Suchergebnisse

The objective of this study was to explore health-seeking behaviors and barriers faced in accessing care among homeless youth living in Ho Chi Minh City, Vietnam. Twelve in-depth interviews were conducted with homeless youth aged 18 to 25. Participants were identified using purposive sampling. Data were analyzed using constructivist grounded theory techniques. Interviews with youth revealed that while living on the streets, they had to balance their need for security with attending to their daily survival needs, which led to a disconnection from thinking about their health. When faced with a major health issue, youth turned to their informal networks of support instead of seeking immediate medical care. To manage their basic health needs, youth obtained medicine and health advice from local pharmacies and sought advice from social workers. Homeless youth interviewed in this study relied on an informal network of peers, social workers, and pharmacies when engaging with the health care system. They also faced several barriers to accessing health services, many of which are tied specifically to policies that make homelessness discriminated against in Vietnam. Within Vietnam's unique political and social context, there is a need for increased collaboration between service providers such as health clinics, local pharmacies, and social workers to provide appropriate health services to this vulnerable population.

The objective of this study was to explore health-seeking behaviors and barriers faced in accessing care among homeless youth living in Ho Chi Minh City, Vietnam. Twelve in-depth interviews were conducted with homeless youth aged 18 to 25. Participants were identified using purposive sampling. Data were analyzed using constructivist grounded theory techniques. Interviews with youth revealed that while living on the streets, they had to balance their need for security with attending to their daily survival needs, which led to a disconnection from thinking about their health. When faced with a major health issue, youth turned to their informal networks of support instead of seeking immediate medical care. To manage their basic health needs, youth obtained medicine and health advice from local pharmacies and sought advice from social workers. Homeless youth interviewed in this study relied on an informal network of peers, social workers, and pharmacies when engaging with the health care system. They also faced several barriers to accessing health services, many of which are tied specifically to policies that make homelessness discriminated against in Vietnam. Within Vietnam's unique political and social context, there is a need for increased collaboration between service providers such as health clinics, local pharmacies, and social workers to provide appropriate health services to this vulnerable population.

Bach Xuan Tran,1–3 Victoria L Boggiano,4 Long Hoang Nguyen,5 Carl A Latkin,2 Huong Lan Thi Nguyen,6 Tung Thanh Tran,6 Huong Thi Le,1 Thuc Thi Minh Vu,7 Cyrus SH Ho,8 Roger CM Ho9 1Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam; 2Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; 3Vietnam Young Physicians Association, Hanoi, Vietnam; 4Berkeley School of Public Health, University of California, Berkeley, CA, USA; 5Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden; 6Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam; 7Department of Immunology and Allergy, National Otolaryngology Hospital, Hanoi, Vietnam; 8Department of Psychological Medicine, National University Health System, Singapore; 9Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore Background: Media representation of vaccine side effects impacts the success of immunization programs globally. Exposure to the media can cause individuals to feel hesitant toward, or even refuse, vaccines. This study aimed to explore the impact of the media on beliefs and behaviors regarding vaccines and vaccine side effects in an urban clinic in Vietnam.Methods: A cross-sectional study was conducted in an urban vaccination clinic in Hanoi, Vietnam from November 2015 to March 2016. The primary outcomes of this study were the decisions of Vietnamese subjects after hearing about adverse effects of immunizations (AEFIs) in the media. Socio-demographic characteristics as well as beliefs regarding vaccination were also investigated. Multivariate logistic regression was used to identify factors associated with subjects' behaviors regarding vaccines.Results: Among 429 subjects, 68.2% of them said they would be hesitant about receiving vaccines after hearing about AEFIs, while 12.4% of subjects said they would refuse vaccines altogether after hearing about AEFIs. Wealthy individuals (OR=0.41; 95% CI=0.19–0.88), and those who displayed trust in government-distributed vaccines (OR=0.20; 95% CI=0.06–0.72) were less likely to display hesitancy regarding vaccination. Receiving information from community health workers (OR=0.44; 95% CI=0.20–0.99) and their relatives, colleagues, and friends (OR=0.47; 95% CI=0.25–0.88) was negatively associated with vaccine hesitancy, but facilitated vaccine refusal after reading about AEFIs in the media (OR=3.12; 95% CI=1.10–8.90 and OR=3.75; 95% CI=1.56–9.02, respectively).Conclusion: Our results reveal a significantly high rate of vaccine hesitancy and refusal among subjects living in an urban setting in Vietnam, after hearing about AEFIs in the media. Vietnam needs to develop accurate information systems in the media about immunizations, to foster increased trust between individuals, health care professionals, and the Vietnamese government. Keywords: vaccination, Vietnam, media, mass media, health literacy

IntroductionThe HIV pandemic disproportionately impacts young women. Worldwide, young women aged 15–24 are infected with HIV at rates twice that of young men, and young women alone account for nearly a quarter of all new HIV infections. The incommensurate HIV incidence in young – often poor – women underscores how social and economic inequalities shape the HIV epidemic. Confluent social forces, including political and gender violence, poverty, racism, and sexism impede equal access to therapies and effective care, but most of all constrain the agency of women.MethodsHIV prevalence data was compiled from the 2010 UNAIDS Global Report. Gender inequality was assessed using the 2011 United Nations Human Development Report Gender Inequality Index (GII). Logistic regression models were created with predominant mode of transmission (heterosexual vs. MSM/IDU) as the dependent variable and GII, Muslim vs. non‐Muslim, Democracy Index, male circumcision rate, log gross national income (GNI) per capita at purchasing power parity (PPP), and region as independent variables.Results and discussionThere is a significant correlation between having a predominantly heterosexual epidemic and high gender inequality across all models. There is not a significant association between whether a country is predominantly Muslim, has a high/low GNI at PPP, has a high/low circumcision rate, and its primary mode of transmission. In addition, there are only three countries that have had a generalized epidemic in the past but no longer have one: Cambodia, Honduras, and Eritrea. GII data are available only for Cambodia and Honduras, and these countries showed a 37 and 34% improvement, respectively, in their Gender Inequality Indices between 1995 and 2011. During the same period, both countries reduced their HIV prevalence below the 1% threshold of a generalized epidemic. This represents limited but compelling evidence that improvements in gender inequality can lead to the abatement of generalized epidemics.ConclusionsGender inequality is an important factor in the maintenance – and possibly in the establishment of – generalized HIV epidemics. We should view improvements in gender inequality as part of a broader public health strategy.