19 years (OR=5.4; 95% CI=4.0-7.2) at first intercourse. There was significant association with having multiple sexual partners for women of lower household wealth and urban residence, but the association with educational attainment was not strong.
  
  
  CONCLUSIONS
  The study results call for health and education policies to encourage the postponement of early sexual activity in young Vietnamese women as protection against risky sexual behaviour later in life.
authors.affiliation: Institute of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam; dinhthaison@gmail.com.
authors.forename: Dinh Thai
authors.initials: DT
authors.lastname: Son
authors.affiliation: JW LEE Center for Global Medicine, Seoul National University College of Medicine, Seoul, South Korea; oh328@snu.ac.kr.
authors.forename: Juhwan
authors.initials: J
authors.lastname: Oh
authors.affiliation: JW LEE Center for Global Medicine, Seoul National University College of Medicine, Seoul, South Korea.|Public Health Joint Doctoral Program, San Diego State University and University of California, San Diego, CA, USA.
authors.forename: Jongho
authors.initials: J
authors.lastname: Heo
authors.affiliation: Institute of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam.
authors.forename: Nguyen
authors.initials: N
authors.lastname: Van Huy
authors.affiliation: Institute of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam.
authors.forename: Hoang
authors.initials: H
authors.lastname: Van Minh
authors.affiliation: JW LEE Center for Global Medicine, Seoul National University College of Medicine, Seoul, South Korea.
authors.forename: Sugy
authors.initials: S
authors.lastname: Choi
authors.affiliation: Institute of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam.
authors.forename: Luu Ngoc
authors.initials: LN
authors.lastname: Hoat
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D000328:Adult; D002648:Child; D003075:Coitus; D017280:Condoms / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000517:prevention & control; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012309:Risk-Taking; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000517:prevention & control; D011795:Surveys and Questionnaires; D014744:Vietnam; D055815:Young Adult
keywords: adolescent sexual behaviour; early sexual initiation; first intercourse; multiple sexual partners; risky sexual behaviours