Understanding the Interplay Between HIV Prevention Strategies and Mental Health in Influencing Sexual Behavior Among Male Laborers

Abstract

The waves of rural-urban migration are increasingly growing in many developing countries, including 
Vietnam. This migratory process, whether voluntary or not, may result in the spread of human 
immunodeficiency virus (HIV) infection to both those who migrate and those who receive migrants. 
Coupled with this process, is the experience of depression that may facilitate risk behaviors for HIV. 
However, there has been little research concerning this dimension. This study examined self-reported 
risk behaviors and factors associated among 450 male freelance laborers in Hanoi, Vietnam. Risk of 
acquiring and transmitting HIV was high among these men. One third reported having intercourse with 
commercial sex workers and one quarter had casual sex partners. One in every 12 men reported 
homosexual or bisexual behavior. These men on average had 3 partners within the preceding year, and 
condom use was inconsistent. These men have limited HIV knowledge and only moderate motivation and 
perceived behavioral skills for protective behavior. Although mobility was not associated with sexual risk 
behavior, three elements of IMB (information-motivation-behavioral skills) model and depression 
associated with this process were a robust predictor of sexual behavior. Men who are better informed, 
motivated, display higher self-efficacy and less depressed are more likely to alter their risk behavior. The 
study highlights an important need for HIV-related information, motivation, self-efficacy, depression and 
risk behavior change.