Predictors of visits to commercial sex workers by male attendees at sexually transmitted disease clinics in southern Vietnam

Objectives: To determine the HIV/sexually transmitted disease (STD) status of male patients at STD clinics and factors associated with frequent visits to commercial sex workers (CSW) in southern Vietnam. Design: Cross-sectional survey. Methods: Confidential interviews and physical and laboratory evaluation of 804 male patients at STD clinics in two semi-rural provinces in the Mekong delta. Results: HIV seroprevalence was 0.5%. The prevalence of urethritis syndrome was 19.3%, gonorrhea 10.2% (Gram-stain positive) and syphilis 2% (reactive rapid plasma reagin test). All the men had visited CSW in the past and 58% had their first sexual experience with a CSW; 73% had visited a CSW in the last 3 years. Married men were equally as likely as single men to have cas ual partners or to have visited a CSW. The men recruited CSW more From the streets (45%) than from brothels (38%). Factors independently associated wi th visiting a CSW in the last 3 years included being single [odds ratio (OR ), 2.2], age under 20 years (OR, 1.9), having first sexual intercourse with a CSW (OR, 2.1), not having a current girlfriend (OR, 2.1), using alcohol before sex (OR, 2.7) and drug use (OR, 1.8). Only 7% of men used condoms co nsistently; 70% had never used them. Only 37% had used a condom last time t hey had intercourse with a CSW. Conclusions: Prevention programs for men in Vietnam, particularly those who are young or single, need to focus on reducing drug and alcohol consumptio n and improving condom use with CSWs. (C) 1999 Lippincott Williams & Wilkin s.