Sexual relationships among men who have sex with men in Hanoi, Vietnam: a qualitative interview study

Using purposive sampling we recruited 17 MSM in Hanoi, Vietnam, for in-depth interviews. Participants were aged between 19 and 48 years and came from diverse socio-economic backgrounds. Interviews were tape-recorded, transcribed verbatim, and translated into English. Latent content analysis was used.Almost all men in the study saw their same-sex attraction as part of their "nature". Many informants had secret but rich social lives within the MSM social circles in Hanoi. However, poor men had difficulties connecting to these networks. Lifetime sexual partner numbers ranged from one to 200. Seven participants had at some point in their lives been in relationships lasting from one to four years. For several men, relationships were not primarily centered on romantic feelings but instead intimately connected to economic and practical dependence. Sexual relationships varied greatly in terms of emotional attachment, commitment, trust, relationship ideals, sexual satisfaction and exchange of money or gifts. Faithfulness was highly valued but largely seen by the men as unobtainable. Several informants felt strong family pressure to marry a woman and have children.The study contextualizes HIV risk behavior among MSM in Vietnam and highlights a potential high-risk group of men in serial relationships with few partners annually but who may have a high number of sexual acts. HIV prevention among MSM in Vietnam needs to consider high-risk sex not only between casual partners but also within the context of relationships.