CHUYEN PE: HOI NGHI KHOA HOC NGANH Y TgTJNH KHANH HOA - LAN THLf II
KIEN THUrC, THAI DO, THITC HANH PHONG CHONG N H l i M HIV CUA NHOM NAM QUAN HE TINH DUC DONG GICTl TINH KHANH HOA NAM 2010
Ton Thdt Toan*, Nguyin Thi Qui Ldm*, Trdn Xuan Chuffng**, Truffng Tdn Minh***
T O M TAT
Nghien ci>u nhSm xAc djnh kien thiic, thSi dp, thuc hSnh phdng chong n h i i m HIV cua nhdm nam quan hp tinh due dong gidi (MSIVI) tai tinh Khdnh Hda nam 2010. Co 455 MSM tham gia nghifin cu'u vdi phuong phSp chpn mSu todn bp theo ket qua ve ban do dia d u xa hOi. Ket qua cho thay da s6 nhdm MSM c6 kien thifc tot ve dudng lay truyen HIV/AIDS. 47,5% tra Idi dung t i i 14-15 cSu hoi ve kien thiic audng I^y truyen vS Ccich phdng ch6ng HIV/AIDS, nhung vdn cbn 30% MSM cho r i n g QHTD qua dudng hdu mdn Id khOng c6 nguy ca. Thdi dp c6 61,5% MSM kh6ng thao ludn vdi bgn tinh nam ve HIV hoac cdc benh LTQDTD khi QHTD qua du'dng hdu mdn khong tra tien. MSM d thdnh pho co ty le thao ludn vdi bgn tinh Id 76,3% cao han n6ng thdn (51%). Thuc hdnh cd 9 9 , 1 % MSM dd tiing s u dgng BCS trong QHTD. Nhung trong lan QHTD gan ddy nhat qua d u d n g hdu mdn phai tra tien (78,6%) vd 65,7% khdng su' dyng BCS khi QHTD vdi bgn tinh n u . Tiep cdn vidn cgng dong Id nguon cung cdp chu yeu BCS (87,9%) vd chat b6i tran tan trong nude (96,2%). Chi cd mdt ty IS thdp (19,6%) MSM cd nhdn dupe djch vu tu" van vd h5 trp ve HIV, Cd 5,7% MSM trong nghi6n ciiu dd tung s u dyng ma tCiy vd 2% cd tiem chich ma tuy.
TO" khda: Nam quan h$ tinh due ddng gi&i, MSM. b$nh LTQDTD, HIV. Kh^nh Hda.
S U M M A R Y
Research to determine knowledge, attitudes, practices in HIV prevention of men who have sex with men (MSM) in Khanh Hoa province in 2010.
There are 455 MSM study participants with all the sampling method as a result of mapping the social geography. The results showed that the majority of MSM have good knowledge about the spread of HIV/AIDS. 47,5% answered correctly from 14 to 15 questions about knowledge of HIV/AIDS transmission and prevention, but still 30% of MSM having thought of anal sex is not at risk. To attitudes, there was 61.5% of MSM have not discussed wilh male sexual partners of HIV or other STIs as anal sex does not pay, MSM rate in urban discussed with partners was 76.3% higher ttian in airal (51%) To practices, there was 99.1% had used condoms dunng sex but in the most recent sexual encounters anal pay (78.6%) and 65.7% did not use condoms when having sex with women The major source o f condoms (87.9%) and water-soluble lubncants (96-2%) were provided from peer educators. Only a low percentage of MSM (19.6%) have received counseling and support for HIV. There was 5.7% of MSM in the study had used dmgs and 2% had injected drugs.
Keywords: Men who have sex with men, MSM. STIs, HIV, Khanh Hoa
LOATVANOI:
Bdt ddu tir cudi ndm 1990, cac nghien ciiu cho thdy rdng d cac nude cd thu nhdp cao nhu Canada, My, quan he tinh due gi^a nam gidi vdi nam gidi (MSM) khdng an todn vdn Id hinh thirc lay nhiem HIV chinh [6].
Cach quan he tinh due ciia MSM qua dudng mieng va dac biet qua dudng hau mdn, nen dl dang chay mau va lay lan HIV tir ngudi da nhilm HFV sang ngudi chua nhilm [3]. M^t nilm tin rdt phd bien Id cac benh lay truySn
* Tnmg tdm Truyin thong GDSK linh Khdnh Hoa,
* * Tnrdng Dai hoc Y Duoc Hui, *** Sd Y ti tinh Khdnh h 242
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qua dudng tinh due Id benh cua phu nit vi vay it nam gidi cd quan he tinh due ddng gidi di xet nghiem cac bSnh lay nhilm qua dudng tinh due va HIV [9]. Tai Viet Nam chi sd bao cao Qudc gia thirc hien tuyen bd cam kht vh HIV/AIDS (UNGASS) vl MSM nam 2008 cho thdy: Ty Ie hien nhiem HIV Id 9%, MSM da x6t nghiSm HIV va biSt kht qua ciia minh la 16%, MSM xac dinh dung cac each du phong lay qua dudng tinh due va phu nhan cac nhdn thiic sai vl lay truyln HIV la 54%, MSM sir dung bao cao su Idn quan he tinh due gan day nhat qua dudng hau mdn vdi mpt ijan tinh nam Id 61%, MSM tilp can chuong trinh du phdng HIV la 25% [4]. Mdt danh gia nhanh dap ling ciia chuong trinh HIV/AIDS ddnh cho MSM tgi Viet Nam ndm 2009 cho th4y rdt nhilu MSM khdng cho rdng minh cd nguy co lay nhilm HIV.
Chuang trinh phdng chdng HIV/AIDS d mot sd noi chi nhan manh ddi vdi cac nguy co nhiem trimg thdng qua dimg chung bam kim tiem, quan h^ tinh dye khdng an toan vdi gai mai dam [2]. De cd bang chiing trong viec igp kl hoach phdng chdng HIV/AIDS cho nhom MSM tai Khanh Hda, chiing tdi da tiln hanh nghien curu vdi muc tieu "Tim hieu kien thirc, thdi do, thuc hdnh phong chong nhiem HIV cda nhdm nam quan he tinh due dong gidi tgi tinh Khdnh Hoa ndm 2010".
ri. o d l l a p N G VA PHUONG PHAP NGHIEN COU:
2.1. Doi tu-ong nghien cihi
Doi tupng nghien ciiu Id nhiing ngudi nam gidi quan he tinh due vdi nam gidi (MSM) tir 16 tudi trd len, gdm cac nhdm:
- Nhom chuyen gidi (bdng Id) - Nhdm GAY (bdng kin)
- Nhdm nam khac: La nhung ngudi nam gidi cd quan hp tinh due vdi nam gidi nhung khong cd khuynh hudng tinh due vdi nam gidi.
Tieu chudn chgn:
• Tu nhan Id cd hanh vi quan he tinh due ddng gidi nam
• Dang sdng tai dia ban nghien ciiu. Id ngudi Viet Nam
• Trong 12 thdng qua phai cd it nhdt mdt lan quan he tinh due vdi nam gidi
Tieu chuan logi trir: Nhiing ngudi khdng dong y tham gia nghien ciiu
2.1.1.Dia bdn nghien ciiv
Nghien ciiu duac tiln hanh d cac nhdm MSM tai 6 huyen, thanh phd cua tinh Khanh Hda thuoc khu vuc thanh thi va nong thdn Id:
huyen Van Ninh, Ninh Hda, Dien Khdnh, Cam Lam, Cam Ranh va thanh phd Nha Trang. Chung tdi khdng tien hanh nghien ciru nhdm MSM tai hai huyen cdn lai ciia tinh Khanh Hda la hai huyen thudc khu vuc miln mii, huy?n Khanh VTnh vd Khdnh Son.
2.1.2. Th&i gian nghien cAu: Tir thang 6/2010 din thdng 6/2011
2.2. Phirong phap nghien cihi 2.2.1. Thiit ke nghiin ciru: Thilt kl nghien ciiu theo phuong phdp dilu tra md td cdt ngang.
2.2.2. C&m&u nghien ciru: Chiing tdi da quyet dinh chpn ca mdu toan bp theo ket qua thyc te ve ban do dia du xa hpi vdi so MSM tham gia nghien cma dupe chpn la 455 MSM.
2.2.3. Phuffng phdp tiin hdnh Cdc budc da tien hanh bao gom xac dinh dja diem tien hanh nghien ciiu, tuyen chpn dieu tra vien, giam sat vien, ngudi din dudng. Tap huan ve npi dung va yeu cau ciia dieu tra, ky nang tiep can, ky ndng phdng van. Phdng van true tiep ddi tupng nghien ciiu theo bd cau hdi da chuan bi trudc.
2.3. PhtfOTig phap xfr Iy so lieu Cac phieu phdng vdn sau khi Idm sach dd dupe nhap vao may tinh bang phan mem phan tich thong ke SPSS version 13.0.
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C H U Y S N BE: HOI NGH! KHOA HOC NGANH Y TE T I K H KHANH HOA - LAN THll II III. KET QUA:
Trong so 455 MSM tham gia nghien cuu, co 107 MSM 6 thanh ph6 Nha Trang va 348 MSM a cac huyen con lai. Qua phan tich, chiing toi thSy co mot s6 diSm khac biet va tuong d6ng giiia MSM thanh pho Nha Trang (gpi la MSM thanh ph6) va MSM 6 cac huyen nong thon {gpi la MSM nong thon).
3.1. Kien thu-c phong chong HIV/AIDS cua nhom MSM tai tinh Khanh Hoa
Bdng 3.2: K i e n t h u c ve ducm
Tra Id"! d u n g cac cau hoi Nhilm HIV qua dung chung BKT
Dung Chung di#n thoai CO the ISv nhiem HIV
Mu5i dot CO the lav nhiem HIV HIV ISy qua sOa me
HIV lav qua QHTD PNMT n h i i m HIV cd the ISy Cho con
Bat tay, 6m hdn c6 the lay n h i i m HIV
An uong chung c6 t h i lay nhiSm HIV
Dung BKT ma ngu'di khac da su' dgng c6 the lay n h i i m HIV
g lay h u i ren HIV/
Thanh p h o N 103
99
70 84 107 100
95
99
105 96,3
%
92,5
65,4 78,5 100,0 93,5
88,8
92,5
98,1 A I D S
Nong N 346
334
152 261 347 298
313
307
346 t h o n
99,4
%
96,0
43,7 75,0 99,7 86,6
89,9
88,2
99,4
T 6 n g N 449
433
222 345 454 398
408
406
451 93,7
%
96,2
48,8 75,8 99,8 87,6
89,7
89,2
99,1 P
<0,05
<0,0S 1
<0,01
<0,01
>0,05
>0,05
>0,05
>0,05
>0,05
Bdng 3.2: K i e n t h u c ve each p h o n g c h o n g H I V / A I D S
Tra I d i dOng cdc c a u hoi
QHTD chi 1 nqu&i phdnq ISv truyin HIV Khdng QHTD h$u mdn phdng lay truyin HIV
D i i u tn d u phdng PNMT n h i i m HIV phdnq lay truyen cho con
Dung BCS dung each phdng lay truyen HIV
SLf dung BCS dung each khi QHTD hau mdn phdnq lay truyin HIV
DCinq BKT rianq phdnq lay truyin HIV
Thanh p h d N 100 86
87
106
107
105
%
93,5 80,4
81,3
99,1
100,0
98,1 Nong t h d n N 339 234
234
344
343
346
%
97,4 67,2
67,2
98,9
98,6
99,1 T o n g N 349 320
321
450
460
450
%
96,5 70,3
70.5
98,9
98,9
93,9 P
<0,01
<0,01
<0,01
>0,05
>0,05
>0.05
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D u d i 1 0 1 0 - 11 ca42- 13 c a M - 1 5 cau cau
SThanhpho "Nongthon Chung
Biiu aa 3.1: KiSn thiic t6ng hpp vd HIV/AIDS (p<0,05)
Da sS MSM dSu co kifa thuc ve duong lay truyln va each phong tranh lay nhiem HIV/AIDS, so MSM tra Idi dung tir 14 - 15 cau chi6m ty Ie cao nhdt (gan 50%). Co su khac biet CO y nghia thdng ke giiia MSM thanh ph6 va MSM nong thon vh ki& thiic HIV/AIDS (p<0,05). MSM thanh ph6 tra loi diing cac cau hdi ve HIV nhi6u hon MSM nong thon.
3.2. Thai (I9 sEn s^ng xet nghiem HIV
Bdng 3.3: Thao luan HIV/AIDS, BLTQDTD voi ban tinh QHTD hau mon khong tri tien (n=442)
T h i o luan HIV/BLTQBTD vi7i b^n tinh Cd, t i t ca Cd, mijt so Khdnq ai ca
T6ng
Thanh phd N 2 38 61 101
%
2,0 37,6 60,4 100,0
Ndn N 2 128 211 341
a thdn
%
0.6 37,5 61,9 100,0
Tdng N 4 166 272 442
%
0.9 37,6 61,6 100,0
X'=2,41 p>0,05
Cd, tit ca Cd, mdt so Khdng ai ca 9Thanh phd .Ndng thon Chung
Biiu do 3.2: Thao luan HIV, BLTQDTD vdi ban tinh QHTD hau mon phai tra tiSn (n=I40, p<0,05)
Tren 50% MSM khong thao l u ^ \'e HIV, BLTQDTD voi ban tinh QHTD hau mon phai tra tiSn, rieng MSM thanh phd co hon 2/3 khong thao luan vdi ban tinh. Cd su khac biet co y nghia thdng ke giita MSM thanh ph6 va MSM nong thon v6 thao luan HIV, BLTQDTD vcri ban tinh QHTD h^u mon phai tra tiSn (p<0,05), MSM nong thon cd ty le thao luan vcri ban tinh cao hem MSM thanh phd.
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C H U Y S N oi: HOI NGHj KHOA HOC NGANH Y TE TJNH KHANH HOA - L^N THCT II
3.3. Thyc hanh phong chong nhiem HIV cua nhom MSM tai tinh Khanh Hoa 3.3.1. Sii- dung BCS trong QHTD
Cd 451/455 MSM da timg su dung BCS trong QHTD chiSm ty le 99,1%. Chi cd 4 MSM d ndng thon la chua bao gid su dung BCS trong QHTD.
Bdng 3.4: Ly do khdng su dung BCS khi QHTD khdng tra tiin idn gain day nhat (n=I78)
L;^ do khdng s i f d u n g BCS Khdnq s i n cd
Khdnq thich s u dunq Ban tinh ti> choi KhSc
Thanh phd N 19 11 10 4
57,6
%
33,3 30,3 12,1
Nonq t h o n N 61 33 46 29
42,1
%
22,8 31,7 20,0
T d n g N 80 44 56 33
44,9
%
24,7 31,6 18,6
P
>0,05
>0,05
>0,05
>0,05 Bdng 3.S: S u d u n g B C S t r o n g lan Q H T D v o l n i l
S i i ' d u n g BCS Cd
Khdnq T o n g
Thanh p h d N 8 20 28
%
28,6 71,4 100,0
gSn day nhat ( n ^ Nona t h d n N 30 59 89
%
33,7 66,3 100,0
117) T d n g N 38 79 117
%
32,5 67,5 100,0
X'=0,26 p>C,06
3.3.2. Diing chat boi trffn tan trong nude trong QHTD hdu mon v&i nam gi&i Bdng 3.6: Sii dung chat bdi tron tan trong nude khi QHTD hau mdn vdi b ^ tinh nam
Sir d u n g chat bdi t r e n Cd
Khdnq Tdng
Thanh phd N 77 30 107
72,0
%
28,0 100,0
Nonq t h d n N 262
86 348
76,3 ^
%
24,7 100,0
T d n g N 339 116 455
%
74,6 25,5 100,0
X'=0,28 p> 0,05
3.3.3. Su dgng ma tdy Bdng 3.7: £)a tung sii dung ma tuy
S i i ' d u n g ma tuy Cd Khdnq
T 6 n g
Thanh p h d N 9 98 107
%
8,4 91,6 100,0
Nonq N 17 331 348
t h d n
%
4,9 95,1 100,0
T d n g N 26 429 455
%
5.7 94,3 100,0
X^=1,98 p>0,05
Bdng 3.8: T i e m c h i c h m a t i i y
Tiem chich ma tuy Cd
Khdnq T d n g
T h i n h p h d N 4 103 107
%
3,7 96,3 100,0
Ndng t h d n N 5 343 348
%
1,5 98,5 100,0
T d n g N 9 446 455
%
2,0 98,0 100,0
X'= 2,24 p>0,05
IV. BAN LUAN:
4.1. Kien thu'c phong chong HIV/AIDS cua nhom MSM tai tinh Khanh Hoa
Kien thiic ve duong lay truyen va bien
phap phdng tranh HIV cua MSM trong nghien ciiu nay tupng ddi tdt, nhdm MSM thanh phd cd kiln thiic tdt hon MSM nong thon. NSu so vcri nghien ciiu MSM Shirman 246
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Ruan 2007 TS Nam - Trung Qudc chi cd 80,5% biSt HIV cd the lay nhiSm qua dung chung bom kim tiem, 65,5% tra loi an u6ng chung khdng lay truyin HIV va 34,8% biet mudi dot khdng Iam lay truyen HIV, cac chi so nghien ciiu MSM Khanh Hda deu tdt hem nhieu.
4.2. Thai d^ ciia nhdm MSM (!oi vol HIV/AIDS va benh lay truyen qua dirdng tinh due
Thai 6q quan tam vol HIV/AIDS, BLTQDTD: Bdng 3.3 cho thdy da sd MSM khdng sdn sang thao luan vpi ban tmh ve HW/AIDS, BLTQDTD khi QHTD hau mon khdng tr4 tiin (61,5%), co 37,6% MSM cd thao luan vdi mpt sd ban tinh va chi cd mpt sd rat it MSM cd thao luan vdi tdt ca ban tmh (0,9%).
Thdi dg s^n sang xet nghiem HIV: Co 98,5% ddi tupng nghien ciiu bay td thai dp sSn sang lam xet nghiem tu nguyen bi mat de chdn doan HIV. Day la bang chiing thuan Ipi khi ban than MSM Khanh Hda da co quan tam din HIV/AIDS.
4.3. Thuc banh phong chong nhiem HIV cua nhom MSM tai tinh Khanh Hoa
4.3.1. Thu-c hanh dung BCS trong QHTD
Kit qua cho thdy 99,1% ddi tupng nghien cilu da timg sir dung BCS trong QHTD. Ty le nay cao hon nhieu so vdi ty le 64% su dung BCS cua MSM d Bangkok, Thai Lan nam 2003- 2007 dupe bao cao bdi tac gia Van Griensven [10]. Di nang cao ty 1$ sir dyng BCS cho MSM, ngoai viec truyen thong thay doi hanh vi cdn cd them cac diim cung cdp BCS thuan Ipi, di MSM di dang tiip cjn va nhan dich vu. Co su khac biet giiJa MSM thanh phd va nong thdn vi mpt sp ly do khong sir dung BCS khi QHTD hau mdn phai tra tiin idn gdn day nhdt (p<0,05).
Da s6 MSM thanh phd ndi rang do hp khdng nghT din, trong khi MSM ndng thon lai neu ly do la khong thich sir dung. Ve mijrc do sic d\mg BCS khi QHTD vdi nit, cd su khac biet cd y nghia thing ke giiia miic dp sir dung
BCS khi QHTD vdi nu giua MSM thanh phd va ndng thon (p<0,01). MSM ndng thon khdng bao gio sir dung BCS khi QHTD vdi nil nhieu hon MSM thanh phi.
4.3.2. Dung chdt boi trorn tan trong nir&c lilli QHTD hau mon v&i nam gi&i Ty le MSM cd sir dung chdt bdi tron tan trong nude khi QHTD hau mon vdi ban tinh nam la 74,5%, cao hpn nhieu so vdi ty le 36% tai TP H6 Chi Minh nam 2001 ttong nghien ciiu ciia Dotm Colby [5]. Khuyen khich viec diing chat boi tron tan trong nude la mpt hanh vi tdt trong du phdng lay truyen HIV cua nhdm MSM.
4.3.3. Su dung ma tuy
Ty le MSM sir dung ma tuy trong nghien cim ciia chiing toi cao hem trong nghien cuu cua Shiman Ruan nam 2007 d Te Nam - Trung Quoc (2,1%) [8] nhimg lai thap hon trong nghien cim ciia Sarah Sheridan nam 2007 d Vienitian ^ Lao (2I,I%)[7], va d?c biet thap hon nhieu so vdi ty le MSM su dung ma tuy trong nghien cuu IBBS cua Bo Y ti tai thanh phd Hd Chi Minh (21%) va thanh phi Ha Npi (22,8%) [I]. So sanh vdi mdt sd nghien cim khac p nhdm MSM cho thdy ty le MSM tiem chich ma tiiy trong nghien ciiu cua chung tdi cap hon nghien ciiu cua Shiman Ruan nam 2007 tai Te Nam - Trung Qudc (0,2%) [8] va Dorai Colby nam 2001 tai TP Hi Chi Minh (0,4%) [5], nhung lai thdp hon nghien ciru IBBS cua Bp Y te d thanh phi Hd Chi Minh (3,8%) va Ha Npi (9,2%) [I]. Tuy nhien trong nghien cuu ciia Bp Y ti, ty le sit dung ma tuy d thanh phd H6 Chi Minh la 22,8% nhung ty 16 tiem chich la 3,8% con nghien cira cua chung toi ty le sir dung ma tuy chi cd 5,7% nhung ty le tiem chich la 2,0%, diiu do cho thdy nhdm MSM Khanh Hda sir dung ma hiy cd iiguy ca nhiem HIV cad hon MSM thanh phd Hd Chi Minh.
V. KET LUAN:
Kiin thiirc: Da s6 nhdm nam quan he 247
CHUYEN PE: HOI NGHj KHOA HQC NGANH Y TETJNH KHANH H O A - L A N T H Q I I
tinh due ddng gidi cd kien thiic tdt ve dudng lay truy§n HIV/AIDS. 47,5% tra Idi diing tir 14-15 cau hdi ve kien thiic dudng lay truyen va each phdng chdng HIV/AIDS, nhung van cdn 30% nam quan he tinh due ddng gidi cho rang quan he tinh due qua dudng hau mdn la khdng cd nguy ca.
Thdi dd: 61,5% nam quan he tinh due ddng. gidi khdng thao luan vdi ban tinh nam vh HIV hoac cac benh lay truyen qua dudng tinh due khi quan he tinh due qua dudng hau mdn khdng tra tien. Nam quan he tinh due ddng gidi d thanh phd cd ty le thao luan vdi ban tinh la 76,3% cao hon khu vuc nong thdn (51%).
Tlnrc hdnh: Cd 99,1% nam quan he tinh due ddng gidi tai Khanh Hda da timg sii dung BCS trong quan he tinh due. Nhung trong lin quan he tinh due gSn day nhit qua dudng hau mon phai tra tien (78,6%) va 65,7% khdng sii dung bao cao su khi quan he tinh due vdi ban tinh nii. Tiep can vien cpng ddng la ngudn cung cap chu yeu bao cao su (87,9%) va chat bdi tron tan trong nude (96,2%). Chi c6 mot ty le thdp (19,6%) nam quan h§ tinh dye ddng gidi ed nhSn duoc dich vu tu van va ho trg ve HIV. Cd 5,7%
nam quan he tinh due ddng gidi trong nghien ciiu da timg sir dyng ma tiiy va 2% (tren tdng sd ddi tugfng nghien ciiu) cd tiem chich ma hiy.
TAI LIEU THAM KHAO
1. B6 Y te (2006), Kit qud chuang trinh gidm sdt ket hop hdnh vi vd cdc chi sd sinh hoc mV/AIDS (IBBS) tgi Vi$t Nam ndm 2005 - 2006, Nha xuat ban Y hpc, Ha Noi, tr.19 - 23,38.
2. David Lowe, Pham Vu Thien (2009), Ddnh gid nhanh tinh hinh vd ddp irng cua cdc
chuang trinh HIV vd AIDS ddnh cho nhdm nam quan h^ tinh due v&i nam tgi Viet Nam, tr. 8.
3. Pham Mginh Hung (2010), "Day manh cong tac tuyen truyen, giao due va truyen thong chuyen doi hanh vi ve giam tac h^i lien quan dhn HIV/AiDS", Tgp chi Thdng tin Y Dugc, (8), Bo Y tl, tr.2.
4. Uy ban Quoc gia phong chong AIDS va phong chong te nan ma tiiy, mai dam (2008), Bdo cdo Qudc gia lan thii' 3 thuc hi^n tuyen bd cam kit ve HIV/AIDS (Bdo cdo UNGASS), tr. 6 -8.
5. Colby D. (2003), HIV Knowledge and Risk Factors Among Men Who Have Sex with Men in Ho Chi Minh City, Vietnam, Journal of the Acquired Immune Deficiency Syndromes. 32,(1), pp. 80 - 85.
6. Grulich A.E. and Kaldor J.M. (2008), Trends HIV incidence in homosexual men in developed countries. Csiro Publising. Sexual Health, (5), pp.] \4-\\8.
7. Sheridao, et al., (2009), HIV prevalence and risk behaviour among men who have sex with men in Vientiane Capital, Lao People's Democratic Republic, AIDS, (23), pp.3.
8. Shiman Ruan, et aL, (2008), HIV Prevalence and Correlates of Unprotected Anal Intercourse Among Men Who Have Sex with Men, Jinan, China, AIDS Behav, pp. 471 - 472.
9. UNAroS (2006), HIV and Men who have Sex with Men in Asia and the Pacific, pp. 23 - 27.
10. Van Griensven, et al., (2007), Trends in HIV Prevalence, Estimated HIV Incidence, and Risk Behavior Among Men Who Have Sex With Men in Bangkok, ThaiLand, J Acquir Immune Defic Syndr, pp. 3.
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