The HIV epidemic in Vietnam is concentrated in high-risk populations, including injection drug users, male and female sex workers, and men who have sex with men MSM Hoang et al. Male sex workers MSWs , who are men who exchange sex for money, goods, or other drugs primarily with other men in Vietnam, are at particularly high risk for HIV acquisition and transmission, and are a crucial group for focusing HIV prevention efforts Hoang et al. A large proportion of MSW in Vietnam are in urban areas, are frequently migrants from other regions, and have unstable housing Clatts et al.
Stigma can broadly be defined as negative attitudes, relative powerlessness, and loss of status related to a particular characteristic King et al. In other contexts, experiences of stigma and discrimination are associated with increased risk for HIV infection, possibly through social isolation, depression, and subsequent increase in risky sexual practices, such as engaging in unprotected anal sex UAS and drug or alcohol use during sex Diaz et al. In addition, stigma and discrimination have been shown to be associated with reduced care-seeking behavior in Vietnam Thanh et al.
Among female sex workers, both stigma has been shown to be independently associated with HIV testing; HIV-related stigma stigma related specifically to being HIV-infected has been shown to be associated with decreased HIV testing and sex work-related stigma stigma related specifically to being a sex worker with increased testing King et al.
Male sex workers in particular may experience stigma from multiple dimensions. Few studies have specifically assessed sex work-related stigma among men. The aim of the present study was two-pronged. First, to better understand factors related to sex work-related stigma among Vietnamese MSW, we assessed correlates of sex work-related stigma in this population.
Second, to understand how sex work-related stigma affects mental health and vulnerability to HIV, we assessed the association between sex work-related stigma and depression and sexual risk-taking behavior.
