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Kien thitc, thai do, hanh vi quan he tinh due cua nam cdng nhSn di cif chifa kdt hon tai khu cdng nghiep Binh Xuygn, VTnh Phiic nam 2011
N g u y i n T h i Phtftfng', L^ Ci/ L i n h '
Mdt sd nghien ciiu gdn ddy eho thdy nguy ca Idy nhiim HIV vd cdc binh lay truyen qua dudng tinh d^c (STIs), nao phd thai do quan he tinh due (QHTD) khdng an loan gia tang dgc biet d ngudi di cU tri luoi. Nghien eiiu cdt ngang tren 203 nam cong nhdn di cUchUa ket hon tai khu cong nghiep(KCN) Binh Xuyin, VTnh Phuc ndm 2011. Kei qud eho ihdy kien thdc ve quan he linh due eua nam edng nhdn chua cao, ihdi dg ve QHTD trudc hon nhdn cdi md. Ty le nam edng nhdn QHTD trude hdn nhdn la 54,7% trong dd 24.1% nam cd QHTD vdi bgn tinh bdt chgt, 12,5% nam edng nhdn co QHTD vdi phu nH mgi ddm (PNMD). Ty If sddung bao cao su (BCS) thudng xuyen vdi ngUdiyeu Id 33,9%, bgn tinh bdi chgt 25,9% va PNMD Id 71,4%. Tdng cudng kien thiic, thuc hdnh tinh due an todn vd cung cdp BCS eho nam cdng nhdn KCN Id nhihig bi^n phdp cdn ihiel gdp phdn ngdn ngita Idy Iruyin HlV/STIs eho bgn linh vd cgng dong cdng nhii gidm Ty le nao phd thai trong ihanh niin tri.
Tbt khoa: nam cong nhdn di cuchua kit hon, quan he tinh due khong an todn.
Knowledge, attitude and sexual behaviors among unmarried migrant male workers at
Binh Xuyen industrial zone, Vinh Phuc province, 2011
N g u y e n Thi Phuong", Le Cu L§ Crf L i n h '
Some recent studies indicated that there was a potential risic with regard ro HIV spread, sexually transmitted infections (STIs) and abortion due to unsafe sex among young migrants. This cross - sectional study was conducted ar Btnh Xuyen industrial zone, Vinh Phuc province, Viet Nam in 2011 among 203 male unmarried migrant workers. The findings showed that the knowledge on sexual intercourse of male workers was not high. Attitude towards premarital sex was found rather open- minded. The proportion of male workers having premarital sex was 54.7%, in which 24.1% of them had sexual intercourse with non-regular sexual partners while 12.5% ever had sex with female sex workers. The proportion of consistent condoms use with lovers, non-regular sexual partners and female sex workers were 33.9%, 25.9% and 71.4%, respectively. Improvements on knowledge, and safe sex practice, especially condom distribution for male migrants at industrial zone are urgently
Tap chl Y r f C « n g c S n g , 6.2013, Sff 28 (28) 63 . N E « , . h t . hJi; 2i.2 2013 . N g i , p h i , bi«= 5.3 2013 • N g i , d , i . h , & : 15.3 2013 . Ngiy Mc chSp obj,. lB»g 25 4.2013
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needed and this could help to prevent HIV/STI spreading as well as to reduce the percentage of abortion among young adulis.
Keyword: unmarried migrant male workers, unsafe sex.
CAc tic gia
1 Trddng Dai hoc Y t£'Cdng cOng
1. Dat vd'n d l
Quan he tinh due (QHTD) finh due khdng an loan la m^t trong nhffng nguy ccf cao liy nhiem HIV v i c i c STIs khac. BSn canh do QHTD khdng an toan trffdc hdn n h i n cung l i nguyen nhan ciia vi'n de nao p h i thai trong nff thanh thieu nien tre dang gia t i n g hien nay. C i c v^n d l trSn khong chi xay ra d thanh thiS'u niSn m i cdn d lao dgng di ctf tre tuo'i.
Tren the' gidi c i c nghien ctfu v^ QHTD cua eong nhan, lao ddng di cff chu ye'u giffa c i e nffdc v i tap trung d c i c nffdc cd kinh te' cham p h i t Irien d Chau A va Chau Phi. Nhin chung ki^n thffc ve HIV va sffc khde tinh diic, su'c khde sinh san ciia lao ddng di ctf cdn thap. Sd'han tinh cua lao ddng di cff eao hdn ngffdi khong di cff, nam lao ddng di cff cd hdn mdt ban tinh (tff 13% - 85%) [6][12]. Ty IS nam lao dgng di cff cd QHTD vdi phu nff mai d i m (PNMD) dao dgng khoang 7-70% [7][8]. Ty le sff dung BCS khi QHTD trong khoang 3 - 86%, tuy nhiSn ty IS pho biS'n khoang 30% trong cac nghiSn cffu dtfde tim t h i y [9][10).
Di cff d Viet Nam thffdng dtfcfc chia thinh ba nhdm: Lao dgng di ctf tff ndng thdn ra thanh thi d e i c khu cdng nghi$p va khu che xui^E; Nhdm d i n di cff v i di bien ddng d khu vffc bien gidi: Lao ddng Viet Nam x u i t kh^u hien dang sdng va lam viec d nffdc n g o i i . Dd'i vdi ca ba nhom trSn c i c nghiSn ctfu ve h i n h vi tinh due v i sffc khoe sinh san (SKSS) chtfa n h i l u dae bi?t la nhdm lao dpng di ctf tai c i c KCN, khu che'xusft. Nghien cffu cat ngang gan day (2010) v e HIV tren cdng nhan cdng ty than tinh Quang Ninh cho ke't qua 1/3 cong nhan cd QHTD trffdc hdn nhan, 74% da tffng QHTD vdi PNMD. gan 1/2 trong so dd khdng sff diing BCS khi QHTD [2].
NghiSn ctfu nay nh^m md ta kiS'n thtfc. t h i i dg, h i n h vi QHTD cua nam cdng nhan di cff chtfa ket hdn lai KCN Binh XuySn tinh Vinh Phuc. Tren cd
sd dd dffa ra mdt sd' khuyS'n nghi cho c i c chffdng trinh sffc khde sinh san (SKSS) v i sffc khde tinh due (SKTD) ddi vdi nam cdng nhan di ctf KCN trSn dia b i n huyen.
2. Phtfdng phap nghien ctfu
Nghien cffu dtfdc tien h i n h tff 11/2011 - 4/2012 tai 3 xa/thi tran Hffdng Canh, Dao Dffc, Tam Hdp.
Nghien cffu cat ngang dinh Itfdng tren toan b§ nam cdng n h i n di cff chffa k€l hdn. Ti^p can c i e nam cdng nhan tren tai phdng tro eua hg vao bu^i trffa, tdi, dung bd cau hoi ttf d i l n khuyS^E danh. Khi de'n gia dinh cd cdng n h i n thue trg xin phep chu n h i v i hdi thdng tin liSn quan de'n tinh trang ket hdn cua c i c nam cdng n h i n tff chii nha, ban thue cung nha tro. Gap gd tai phdng trg va gidi thi?u muc dich dieu tra, n h i n manh tinh khuyet danh, htfdng d i n dien phieii v i ngdi khong q u i xa cd t h i quan s i t d l han che tdi da ban bac trao ddi giffa c i c nam cdng n h i n cung nhff tra Idi t h i e mac khi c l n thiet.
s d lieu dtfdc n h | p bang p h i n mem Epi data va p h i n tich bang SPSS 18.
Mgt sd khdi niim vd thang do ddng trong nghien cliu
QHTD trong nghiSn cffu nay dtfdc hieu la sff giao hdp dffdng i m dao h o i c hau mdn. Ban tinh thtfdng xuyen: dtfde h i l u l i ngtfdi yeu, ngtfdi sdng cffng. Phu nff mai d i m : l i ngtfdi cd quan he tinh due ddi lay tien, qua t i n g (vit chat) hoac ma tdy. Ban tinh khdng thtfdng xuySn (ban tinh bat chdt) khong phai ngtfdi yeu, khdng sd'ng cung, khong quan h§
tinb due doi lay tiln, khdng cd quan he tinh due thtfdng xuyen ma chi quan hd tinh due ngau hffng.
bat chdt [13]. Chtfa cd dinh nghia thdng nhat ve ngtfdidictf cung nhtfedng nhan di ctf, trong nghiSn cffu nay, nam cdng nhan di cff la nam gidi di chuyen tff ndi thffdng tni (que quin) dS'n d ndi k h i e (tam thdi h o i c lau dai) de l i m cdng n h i n . 64 Tap chi Y t^ Cdng cdng, 6.2013, Sd 28 (28)
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Thang do kien thffc chung: gom 10 cau hdi cd ban nhi't ve: tinh due an t o i n . thai nghSn, c i c bSnh l i y qua dffdng tinh due, stf dung bao cao su ddng c i c h trong phdng trinh thai va t r i n h STIs. Vdi cau hoi 1 Iffa chgn diem tdi da l i 1 d i l m . cau hdi nhieu Iffa ehgn diem td'i da la 2 (ehgn dung 1/2 so'Itfa chgn dtfdc 1 diem, hdn 1/2 sdltfa chgn dffdc 2 dilm). Sd diem nhd nhS^t la 0, cao nhat l i 16 diem. Ngtfdi c6 tdng diem eao hdn d i l m trung binh chung cua quan the (mean) dtfdc ggi l i cd kie'n thffc "phu hdp", e i c trffdng hdp con lai goi la "chffa phu hdp".
Thang do t h i i dg ehung: Cd 10 quan d i l m chia lam 2 nhdm de' tinh d i l m : cd quan diem phii hdp vdi hilu biet c&a da s d m o i ngtfdi de bao ve stfc khoe dtfdc tinh 1 diem v i quan diem ngtfdc lai tiuh 0 d i l m . Tdng d i l m tdi thieu la 0, tdi da la 10. C i n cff v i o gii tri trung binh d i l m t h i i dg cua quan the nghiSn cffu (mean) m i chia thinh 2 nhdm t h i i dd
"phii hdp" v i "chffa phii hdp".
3. K&'t qua nghidn cihi
5.7. Mgt sdddc diim ciia nam cong nhdn dicii
Trong toan bg 239 nam cong nhan di cff chffa k i t hdn (trong nghien cda nay ggi nit ggn l i nam edng nhin) cd 5,9 % tff cho'i tham gia va 7,3% phiS'u
Bang 1. Mgi sdddc diem chung cda nam cong nhdn di cU
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IS-25 26-35 Hpc v&i
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201 1:9 72 203 11 51 126 15 203 123 SO 191 123 58 10
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64.4 30,4 5.2
khdng dli thdng tin cdn 203 ngffdi tham gia v i h o i n thinh phie'u hdp IS.
Cd 7 nhdm n g h l cbinh ciia nam cdng nhan tham gia lao ddng, trong do n g i n h san xui't vat li?u x i y dffng c h i l m ty 1? cdng nhan tham gia nhieu nhi't (40,7%), tid'p theo l i nhdm n g i n h san xui't l i p r i p xe m i y d td va san xua't linh ki?n dien tu". Nhin chung, hg thffdng sd'ng mgt minh (58,7%), 3 % sd'ng vdi ngtfdi ySu/ban gii/bd dtfde gbi n h i n qua phi^u d i l u tra. TrSn thffc tS'qua quan s i t khi de'n phong vi'n cung thdng tin cua ban cung n h i trg cho th^y nhffng ngffdi sd'ng vdi ngffdi ySu thffdng tff chdi khdng tham gia d i l u tra, ffdc tinh ty IS nay trSn thffc te' khoang 10%. Phan ldn trong sd' hg d i u v l thim n h i Irong t h i n g , trong dd ty le v l tff 1-3 lan chiem da sd' (47,5%). Nam edng n h i n chu ydu l i m viec 8 tieng/ngiy, g i n 1/3 cdng n h i n khdng tham gia hoat ddng t i p the n i o , hoat dgng the thao dtfdc tham gia nhieu nhrt (59,1%).
3.2. Kien thdc ve QHTD Kien thiie ve trdnh thai vd nao hiit thai Trung binh moi nam cdng n h i n di ctf nghe ndi/biet 3,6/10 bien phap t r i n h thai. H i u hl^t trong sd'hg nghe ndi den BCS d l trinh thai v i it biet den tiem thude/cay que trinh thai v i dung thud'c di§I tinh trung. P h i n ldn (90,6%) cac nam cong nhin ti/
danh g i i minh biet sd dung BCS, cae BPTT khic nam cdng nhan bie't thtfc hiSn nhtfng chiS'm Iy 1§
khdng cao. Cd 4,9% nam cdng n h i n khdng bie't bat ki BPTT nao. Cd 1/5 nam cdng n h i n tra Idi dung thdi d i l m dS mang thai d phu nff (xem bieu dd 1).
Cd 14,8% nam cdng nhan khdng bie't l i c hai n i o
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Biiu ddi. Ty l^ nam cong nhdn biit cdch sddgng hifn phdp trdnh thai
cua nao p h i thai, tae hai dtfdc biet nhilu nhat la vd sinh chii'm ty 1§ cao nhat (59.6%).
Kidn ihiie vi cdc binh lay truyin qua dudng tinh due (STIs)
Tap chf Y tg Cdng cdng, 6.2013, Sd 28 (28) 65
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Hau hg'l (99%) nam cdng n h i n deu biet ten it nhi't ten 1 STIs. C i c benh it dffdc bie't de'n la hot x o i i , trCing roi. nS'm Clamydia, mtin rgp sinh due (hecpet) ChiS'm tff 10% trd xudng. Khi dffdc hdi ve nguyen n h i n mac STIs. hdn 2/3 nam cdng n h i n biet raic benh do: tiS'p xffc trffc tiep thin t h i hoJie QHTD vdi ngffdi mac bSnh khdng dffng BCS v i do QHTD vdi nhieu ngtfdi. c i c nguySn nhan khac it dffdc biS't dS'n hdn v i van cdn 5.9% nam cdng nhan khdng biSt nguyen nhan nao. Ty 1? biS't c i c b i l u hien cua STIs kha t h i p . b i l u hiSn biet nhilu nhat cung chi dat 42,4%, cd tdi hdn 1/4 (26,6%) nam cdng nhan khdng bid^t bat cff bieu hien n i o .
Biiu do 2. Ty If nam cdng nhdn biet bieu hifn thudng gap cua cdc bfnh STIs
Ve t i c hai eua c i e STIs vdi stfe khoe, nam cdng n h i n cung chtfa bie't n h i l u . T i e hai dffdc biS't nhilu nhi't dd la viSm cd quan sinh due (66,0%), biS't it nhi't l i tff vong (7.9%). Van cdn tdi hdn 1/4 (26,6%) nam cdng nhan khong biet: ludn sff dung BCS dtfng e i c h cd the phdng t r i n h dffdc c i c benh STIs. Ty 1^
nam edng nhan ttf d i n h gia bie't sff dung BCS ri't cao (90,6%), tuy nhiSn chi cd 62,1 % nam cdng n h i n Iffa chgn dung c i c h sff dung BCS dung trong bg c i u hoi. Van cdn 4,4% nam cdng nhan khdng biet ndi n i o cd t h i dieu tri c i c benh STIs,
D i n h g i i kie'n thtfc chung v l QHTD, cd 61,2%
nam cdng n h i n cd kiS'n thtfc "phu hdp" ve QHTD ( d i l m kiS'n thtfe chung quan the' l i 8,04/14 diem).
3.3. Thdi dg ve QHTD
Thai dd v l QHTD bao gdm 4 van d e : quan d i l m ve finh due. STIs. mang thai v i nao hdt thai, stf dung BCS. D i e m trung binh chung (mean) quan the nghiSn cffu la 6,04/10 diem. Ty IS nam cdng nhan cd t h i i dd "phii hdp" (> 6 d i l m ) chie'm 41,9% v i
"chtfa phff hdp" la 58,1%.
Xel c i c quan diS'm v l QHTD cho thi'y quan
diem cua nam cdng n h i n v l QHTD tffdng dd'i edi md. Cd 49,3% nam cdng n h i n ddng y vdi quan diem: "Cd the QHTD trUdc hdn nhdn neu hai ngUdi yeu nhau". Ket qua tuang tii vdi quan diim: "Khdng nen QHTD khi chua ket hdn " 40,9% nam cdng n h i n ddng y.
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k CAiWqHITi C c i W ^ i n >Bieu do 3. Thdi d$ cia nam cdng nhdn ve quan hf linh due
Da sd (82,6%) nam cdng nhin deu ddng finh vdi quan diem: C i c benh STIs cd the phdng tranh dtfdc.
Tuy nhien cd ltfdng ldn chie'm gan 2/3 (59,7%) nam cdng n h i n ddng finh vdi quan diem: Chi cd nhffng ngffdi QHTD bffa bai mdi mac c i c b^nh lay qua dtfdng tinh due,
Quan diem v l t r i n h thai v i nao hut thai cho thi'y nam cdng nhan cd thai dg tich ctfc v i tiS'n bd.
H i u he't nam cdng nhan (88%) ung hd quan diem:
Nam gidi cung eln ed trich nhiem trinh thai cho nff gidi. Va cd 77.6% nam gidi phan dd'i quan diem:
Nao hut thai la chuy?n binh thffdng nS'u cd thai ngoai ^ mudn.
Trong hai quan diem ve sff dung BCS cho thay hdn 2/3 nam gidi deu ddng finh vdi quan diem tich cffe (Dung bao cao su t h i hien trich nhiem va stf quan tam den nhau) v i khdng ddng 'y vdi quan d i l m : BCS chi d i n h eho mai dam v i ngtfdi khdng chung thuy.
3.4. Hanh vi quan h$ tinh due tntdc Hon nhan Trong sd'203 nam edng nhin chtfa ke't hon Iham gia nghiSn effli cd 112 ngtfdi (chie'm 54.7%) d i tffng QHTD. Trong sd' nhffng ngffdi d i QHTD, sd ban finh trung binh eua nam cdng n h i n tff trffdc den nay l i 2.1 ngtfdi, Ty IS da QHTD t i n g Ien theo nhdm tudi.nhdm 18-21 tudi cd g i n 1/3 d i QHTD va nhdm mdi cao nha't 30-35 tudi cd tdi 82,4% da tffng QHTD.
Trong sd'nam cdng nhan d i tij^g QHTD. sd nam 66 Tap chi Y t^ C6ng c0ng, 6.2013, Sd 28 (28)
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Biiu do 4. Ty If QHTD trUdc hon nhan theo nhom tuoi
cd 2 ban tinh trd ISn chiein 38.4%, cd 3 ban flnh trd ISn chidm 85,6%, 16.9% cd tff 4-27 ban finh. 100%
nam cong nhin da tffng QHTD cd ban finh la ngffdi ydu, gan 1/4 trong s d h o c6 QHTD vdi ban tinh ba't chdt va 12,5% da tffng QHTD vdi PNMD. S d b a n tinh trung binh l i ngffdi yeu eua nam cdng nhan di cff KCN l i 2 ngffdi (1,9), ban finh bat chdt la 2 ngffdi (2,1) va PNMD l i 3 ngffdi (2.6).
Bdng 2. Ty If sd dgng BCS vdi cdc logi bgn linh
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dffdc t m y l n thdng, gan 1/4 cho bie't ho dffdc truyen thdng 1 -2 lan ehu ydu la ndi chuyen trffc tie'p d cdng ty/nba m i y . Trong n i m vffa qua tai xa dang tam tni, 65,1 % nam cong n h i n khdng dffdc truyin thdng lan n i o , 2 1 % dffdc truyen thdng chu yeu b i n g p h i t tin tren loa truyin thanh cua c i e xa/thi t r i n . 20,7%
nam cdng n h i n dffdc ttf van QHTD an t o i n , chu yeu tff e i n bd y te d que (18,1 % ) , y te nha miy/cdng ty v i y te ndi tam tru (11,3% - 11,8%).
3.5. Cdc mdi lien quan den hdnh vi QHTD tn^c hon nhdn
Sau khi nghiSn cffu td'ng quan tai li^u v l QHTD d cdng n h i n . ngffdi lao ddng tren thS'gidi v i d Viet Nam chung tdi da Iffa chgn mgt sd' yeu td'liSn quan cd S nghia thd'ng kS dffa v i o p h i n tieh Bdng 3. Mo hinh hoi guy da biin cdc yiu tdliin
quan din QHTD cua nam cong nh&n
Nam cdng nhin b i t d i u QHTD lan dau trung binh khi 21 tudi (sdm nhat la 16 va mugn nhat l i 26 tudi). Ban finh d i u tiSn eua ho da sd (88,4%) l i ngffdi ySu ngoii ra cdn ban g i i (khdng phai ngffdi ySu) chiem 7.1%. Trong lln QHTD lan dau tiSn, g i n 1/4 nam cdng nhan khdng dung ba't ctf biSn p h i p n i o va chi 1/2 trong sd dd stf dung BCS khi QHTD vdi ban fmh dau uSn. Cd 6,3% nam cdng nhin cho biet ngffdi ySu eua hg d i mang thai ngoai y mudn 1- 3 lan v i c d t d i 1/5 trong so'dd khdng biet ngtfdi ySu minh ed mang thai hay khdng. Ty 1^ nam cdng nhan ttf b i o mac STTs la 3,6%.
Trong nam vffa qua, ngudn thdng lin ehu yeu m i nam cdng nhan nhan dffdc la ti vi chid'm 64%, Internet chiS'm 45,8%, d i i va sach bio/tap chi. td rdi chiem tff 37-39%. ban bS, ngffdi than ehiem 22- 24%, c i c nguon khac chiem ty le dffdi 20%. Tai KCN. 66.7% nam cdng nhan cho bidt ho khdng
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Tap chl Y t( C6ng cflng, 6.2013, S6 28 (28)
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ddi bien (kiem dinh chi-square) v i da bien. C a c ySu td' bao gdm: tudi, hoc van, ngtfdi d cung, thu nhap, loai di cff. s d l l n \i tham nha, s d gid l i r a vi^c trung binh, tinh trang sff dung rtfdu/bia, xem phim anh khiSu d i m , diem ki^n thffc v l QHTD, d i e m t h i i dd ve QHTD. Sau khi thffc hiSn e i c k i e m dinb thdng ke md hinh hdi quy da bie'n d b a n g 3 l i md hinh phu hdp.
Kiem dinh hdi quy da biS'n cho thay nam cdng nhan di ctf ldn tuoi c6 nguy cd QHTD trtfdc hdn n h i n cao gap 6,6 lan nam cdng nhan tff 25 tuoi trd xud'ng.
Tffdng Iff nhtf v§y nguy c(} cua nam cdng nhan d mgt minh gi'p 2.7 l l n nam edng nhin d cung ngffdi k h i c . Nhiftig nam cdng nhan lam viec tff 6-8 tidng/ngiy cd nguy cd gi'p 7,7 lan nhffng ngtfdi l i m viSe hdn 8 tieng/ngiy. Nam cdng n h i n cd sff dung rffdu bia co nguy cd QHTD trffdc hdn nhan nhieu hdn 6 l l n nam khdng sff dung rffdu bia. Nam cdng nhan cd diem kien thffc tdt cd nguy ed QHTD trtfdc hdn nhan ga'p 3,48 lan nam cd diem kie'n thtfc chffa tdt.
4 . B ^ n luSii
Tai Ddng Nam A ndi chung va Viet Nam ndi ridng, nam gidi v i n ddng vai trd quyet dinh, quan trgng trong QHTD v i sff dung c i c bien p h i p t r i n h thai. Hidu bid^t vd c i c bien p h i p trinh thai va t i c hai cua nd l i yS'u td quan trgng gdp p h i n phdng tranh thai va sff dung BCS thffdng xuySn diing each l i m giam ty IS l i y n h i l m HIV/STIs. Tuy nhien nam cdng n h i n di cff KCN chi biet 3,6/10 biSn p h i p t r i n h thai, thi'p hdn t? IS chung cua thanh thid'u nien qudc gia ( S A W lan 2) 5/10 bien p h i p [4]. N g o i i ra c i e bidu hiSn thtfdng gap cua STIs l i c l n thiet dd nam eong nhan di k h i m va dieu tri tuy nhien cd ty 1? d i n g ke nani cdng n h i n khdng bie't bidu hien thffdng gap n i o (26,6%). Dieu dd cho thay c i c thdng tin nay cdn thiS'u ddi vdi nam cdng nhan di cff.
Ty le nam cdng nhan chffa kdt hdn da tffng QHTD chiem t^ le ttfdng ddi cao (54,7%), cho thi'y vi^c QHTD trffdc hon nhan hien nay tffdng dd'i pho biS'n. Ke't qua nay cung tffdng ddng vdi quan diem ciia da so; nam gidi thtfdng dtfdc c h i p n h i n QHTD trffdc hdn nhan v i kinh nghi^mtinh due xem nhtf l i thude finh quau U-gng cua nam gidi [14]- Ty le nay cung cao hdn kS't qua nghien cffu trSn cdng nhan than Nui Beo, Quang Ninh (1/3 QHTD trffdc hdn nhan) v i cao hdn nhidu so vdi nghiSn effu tren cdng nhan thuy di?n Sdn La (5,23%) [2], [3]. T j le QHTD trtfdc hdn nhan ciia nam cdng nhan Binh
Xuyen cao cd the do nghiSn cffu nay fien hanh trSn nam cdng n h i n di ctf trong khi cac nghiSn cffu k h i c tien h i n h tren cdng nhan noi chimg v i k h i c biet vd phffdng p h i p tiep can.
Kiem dinh da bien cho thay nhffng nam cdng n h i n Idn tudi hdn (>25 tudi), nhffng nam cdng nhan lam viec tff 8 tidng trd xud'ng cd xu hffdng QHTD trffdc hdn n h i n nhidu hdn. Cd the nam cdng nhan ldn tudi cd khoang thdi gian dgc than l i u hdn va cd thdi gian d i i de tim hieu nhidu ban gai hdn nSn cd xu hffdng QHTD cao hdn nhdm edn lai. Kdt qua n i y eung tffdng tff ket qua nghien cu^ SAVY lan 2 [5].
Tffdng ttf nhff vay nhffng nam cdng n h i n sd'ng mdt minh cung la didu ki^n thuan Idi de thtfc hiSn QHTD trtfdc hdn nhin. Ngoii ra nhffng nam cdng nhan cd sff dung rffdu bia cd ty IS QHTD trffdc hon n h i n nhidu hdn mdt lan nffa khang dinh rffdu bia l i ye'u td anh hffdng den h i n h vi tinh due.
NghiSn ciJu eung cho thSTy nam cdng n h i n ed diem kie'n thffc cao c6 nguy cd QHTD trffdc hdn nhan nhidu hdn, didu n i y gdi ra vi'n de Ii?u ed phai nam cdng nhan da QHTD cd trii nghidm thffc te'nen hidu hdn, quan t i m fim hieu kie'n thffc nhieu hdn ching? Van de n i y can bd sung thSm thdng tin tff cac nghiSn cffu k h i c de cd ket luan chinh x i c . Dd cung la ban ehd eiia nghien cffti nay va nghiSn ciSli cat ngang k h i c trong viec 1^ giai nguyen nhan.
N g o i i ra nghien cffu thtfc hien tren mau chtfa ldn d dia b i n nho nen chffa dai diSn cho nam cdng n h i n d e i c KCN va e i c vung k h i c .
Ben canh dd, ty le QHTD vdi ban finh la PNMD eung khdng nho, kS't qua cua nghien ctfu nay 12.5%
tff trffdc tdi nay eao hdn kdt qua nghiSn cffu d Khinh Hda (10% ngff dan v i 8,3% d cong n h i n ddng tau) [11]. Dieu n i y cho tha'y nam edng nhan di ctf tai c i c KCN ed nguy cd ttfdng dd'i cao trong l i y truyen e i c benh STIs d^c biSt la HIV/AIDS. Ben canh do van cdn bdn 1/4 nam khdng sff dung BCS thtfdng xuySn khi QHTD vdi PNMD. Tf le n i y cao hdn nhieu so vdi nghien ctfud Ihanh niSn H i i Phong (10.8%) [1].
Dd thtfc stf la nguy cd ldn mang den bSnh tat anh hffdng de'n sffc khoe. sffc khde finh due va sinh san ciia cdng nhin,
Y te' c i c cap e l n phd'i hdp vdi c i e cdng ty/nhi miy/xi nghidp tai cac KCN huyen Binh XuySn cung ci'p them c i e thdng tin vd tinh due an l o i n cho nam edng nhan di ctf, chu trgng de'n thong tin ve stfdung BCS, tac hai cua STIs v i nao p h i thai. Ben canh dd, khi x i y dtfng cac ehtfdng trinh can thiep cho nhdm Tap chi Y t^ Cdng cdng, 6.2013, Sd 28 (28)
I TOMB QUAN & NGHIlN C t U I
n i y eung ltfu y tfu tiSn nam edng nhan ldn tudi, d mdt minh va cd siJdung rtfdu bia. Ngoai ra eai thien thtfc h i n h finh due an t o i n qua sff dung BCS dung
c i c h ciing nhff dtfa e i c dich vu ve sffc khoe sinh san dS'n g i n theo dac tnmg cua cdng nhan di etf trSn dia ban huyen.
Tii ][$u tham khao Tifng Vift
1. Dtfdng CSng Thanh vi cdc cgng sir. (2008), "Cdc hinh vi tinh due nguy cd vi b^c cdu trong tbaoh oifn d Hai Ph6ng, Vi^t Nam", Gi<3i, Qnh due vi site khoe dnh due 15/2008 2. mo Hue Lan (2011), KiS'n thtfc, thii dO, thtfc hinh v^
phdng. cbSog HIV/AIDS vi m$l so yeii t6 lien quan cia cfing nhSn tai eong ty than Nili B6o Quing Ninh nim 2011, DHYlf C6ngc$ng,
3. D5 van Thinh (2007), Kifn thtfc. thfii dO, thtfc hanh ph6ng chfi'ng ISy nhifim HIV/AIDS d c6ng nhSn xgy dtfng thuy di^n Sdn La nim 2007, D^i hpc Y tfcdng c$ng. Hi Npi.
4. Tdng cue Dan sf-KHHGD, QuJ Dan sf Lien b(Jp qu6c vi NgSn hing phfit uiia Chiu A (2010), Bdo cio ehuyen Si Stfc kh6e sinh san Sifc kh6e Qnh due cia Thanh thifu nien Vi^t Nam - SAVY2,
5. T5ng c\fc Dan so-KHHGD vi long cue thfi'ng k6 (2010), Diiu tra qucfc gia vi Vi thinh nifin vi Thanh ni6n Vi^t Nam llntbit2,HiNpi.
6 A. Faiscl vi J. Cleland (2006), Migrant men, a priority for HIV control in Pakistan?, 82307-310.
7. A, K. Deb et al. (2009), "HIV transmission potential among local and migrant factory workers in Kolkata, India",
AIDS Behav. 13(5), p. 928-38.
8. A. P. Emilio, A. F. Chcnoa and M. Chris, Q., (2004), "Use of Commercial Sex Workers Among Hispanic Migrants In North Carolina: Implications for the Spread of HIV", Perspectives on Sexual and Reproductive Health.
36(July/August 2004).
9. A, S, Melissa et at. (1/11/2004), "The Epidemiology of HIV Among Mexican Migrants and Recent Immigrants in California and Mexico", JAIDS Journal of Acquired Immune Deficiency Syndromes. 37(pp S204-S214).
10. M. W. Borgdorff ct al (1994), "Sexual partner change and condom use among urban factory workers in northwest Tanzania", Genitounn Med. 70(6), p. 378-83.
11. Nguyen Van Hiep, C. Donn and Ton That Toan (2008).
Homosexual behavior and sex work among migrant male workers in Vietnam (in Khanh Hoa province).
12. P, Thongphit (2009), "PHAMIT: A program on HIV/AIDS prevention among migrant workers". Field Actions Science Reports. 3/2009.
13. Population Council (2007). "Injecting drug use in India:
Understanding Sexual Behaviours and Sexual Networks to Design Effective Change Strategies", Population Council 4/2007, p. 1.
14. Quach Trang (June 2008). "Femininity and sexual agency among young immairied women in Hanoi", Culture, Health & Sexuality. 10 (Supplement),
Tap chi Y td Cdng cdng, 6.2013, Stf 28 (28) 69
