]Six categories of STIs, sexuality and gender relations emerged from the FGDs: Having information but lack of knowledge, different sources of information about STIs, premarital sexuality and imbalance in gender relations, unsafe sex and contracceptive practices, sharing responsibility to prevent STIs, and need of sexual and reproductive health education.
Having information but lack of knowledge
All participants in the FGDs, male and female, described that although they had heard about STIs, they did not have knowledge about STIs, in particular HIV/AIDS, and their transmission. They expressed that STIs are diseases that persons can get from unsafe sex. Some female participants had misunderstandings about STIs, e.g. that they would originate from mosquitos or that HIV/AIDS can not be transmitted from mother to child. In spite of having heard about STIs, some male participants did not make use of condom.
“I have heard about STIs and their causes, especially HIV/AIDS…But I think that I don’t know how people can get the disease and how to prevent it. I think STIs can be transmitted sexually but I am not sure about mother to child ...” (Female, FGD2)
“The health care staff came to our school and told us about STIs and their prevention but it was very short time. I do not understand and know so much about these diseases…” (Male, FGD1)
Different sources of information about STIs
All participants had received information from healthcare professionals visiting high schools. They had informed about health related to gender including anatomy, physiology and sexuality but not focusing on STIs. The participants had recieved information about STIs from other sources such as the Internet, friends, magazines, TV, radio and posters. A few female participants described that they had received unclear information from their parents. Male participants mentioned STIs such as HIV/AIDS, syphilis, gonorhea, chlamydia and genital herpes, while female participants mentioned HIV/AIDS, vaginal yeast infections (Candidiasis) and chlamydia.
“I got information from the Internet, friends, magazines, and TV. Teachers at the school and doctors who came to the school gave information and health education. My mother did not tell me…but we can chat with persons on the Internet…” (Female, FGD1)
“I and my friends got information about STIs, particularly from the Internet. We could find any information we wanted, for example by using google and typing ‘gonorrhea’ or ‘HIV/AIDS’.... We also talked together if we had a problem.” (Male, FGD3)
Premarital sexuality and imbalance in gender relations
Most participants, male and female, described that Vietnamese young adults try to import Western/European life styles, e.g. by engaging in sexuality and having sex early. Some male participants mentioned that they live together and have sexual relationship with their girlfriends, while some female participants told that sex is for both heterosexual and homosexual persons. Additionally, some male participants mentioned that their friends were curious and used the Internet to watch pornographic films. Then they tried to act like the superstars.
“I think young people have high confidence. Western culture has come to Vietnam so they try to do as in the West. They have sex earlier and … sex is … also for homosexual people. It is important to think about consequences of unsafe sex.” (Female, FGD3)
“My girlfriend and I talked about sexuality. We have been together one year so we trust each other and have agreed when we have had sex...” (Male, FGD2)
There were imbalances in gender relations when comparing discussion of premarital sexuality and condom use between men and women in the FGDs. The male FGD participants indicated that men are inherently sexual and therefore premarital sex for them was socially acceptable. The female FGD participants said that, in accord with Vietnamese traditional culture, women should have a passive attitude to sexual matters. They said also that a woman should not have premarital sex to maintain the respect of their future husband and husband’s family. However, some female FGD participants argued that woman could have sex with her boyfriend when they love together.
“Now Vietnamese young people want to live together before marriage. My friend has sexual relationship with her boyfriend. Young men go to prostitutes … and they don’t think about consequences of having unsafe sex…” (Female, FGD4)
“My friends who had had sex with prostitutes told me that they had already had sex … and suggested me to follow them.” (Male, FGD1)
Unsafe sex and contraceptive practices
A few male participants did not use condom when they had sexual intercourse. The reasons were that they wanted to prove that they did not have any STIs, and they did not want to be asked by the shop sellers if they were old enough to use condom. The male participants’ friends suggested them that they could have sex with prostitutes. Some female participants described that young people need sex and therefore they wanted to try having sexual relationship. A few of them said that they had boyfriends. Additionally, the participants described that young adults commonly use traditional contraceptive methods when having sexual intercourse. Some of the men and women in the FGDs mentioned that they did not use any contraceptive methods when they had sex unexpectedly. However, some men mentioned that they used condoms or withdrawal when they had sex. They did not like to use condoms because they thought condoms reduced their sensation during sexual intercourse.
“My girlfriend and I were together during the weekend. We could not control our emotion so we had sex and did not use any contraceptives…” (Male, FGD2)
“I asked my boyfriend to use condoms but he did not accept and used withdrawal. He did not like using them. I had to follow him.” (Female, FGD3)
Sharing responsibility to prevent STIs
STIs can affect the style and quality of life in the family and in the community. Some participants mentioned that young adults are a high-risk group for getting STIs and that these can be prevented. All participants mentioned that men and women should have responsibility together about prevention of STIs. They indicated that they should protect themselves from STIs, e.g. by having sexual relationship with one partner only. They had to protect themselves and avoid transmitting diseases to their partners or others. Some female participants expressed that men and women make love together and therefore they have responsibility to protect themselves and their partners. Also some male participants mentioned that when two persons have sex both of them have responsibility to protect themselves.
“A person who has sex with another person can bring STIs to his/her partner… When having sex there are two persons and not only one…It doesn’t work if one person wants to protect but the other doesn’t want … We have to share responsibility for safe sex.” (Female, FGD4)
“HIV/AIDS is a problem because it always ends up with dying if we get it. I think we should take responsibility to have safe sex when we have sexual intercourse with our girlfriends …” (Male, FGD2)
Need of sexual and reproductive health education
Knowledge about sexuality and reproductive health is an important issue for young adults. All participants indicated that on different educational levels (secondary school, high school, and university) they wanted to get more information and knowledge about STIs related to, e.g., their causes and prevention. They told that in high school they had only had a health education program about gender including anatomy and physiology. Both male and female participants expressed that it is important to have health education programs, which concern gender, sexuality, reproductive health including STIs, safe sex, and contraception for young adults. The participants mentioned that reproductive health education programs for students, involving reproductive health campaigns and group discussions with healthcare professionals or counselors can make young adults feel comfortable with asking questions. A few female participants mentioned that gender equality should be included in reproductive health education programs.
“Commonly in Vietnam, people do not want to discuss or talk about this (sexuality or STIs) at home because of Vietnamese cultural traditions. We should have healthcare providers come to our school and talk about diseases and prevention to students, a little bit at secondary school, more and more at high school … also at university.” (Female, FGD3)
“I don’t know about symptoms of STIs. If I have got a kind of STI, I would be ashamed to go to the clinic. I think we should get knowledge about STIs and their transmission at schools, college and university so that young adults can protect themselves when having sexual intercourse … and they can receive correct information concerning sexuality and safe sex.” (Male, FGD2)