AEGiS-15IAC: Power relations, drugs, sexuality and HIV/AIDS: a study on Vietnamese drug users and their sexual relationships.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

Power relations, drugs, sexuality and HIV/AIDS: a study on Vietnamese drug users and their sexual relationships.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. D10431)

Lam NT
Amsterdam School for Social Science Research, Amsterdam, Netherlands

BACKGROUND: The current transmission of AIDS in Vietnam is mostly linked to drug injection, but there is potential of a sexual epidemic. HIV education programs focus on the personal responsibility model of risk, yet failing to address adequately other aspects of HIV risks in social contexts. This paper examines HIV risk in drug-using sexual relationships.

METHODS: The study is based on ethnographic fieldwork conducted in 2002 in Hanoi and Quang Ninh, Vietnam, with 56 audiotaped interviews, 04 focus group discussions and 03 case studies. Purposeful sampling was carried out for injecting drug users (IDUs) in three patterns of stable relationships. The analytic groupings consist of: 1- IDU-IDU relationship; 2- IDU-smoker relationship; and 3- IDU-non-user relationship. The analysis is based mainly on social theories of risk.

RESULTS: in pattern 1 (IDU-IDU), syringe sharing and condom non-use are the most salient risks. Trust and love can be seen as solutions to dangers and uncertainties. In pattern 2 (IDU-smoker), smoking partners are often "pulled into" injecting by a shooting partner and their high demand for sex may lead to rejecting a condom. In pattern 3 (IDU-non user), when the "hiding tactics" (used by IDUs to conceal their addiction) is still effective, a non-using partner may agree to have condomless sex. In many cases, injecting women could exert control over the use of condom in contrast with the stereotypic gender roles and the implied subordination of women.

CONCLUSIONS: stable relationships play an important role in managing AIDS risks among IDUs. HIV prevention should take into account the positive aspect of condom non-use and syringe sharing in a loving-trusting relationship. Notably, there is a significant variability in the perceived effects of drugs on sexual experience. Care and responsibility confer different meanings in the drug scene. It is suggested that different strategies are needed for different relationship patterns of IDUs.

Keywords: AEGIS, Acquired Immunodeficiency Syndrome, Sexual Behavior, HIV Seropositivity, Substance Abuse, Intravenous, Sexuality, Needle Sharing, Condoms, Power (Psychology), Ethnic Groups, Substance-Related Disorders, Behavior, Vietnam, Humans, Female

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D10431