Premarital sex—often with a future spouse—on the rise in Vietnam

Though HIV prevalence in Vietnam is currently estimated to be less than 1%, public health officials fear that an increasing number of men are having sex before marriage and that this trend may lead to a rise in the epidemic. A new study reveals that many men who have sex before they marry do so only with the woman who eventually becomes their wife. Overall, 22% of men in the South and 17% of those in the North report having had premarital sex with a girlfriend they did not marry, thus increasing their risk of contracting and spreading HIV.

The study, "Continuity and Change in Premarital Sex in Vietnam," by Sharon Ghuman of the Population Council, et al., appears in the current issue of International Family Planning Perspectives.

Also in this issue:

Nigerian women often turn to abortion to end unwanted pregnancies, according to “Unwanted Pregnancy and Associated Factors Among Nigerian Women,” by Gilda Sedgh of the Guttmacher Institute, et al. The authors analyzed findings from a community survey of nearly 3,000 Nigerian women and found that of the 28% who reported having experienced an unwanted pregnancy, half had attempted to end that pregnancy. Forty-four percent of women not practicing contraception when they became pregnant said they were not aware of family planning and 22% said that they did not have access to contraceptive services, that services were too expensive or that they were afraid of side effects.

In analyzing surveys of women from Burkina Faso, Ghana and Kenya, Ilene Speizer of the University of North Carolina and MEASURE Evaluation Project, both in Chapel Hill, NC, argues that measures of unmet need for contraceptive services may not be the best way to identify prospective clients of contraceptive services. In “Using Strength of Fertility Motivations to Identify Family Planning Program Strategies,” she explains that while one in four women want to delay their next pregnancy or limit the number of pregnancies they experience, 16–31% of women surveyed in Burkina Faso and Ghana and 30–56% of those in Kenya said that getting pregnant in the next few weeks would be no problem or a small problem.

In “Relationship Between HIV Risk Perception and Condom Use: Evidence from a Population-Based Survey in Mozambique,” Ndola Prata of the University of California, Berkeley, et al., find that most men and women in Mozambique underestimate their risk of exposure to the virus and that this misperception of risk appears to affect whether they use condoms. Men and women who had never been married and who assessed their risk correctly were, respectively, 18% and 17% more likely than others to use condoms. Educational campaigns to help individuals correctly estimate their risk are needed, the authors conclude.

Reproductive health providers should take into account the effects of sexual and physical violence on their patients, according to “Domestic Violence and Symptoms of Gynecologic Morbidity Among Women in North India,” by Rob Stephenson of Emory University, Atlanta, et al. The authors analyzed surveys from 3,642 couples in North India and found that women who had experienced sexual and physical violence were more likely than other women to have gynecological health symptoms.

In “Choice Is Empowering: Getting Strategic About Preventing HIV Infection in Women,” by Erica L. Gollub of the University of Bordeaux II, Bordeaux, France, argues that effective HIV prevention for women must address the fact that most women around the world rely on men’s use of the male condom as their sole protection against the virus. A better solution would include investing in the development of women-controlled methods like microbicides.