The influence of primary male sexual partners' risk/protective factors on gynecological health outcomes among women in Ho Chi Minh City, Vietnam
Men have influence on gynecological health outcomes of women both positively and negatively. This dissertation examined how women's health regarding sexually transmitted infections (STIs) is influenced by their male partners. The first aim was to examine husbands' behavioral risk factors for women's genital Human Papillomavirus (HPV) infection. The second aim was to examine primary sexual male partners' risk factors for women's history of STIs. The last aim was to describe women's self-efficacy and primary sexual male partners' cooperation in STI examination and treatment. In aim 1, data were collected from a population-based survey, using a two-stage sampling process. Socio-demographic/behavioral variables were obtained by self-report. HPV genotypes in cervical specimens were identified using PCR protocols. Husbands' smoking status and number of lifetime partners were not associated with women's genital high-risk/multi-type HPV infection. Participants' lifetime smoking and older age of first sex were significantly associated with any high-risk and multi-type HPV infections. Regular condom use was inversely associated with high-risk and multi-type HPV infection. Our findings suggested that women's risk of having HPV may be determined more by the risk of individuals than by the risk of their partners. In aim 2, women were recruited from two gynecology clinics in Ho Chi Minh City (HCMC). All variables including partners' characteristics and women's number of bacterial STI diagnoses were obtained by women's self-report. We used Zero-Inflated Poisson regression to examine associations between both participants' and partners' demographic and behavioral characteristics and women's number of bacterial STI diagnoses. Among women who had one male partner during their lifetime, significant associations between partners' number of female sexual partners (prevalence ratio (PR) = 4.63, 95%CI = 1.44-14.88) and partners' number of STI diagnoses (PR = 27.32, 95%CI = 1.56-477.70) and women's number of bacterial STI diagnoses were found, after adjusting for women's education level. For women who had > 1 lifetime male partner, a greater number of women's bacterial STI diagnoses was associated with partners' STI history (PR = 9.12, 95%CI = 2.44-34.11). The risk of STIs in women is increased both by individual behavioral characteristics and by their primary male partner's behavioral risk factors. Therefore, primary male partners' risk factors should be included in STI risk assessments, treatment, and interventions for women. In aim 3, we used the same data as in aim 2. The proportions of participants who were "confident" or "very confident" to disclose their STI status to partners, to ask partners to have an STI examination or treatment, and to give STI medications to partners were 70.3%, 62.1%, and 69.0%, respectively. Participants' rates of perception that their partners would be "very likely" to have a STI examination and to take STI medications were 16.2% and 38.8%, respectively. A significantly lower level of self-efficacy was observed in women who had lower education levels, who had ever traded sex, and whose primary partners were not husbands or fiancés. Our findings suggest potentials for piloting partner-targeted STI interventions in HCMC, Vietnam.
Tran, Ly Thi-Hai, "The influence of primary male sexual partners' risk/protective factors on gynecological health outcomes among women in Ho Chi Minh City, Vietnam" (2014). Texas Medical Center Dissertations (via ProQuest). AAI3643706.