Male Sex Work and HIV Risk among Young Heroin Users in Hanoi, Vietnam

The present study describes complex drug and sexual risk in a group of male sex workers who were recruited in the context of a larger study of young heroin users in Hanoi, Vietnam. Male sex workers were significantly more likely than male non-sex workers to be migrants and to have unstable housing, to have lifetime exposure to marijuana, 3,4 methylenedioxymethamphetamine (MDMA, ecstasy), amphetamines, cocaine and morphine. Male sex workers are more likely to currently use MDMA, amphetamines, morphine and to 'smoke' as their most frequent mode of heroin administration. Male sex workers are more likely to have both male and female concurrent sex partners, to have a history of sexual victimisation, to have had more than three different sex partners in the past 30 days, and to have had partners who injected drugs before sex or who used drugs during sex. In their last sexual encounter with a client partner, approximately one-third (31.1%) reported having had receptive anal sex. In nearly three-quarters of these exchanges (71.4%), no condom was used. Similarly, in their last sexual encounter with a client partner, 42.2% reported having had insertive anal sex and in nearly half (47.4%) of these encounters no condom was used. Consistent with recent data from elsewhere in the region, there is an urgent need for additional research on male sex work in South-east Asia in order to properly situate behavioural interventions for male sex workers in this region.