Barriers to reproductive tract infection (RTI) care among Vietnamese women: Implications for RTI control programs

Background: Vietnamese women may be especially vulnerable to reproductive tract infections (RTIs) and their biological and social sequelae. Few data are available on the prevalence of and health-seeking behavior for RTIs among women in Vietnam. Goal: To assess prevalence of RTI symptoms, describe treatment-seeking behaviors, and identify barriers to care among Vietnamese women. Study Design: A population-based survey was conducted among 1163 Vietnamese women aged 18 years to 49 years. Results: Five hundred seven women (43.6%) reported RTI symptoms in the previous 6 months, including abnormal vaginal discharge (78.3%), lower abdominal pain (46.7%), and genital ulcers (3.6%). Sixty-four percent of these women sought care at some type of medical venue: health station (i.e., government clinic; 24.7%), hospital (15.8%), pharmacy (15.2%), or private doctor (8.1 %). The remaining women ignored symptoms (24.8 %) or were self-treated (11.4%). In multivariate analysis, stigma associated with sexually transmitted infections (odds ratio [OR] = 1.83; 95% confidence interval [CI] = 1.25-2.70); not seeking informal advice (OR = 2.90; 95% CI = 1.82-4.62); mildness of symptoms (OR = 3.01; 95% CI = 1.45-6.23); absence of perceived morbidity (OR = 3.56; 95% CI = 2.20-5.77); and short duration of symptoms (OR = 2.53; 95% CI = 1.04-6.16) were significantly associated with ignoring RTI symptoms. Conclusion: A substantial number of women in northern Vietnam who reported RTI symptoms did not seek care. Interventions to raise awareness about RTI symptoms and their consequences, dissipate negative stereotypes, and encourage open discussion about RTIs should facilitate appropriate careseeking for RTIs.