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Down on the farm: homosexual behaviour, HIV risk and HIV prevalence in rural communities in Khanh Hoa province, Vietnam
  1. D Colby1,
  2. T Tan Minh2,
  3. T T Toan3
  1. 1
    Harvard Medical School AIDS Initiative in Vietnam Tropical Diseases Hosptial, Ho Chi Minh City, Vietnam
  2. 2
    Khanh Hoa Province Department of Health, Nha Trang, Vietnam
  3. 3
    Centre for Health Education and Communication (CHEC), Nha Trang, Vietnam
  1. Dr D Colby, Harvard Medical School AIDS Initiative in Vietnam, Tropical Disease Hospital, 190 Ham Tu, Q5, Ho Chi Minh City, Vietnam; donn{at} or doctordonn{at}


Objectives: To determine HIV prevalence, measure risk behaviour and determine levels of knowledge among men who have sex with men (MSM) in both urban and rural districts within Khanh Hoa province, Vietnam.

Methods: 295 MSM were recruited using respondent-driven sampling from one urban and four rural districts. Information on demographics, risk behaviour, knowledge and attitudes was obtained using a standardised questionnaire. HIV testing was performed on all subjects.

Results: Rural MSM had fewer risk behaviours when compared with urban MSM in the province: they became sexually active at a later age, were less likely to buy or sell sex and were less likely to use drugs. However, they had poorer knowledge about HIV transmission and prevention and were less likely to know that unprotected anal sex was high risk for HIV. Condom use was high among both rural and urban MSM, but most MSM in rural areas had never used water-based lubricant. None of the 295 men tested for HIV were infected (HIV prevalence 0%).

Conclusions: Although most programmes for MSM in Vietnam and other Asian countries target urban areas, there are significant numbers of MSM in rural areas who can be reached through peer educator interventions. Rural MSM have less access to specific HIV prevention information on homosexual sex and less knowledge about how to protect themselves from HIV infection. More programmes are needed for MSM in the rural areas of Vietnam.

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  • Funding: This research was made possible through funding from the Ford Foundation Vietnam and the strong support of the Khanh Hoa Health Department.

  • Competing interests: None.

  • Ethics approval: The study was approved by the scientific and ethical review committee at the Khanh Hoa Department of Health.

  • Patient consent: Obtained.

  • Contributors: All three authors contributed equally to the development of the study design and the research protocol. TTM and TTT trained the research staff, directly supervised all stages of data collection and managed the database. TTT and DC completed the data analysis and reporting. DC wrote the final manuscript with input from the other authors.

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