Effect of level of education and alcohol use on condom use among men who have sex with men (MSM) in Hanoi city, Vietnam

Abstract

Men who have sex with men (MSM) are known to have high-risk behaviors associated with HIV infection in many communities in Vietnam. Using alcohol before or during sex is related to inconsistent condom use in MSM. In addition, educational attainment has been found to be one of the most important factors affecting alcohol use and condom use among MSM. This cross-sectional study used respondent-driven sampling (RDS) to survey 450 MSM who drink alcohol. The χ2 test and logistic regression are used to determine the direct effect and interactive effect of level of education and alcohol use on condom use among MSM. The survey found that 75.3% of MSM drank more than three units of alcohol per drinking session during the previous month. Those with higher drinking levels also had a higher frequency of having sex after drinking during the previous month (χ2= 60.1 p = 0.000). The higher the total amount of alcohol or of beer that was reported during the previous month, the higher the frequency of having sex after drinking (χ2=71.64 p = 0.000 and χ2= 16.2 p = 0.002). Those who drank 40% alcohol or more than 40% during the previous month had a significantly lower frequency of condom use with male partners during the previous month (χ2 = 11.9, p = 0.005). Those with higher educational levels were associated with lower amounts of beer consumed at one session during the previous month (χ2 = 12.8, p = 0.04). The multivariate model on the determinants of condom use found that there is an interactive effect for alcohol use and educational level. Those with a higher level of education who drank less than 3 units of alcohol per day were 1.69 times more likely to use a condom than who drank more than 3 units, controlling for socio-demographic variables (p<0.05). Consistent intervention programs are necessary to reduce the effect of alcohol use for different educational levels and increase the frequency of condom use among MSM.