Prevalence, risk factors and genotyping of chlamydia trachomatis from endocervical specimens of infertile women at a tertiary care hospital, Vietnam.

BACKGROUND: To our knowledge, the prevalence, risk factors and distribution of C. trachomatis genotypes are rarely mentioned in Vietnam. This study aimed to find the prevalence, risk factors and distribution of C. trachomatis genotypes in infertile Vietnamese women. METHODS: Endocervical swabs were collected from infertile women at the National Hospital of Obstetrics and Gynecology, Vietnam, between January 2020 and December 2021. All samples were analyzed for C. trachomatis presence by Cobas 4800 CT/NG Test. Sequencing methods of ompA gene were used to determine the C. trachomatis genotypes. An approximately 1200 bp ompA fragment was aligned with reference sequences from GenBank to identify the corresponding genotype. RESULTS: The prevalence of endocervical C. trachomatis infection was 15.6% of 761 participants. Factors independently associated with CT infection among infertile women, obtained by multivariate analysis, included abnormal vaginal discharge, cervicitis, lower abdominal pain, a history of ectopic pregnancy, having more than one sex partner, and age at first intercourse. Among the samples, genotype E (25.93%) was most frequently found, followed by genotypes D/Da (22.23%), F (13.58%), G/Ga (12.35%), J (12.35%), H (6.17%), K (3.70%), B/Ba (2.47%), and I/Ia (1.23%), respectively. Genotype F was related to types of infertility, and genotype H was associated with a history of miscarriage. CONCLUSIONS: The present study indicated a high prevalence of C. trachomatis in infertile Vietnamese women. The most common genotypes found in this population were E, D, and F. Our findings suggest that routine screening is necessary for early detection and performance of infection control methods.

HIV- and AIDS-related knowledge and attitude of residents in border regions of Vietnam.

BACKGROUND: Residents in border areas are vulnerable to HIV/AIDS due to high rates of risk behaviors such as unprotected sexual practices or illicit drug use. Improving knowledge and attitude toward HIV/AIDS prevention and treatment are vital to diminish the burden of the HIV epidemic in this setting. However, evidence about this issue in Vietnam has been limited. This study aims to explore the knowledge and attitude toward HIV/AIDS among people in Vietnam border zones. METHODS: We conducted a cross-sectional study in three border communes in Thanh Hoa province with 600 HIV(-) residents. Data about socio-demographic characteristics, general HIV knowledge, knowledge about prevention of mother-to-child transmission, treatment and care, HIV testing services, and attitude toward HIV/AIDS were collected. Multivariate Tobit regression was used to determine related factors with the knowledge and attitude. RESULTS: The highest percentage of people having correct statements was for "HIV could be transmitted from mother to child" (98.2%), while the lowest percentage was for item "Know health facilities where HIV-positive people could register for care and check-up" (28.2%). People had the highest score in "Knowledge about HIV transmission routes" and the lowest score in "Knowledge about HIV/AIDS prevention measures". Most of the people were not afraid of being exposed to HIV-positive individuals (66.0%), willing to buy goods from HIV-positive sellers (78.9%), and willing to take care of people living with HIV in their family (90.1%). Education, ethnic, marital status, occupations, and HIV/AIDS information sources were found to be associated with knowledge and attitude toward HIV/AIDS. CONCLUSIONS: The general knowledge and attitude on HIV/AIDS of residents were relatively good. Educational campaigns to improve knowledge and attitude toward PLWH, involving peer educators and local associations, are potential strategies for sustaining HIV intervention in this remote setting.

Concurrent drug use among methadone maintenance patients in mountainous areas in northern Vietnam.

OBJECTIVES: With the rise in methadone maintenance therapy (MMT) for drug users in Vietnam, there has been growing interest in understanding if and how often MMT patients engage in concurrent illicit drug use while on methadone therapy in various settings. This study examined factors associated with concurrent opioid use among patients on MMT in a mountainous area in Vietnam. SETTING: One urban and one rural MMT clinics in Tuyen Quang province. PARTICIPANTS: Survey participants consisted of patients who were taking MMT at the selected study sites. A convenience sampling approach was used to recruit the participants. PRIMARY AND SECONDARY OUTCOME MEASURES: Participants were asked a series of questions about their socioeconomic status, current alcohol and tobacco use, health problems (measured by the EuroQol-Five Dimension-Five Level instrument), psychological distress (measured by Kessler score), and factors associated with current and/or previous drug use. Regression models were used to determine factors associated with concurrent drug use among MMT patients. RESULTS: Among the 241 male MMT patients included in the study, 13.4% reported concurrent opioid use. On average, the longer patients had been enrolled in MMT, the less likely they were to concurrently use drugs. Conversely, patients with higher levels of psychological distress were more likely to engage in concurrent drug use while on MMT. CONCLUSION: Longer duration of MMT was significantly correlated with reduced illicit drug use among participants. Higher levels of psychological distress were associated with increased use of illicit drugs among MMT patients. Regardless of distance, long-term MMT is still effective and should be expanded in mountainous areas.

Alcohol and tobacco use among methadone maintenance patients in Vietnamese rural mountainside areas.

INTRODUCTION: The expansion of methadone maintenance treatment (MMT) program requires more data about the factors affecting the effectiveness of treatment, especially behavioral data such as smoking and alcohol use among patients. This study aimed to examine the prevalence of tobacco and alcohol consumption and identify related factors among MMT patients in the Vietnamese rural mountainside. METHODS: We interviewed 241 MMT patients in two clinics in Tuyen Quang, a mountainous province in Vietnam. Patients were asked to report the smoking status (current smoker or not), nicotine dependence (by Fagerström test for nicotine dependence - FTND) and alcohol use (by using the Alcohol Use Disorders Identification Test - AUDIT-C). EuroQol-5 dimensions-5 levels (EQ-5D-5L) and EQ-Visual analogue scale (EQ-VAS) were employed to measure health-related quality of life. Multivariate logistic and Tobit regressions were used to identify the associated factors. RESULTS: The majority of respondents were current smokers (75.7%) and a low proportion were hazardous drinkers (18.3%). People receiving treatment in a rural clinic (OR = 0.45; 95%CI = 0.22-0.92) and had problems in usual activities (OR = 0.20; 95%CI = 0.06-0.70) were less likely to be smokers. Q-VAS score (Coef. = 0.03; 95%CI = 0.02-0.05) and having problems in mobility (Coef. = 0.72; 95%CI = 0.03-1.42) was found to be associated with the increase of nicotine dependence. In terms of alcohol drinking, people with other jobs were more likely to drink hazardously compared to unemployed patients (OR = 2.86; 95%CI = 1.20-6.82). Similarly, patients having higher duration of MMT had higher likelihood of being hazardous drinkers (OR = 1.07; 95%CI = 1.01-1.13). CONCLUSIONS: This study highlights the low rate of alcohol abusers but a considerably high proportion of current smokers among MMT patients in the rural mountainside area. Alcohol and tobacco counseling programs combined with social and family support also play an essential role in alcohol and tobacco control. In addition, implementing mass community-based behavioral change campaigns to reduce drug addiction-related stigmatization should also be prioritized.

Sexual behaviors among methadone maintenance patients in a mountainous area in northern Vietnam.

BACKGROUND: Methadone maintenance treatment (MMT) improves patients' ability to access HIV-related services and reduces needle sharing and other risky HIV-related behaviors. However, patients may continue to engage in risky sexual practices. In this study, we evaluate sexual behaviors of MMT patients in a mountainous province in Northern Vietnam. METHODS: We explored the health status, MMT and substance use history, and sexual practices of 241 male MMT patients in Tuyen Quang province. Health status was investigated using the EuroQOL-5 Dimensions-5 Levels (EQ-5D-5 L). Multivariate logistic regression was employed to assess associated factors. RESULTS: Most patients (66.4%) reported having at least one sexual partner within the previous twelve months. Most of these partners were spouses or primary partners (72.6%). About 8.3% of patients had casual partners, and 5.8% had visited sex workers; of those who engaged in casual sexual relationships, 90.9% reported using condoms. Current drug use and living in a remote area were associated with an increased odd of having two or more sexual partners, while anxiety or depression was associated with lower odds. CONCLUSION: This study highlights a low proportion of having sexual risk behaviors among MMT patients in Vietnamese mountainous settings. Integrating education about safe sexual practices into MMT services, along with providing medical care and ensuring methadone treatment adherence, is an important component in HIV risk reduction for these patients who were at risk of unsafe sexual practices.

Ability to join the workforce and work productivity among drug users under methadone maintenance treatment in a mountainous area of Northern Vietnam: a cross-sectional study.

OBJECTIVES: A major measure of treatment success for drug users undergoing rehabilitation is the ability to enter the workforce and generate income. This study examines the absenteeism and productivity among people who inject drugs (PWID) enrolled in methadone maintenance treatment (MMT) in Northern Vietnam. SETTING: We conducted a cross-sectional study in two clinics in Tuyen Quang province. PARTICIPANTS: A total of 241 patients enrolled in MMT. PRIMARY AND SECONDARY OUTCOME MEASURES: Patients' work productivity was measured using the WPAI-GH instrument (Work Productivity and Activity Impairment Questionnaire: General Health V2.0). We also collected additional characteristics about participants' employment history, such as proficient jobs, whether they actively found a new job and be accepted by employers. RESULTS: Most of the participants (>90%) were employed at the time of the study. Rates of absenteeism (missed work), presenteeism (impairment while working) and overall loss of productivity were 15.8%, 5.6% and 11.2%, respectively, as measured by the WPAI-GH questionnaire. The most proficient job was 'freelancer' (17.5%), followed by 'blue-collar worker' (10.6%) and 'farmer' (10.2%). Only 26.8% of patients reported that they actively sought jobs in the past. About half of them had been refused by employers because of their drug use history and/or HIV status. We found no statistically significant difference between patients enrolled in MMT for <1 year and those who had been enrolled >1 year. Factors associated with higher work productivity included not endorsing problems in mobility, self-care or pain; being HIV-negative and having greater MMT treatment adherence. CONCLUSION: Our study highlights the high employment rate and work productivity among PWID in MMT programmes in remote areas of Northern Vietnam. The results can help to improve the quality and structure of MMT programmes across Vietnam and in other countries.

Psychological Distress Among Methadone Maintenance Patients in Vietnamese Mountainous Areas.

We conducted a cross-sectional study in Tuyen Quang Province, a mountainous province in northern Vietnam, to examine rates of psychological distress among 241 patients receiving methadone maintenance treatment (MMT). Using the Kessler psychological distress Scale, we found that approximately one-fourth (26.8%) of respondents suffered from mental health pathologies. Physical health problems, current drug use, and alcohol abuse were found to be associated with mental health problems among the participants. Our findings highlight the high prevalence of psychological distress among MMT patients in northern Vietnam, and the need to integrate mental and physical health care services, as well as behavioral health counseling, into currently existing MMT clinics in this region.

Quality of life and healthcare service utilization among methadone maintenance patients in a mountainous area of Northern Vietnam.

BACKGROUND: The expansion of methadone maintenance treatment in mountainous areas in still limited and little is known about its health impacts on drug users. This study aimed to examine health-related quality of life (HRQOL) and health care access among patients engaging in methadone maintenance treatment (MMT) in Tuyen Quang, a mountainous province in Vietnam. METHODS: We conducted a cross-sectional survey with 241 patients conveniently recruited in two MMT clinics (Son Duong and Tuyen Quang). EuroQol-5 Dimensions - 5 levels (EQ-5D-5 L) and Visual analogue scale (VAS) were employed to measure HRQOL. Multivariate logistic and tobit regressions were used to determine the factors associated with HRQOL and health care utilization. RESULTS: The overall mean score of the EQ-5D index and EQ-VAS were 0.88 (SD = 0.20) and 81.8% (SD = 15.27%), respectively. Only 8.7% utilized inpatient services, and 14.9% used outpatient services. Being more highly educated, suffering acute diseases, and using health service within the last 12 months were associated with a decreased EQ-5D index. Individuals who were multiple substance abusers and those who recently had inpatient care were more likely to have a lower VAS. Older respondents, those taking their medications at the more impoverished clinic, substance abusers, and individuals who were struggling with anxiety/depression or their usual daily activities were more likely to use both inpatient and outpatient care. CONCLUSIONS: In summary, we observed good HRQOL, but high prevalence of anxiety/depression and low rates of service utilization among MMT patients in Tuyen Quang province. To improve the outcomes of MMT services in mountainous areas, it is necessary to introduce personalized and integrative services models with counseling and interventions on multiple substance use.

Stigmatization among methadone maintenance treatment patients in mountainous areas in northern Vietnam.

BACKGROUND: Stigma and discrimination may adversely affect the benefits of methadone maintenance treatment (MMT) for drug users, especially in disadvantaged settings. This study assessed stigma and discrimination against MMT patients in the mountainous and rural areas in Vietnam and explored their associated factors to inform implementation strategies. METHODS: We interviewed 241 MMT patients in two clinics: one in Tuyen Quang Province's inner city and the other in Son Duong District, to assess stigma and discrimination that patients perceived and experienced. Socioeconomic status, health behaviors, health status, and history of drug abuse were examined. Multivariate linear and logistic regression models were used to explore factors associated with stigma and discrimination. RESULTS: The majority of respondents reported experiencing stigma and discrimination including blame/judgment (95.1%), shame (95.1%), disclosure (71.4%), and the fear of human immunodeficiency virus (HIV) transmission by others (74.1%). Unemployed patients were more likely to experience discrimination (Coef = -1.18, 95% CI = -1.87; -0.89). Those who were taking an antiretroviral were more likely to disclose their health status (Coef = 2.27, 95% CI = 0.6; 3.94). In addition, a higher likelihood of being blamed/judged and shamed was associated with those who suffered from anxiety/depression (Coef = 1.59, 95% CI = 0.24; 2.93 and Coef = 1.07, 95% CI = 0.36; 1.79, respectively). CONCLUSIONS: MMT patients in these mountainous areas perceived high levels of stigma and discrimination which were associated with mental health disorders, unemployment, and HIV infection. These findings highlighted the importance of reducing drug use and HIV-related stigma against high-risk populations. Besides, psychosocial and familial supports, as well as job referrals, also play crucial roles in terms of promoting quality of life among MMT patients.