nghiên cứu thực trạng bệnh tật và hiệu quả một số giải pháp chăm sóc y tế cho người cai nghiện ma túy tại các trung tâm chữa bệnh tóm tắt luận án tiếng anh

BACKGROUND
Until 6/30/2012, there are about 171,400 people nationwide had opiate addiction with records
management, including Heroin addiction is still largely at a rate of about 84.7%. In particular, according to
the survey results and practical struggle in many districts and the police of Ho Chi Minh City, the number of
addicts is now up to about 30,000 people. Opiate addiction crime increasing created insecurity in social life,
causing great harm to the health, adversely affect national race, leaving serious consequences for future
generations.
With the purpose of strengthening examination, treatment work and health care for opiate addiction
people in the Social Labor Education Treatment Center, the thesis focused on the following objectives:
1. Describe the situation demands, using health care services from opiate addiction and the ability of
Clinics of Social Labor Education Treatment Center in Ho Chi Minh City 2007.
2. Assess the effectiveness of some measures to strengthen health care activities for drugs
rehabilitation people at the Social Labor Education Treatment Center (2008-2010).
* New contributions of the thesis:
On the basis of describing the opiate addiction situation and drug rehabilitation at 7 Social Labor
Education Treatment Center of Ho Chi Minh City we have intervened in Phu Van Treatment Center, has
shown remarkably effective: Rate student assess the ability of health services at high level after the
intervention was increased from 12.2% to 15.7%, intervention efficiency rate reached 26.2%. Rate
consulting practitioner at Health Center increased from 24.3% to 39.3%, intervention efficiency rate was
52.3%. Percentage student had health advice every sick time was increased from 80.7% to 21.8%,
intervention efficiency reached 264.4%
* Layout of the thesis: The thesis consists of 119 pages: Introduction 2 pages; Chapter 1 –
Overview: 34 pages, Chapter 2 – Subjects and Methods: 19 pages; Chapter 3 – Results: 32 pages; Chapter 4
1
– Discussion: 29 pages; Conclusion: 2 pages; Recommendations: 1 page, 50 tables, 7 charts, 2 figures; 118
references (88 in Vietnamese and 30 in English).
CHAPTER 1
OVERVIEW
1.1. Effect of narcotics to human health:
1.1.1. The concept of narcotics and opiate addiction:
* Narcotics: As derived substances, natural or synthetic, when introduced into the human body, it

has the effect of changing consciousness and physiology of the person. If drug abuse, people will rely on it,
as it causes damage and harm to the user and the community.
* Opiate Addiction: A state of the human body depends on one or more drugs, when used long-term
habit, caused state of "hunger" chronic drug in each period and the puppets disorders both physical and
psychological, harm to individuals and society addicts.
1.1.2. Effect of narcotics:
Narcotics has affected to the drug users health, addicts, their family and society.
1.2. The actual use of health care services of drug rehabilitation people in centers:
The care and recovery health for drug rehabilitation people (DRP) at the center were concerned: nutrition
diet, health care services in center, ensure personnel, health equipments, facilities, ensuring adequate treatment
drug for drug rehabilitation people, especially the treatment of TB and HIV/AIDS; environment: enough clean
water, waste, waste water
1.3. Solutions about the care and to improve health of drug addicts:
1.3.1. Solutions for health care management, treatment and health recovery:
+ Health Management: Risk for opiate addicts health was very high, the structure of disease of the
drug rehabilitation people was complex, high health care needs, it required health management: Medical record;
Health monitoring cards; Organize health checks regular and irregular.
2
+ Organize examination and treatment: detoxification, rehabilitation and treatment of infectious
diseases, ensure nutrition diet
1.3.2. Solutions of psychological therapy, health education:
+ Psychotherapy: Motivation objects; Create the trust of students; improve service quality, both in
terms of facilities and equipment qualification; raise the spirit of service, a sense of responsibility of health
workers.
+ Health Education: includes direct Health education, indirect Health education and organization of
peer education groups.
1.3.3. Solutions related to social, community reintegration:
+ Fitness and sport: Slogan "Morning gymnastics, afternoon sports" for disease at Social Labor
Education Treatment Center.
+ Labor therapy: Helps the body to function better, more flexible, help object reintegrate the

community: by organized, managed and monitored; appropriate to health of each people; observe labor
discipline.
+ Other measures: Nutrition, Rest, Sauna, massage.
1.4. Results of implement Resolution 16/2003/NQ-QH11 in Ho Chi Minh City:
1.4.1. Communication activities, counseling, education: Contributing to alter perceptions, behaviors of
students, drug users, helping them to reintegrate into local communities back with a perfect personality.
1.4.2. Literacy, vocational training: There were 17.279 people completed courses of vocational certificate,
which has long-term vocational equivalent grade 3/7 to 1.700 people and the number of diploma graduates is
830 people.
1.4.3. Creating jobs for drug users: associated production activity, create jobs and improve lives, create jobs
in Nhi Xuan Industrial Zone, with Total Volunteer Team, in enterprise out School, Center.
1.4.4. Practitioners health care and HIV/AIDS:
3
+ Division of the General Hospital and Specialist do as the following line to receive the case beyond
the capacity of the treatment; division hospitals supports professional group and specialty groups seek
alternate-healing, exchange experiences with doctors and nurses of the centers.
+ Establish Tuberculosis unit, equipment investment, training on Tuberculosis control; open training
courses for people with HIV/AIDS program implementation VCT and antiretroviral therapy (drug
Antiretroviral HIV) in the center; organization and replication peer education in the School, Center with
more than 1.000 participants…
CHAPTER 2
SUBJECTS AND METHODS
2.1. Object, location and time study:
2.1.1. Study subjects:
- The user of health services: Drug Rehabilitation People.
- The supplier of health services: Medical staff.
2.1.2. Study sites:
- Phase 1, describes the situation: 7 Social Labor Education Treatment Centers, Department of
Labour, Ho Chi Minh City.
- Phase 2, intervention: Phu Van Health Center .

2.1.3. Study period:
- Phase 1: Survey describes the current status and development of interventions from 01/2007 –
12/2007.
- Phase 2: Apply and evaluate the effectiveness of interventions, from 01/2008 – 6/2011 in Phu Van
Health Center.
2.2. Research Methodology:
4
2.2.1. Study Design: The study cross-sectional descriptive survey combined with retrospective data analysis
and communities intervention compared before and after intervention and compared with the control group.
2.2.2. Conceptual framework for the study:
- Independent variable: The drug rehabilitation people, Family, Health Department of Center.
- Intermediate variable: demand for health care, behavior health services used by DR students;
ability of health services to meet the health care.
- Dependent variable: Some health care solutions for DRP.
2.2.3. Method of cross-sectional descriptive survey:
Respondent sample size of drug rehabilitation people was counted by the following formula:
p (1 – p)
n = Z
2
)2/1(
α
−
x DE
d
2
Among them:
+ Z: The reliability coefficients, with probability = 5% threshold, with Z = 1.96.
+ d: error acceptable, choose d = 0.025
+ p: Percentage using medical services of drug rehabilitation people in Center 2 weeks preceding the survey.
Estimated p = 0.5.

+ DE: Effective design, by design random sample many levels, so pick DE = 1.8.
As the formula above we get n = 2,766. Practice has surveyed 2,800 people.
2.2.4. Community intervention method:
Sample size of community intervention was calculated using the formula:
q
1
/p
1
+ q
2
/p
2
5
n = Z
2
)2/1(
α
−

{ln (1 – ε)}
2
Among them:
n: The minimum sample size.
Z: The reliability coefficients, with probability limit α=5%, we have: Z
)2/1(
α
−
= 1,96.
p1: Percentage of students evaluate the ability of health services to meet the demand at the above average
level, according to the survey described as 76.1%, p1 = 0.76.

q1: q1 = 1 – p1 = 1 – 0.76 = 0.24.
p2: Percentage of students evaluate the ability of health services to meet the demand after intervention in
moderate or higher, the expected result is 90%, p2 = 0.90.
q2: q2 = 1 – p2 = 1 – 0.90 = 0.10.
ε: The relative error, choose ε = 7.5%. Put the values in the formula, get n = 271, votes reserve is 10%, n =
298. In fact, 300 people were surveyed.
Content of intervention methods:
(1). Training to enhance professional skills for medical staffs.
(2). Health education for drug rehabilitation students in the Social Labor Education Treatment Center
(3). Fitness – sports methods, working therapy.
(4). Measures of psychological therapy, recreation.
2.3. Data processing:
- Research data collected will be handled according to the method of biomedical statistics, using
software EPI INFO 6.04.
6
- Using the techniques of data analysis and statistical comparisons, the test statistics: t test,
2
χ
to
compare variables.
- Assess the effectiveness of interventions: EI = ER
A
– ER
B

ER
A
: The effectiveness rate of the intervention unit.
ER
B

: The effectiveness rate of the control unit.
2.4. Limited errors technicque:
- Random error by chance: Large enough sample size, different localities.
- System error: Determining the right audience.
- Wrong number of observations in the data collection: Questionnaires, training
- Error due to the confounders: Random sampling, stratified
2.5. Research Ethics:
- Serving the interests of the drug rehabilitation people, only those interviewed voluntarily participate
in the study.
- Keep confidential all information of drug rehabilitation people and is only used for research
purposes.
CHAPTER 3
RESEARCH RESULTS
3.1. The situation demands, using health care services of practitioner's drug addiction and the ability
to meet the demands of health department centers:
3.1.1. Some characteristics of participants in drug rehabilitation centers:
Study subjects (drug rehabilitation students) in Bo La Center is taking the highest number (601
students), the lowest in Youth 2 Center (250 students). 7 centers also had male and female students, the
7
percentage of male students (83.0%), higher than female students percentage (16.1%). In particular, in Phu
Duc, male students accounted for 97.9%.
Students at drug rehabilitation center the majority of young people, in detail: Below 18 years was
2.5%, from 18-29 years old was 66.7%, 25.3% age of 30-39, the age group of 40 or older accounted for only
5.5%. The average age of participants was 28.9 ± 17.8 years.
Education Level of drug rehabilitation students was very low: only 3.4% of participants with
intermediate or higher professional, high school graduation was 21.0%, the rest i was secondary or less,
including 5.7% are illiterate, 24.2% had primary education and secondary school qualifications was 45.7%.
Average number of students came in the drug rehabilitation center is 1.2 times. There are 85.1% of
participants firstly, 14.6% of participants came in the center 2-3 times, 0.3% of participants in the center
from 4 times or more.

3.1.2. Demand for health care of drug rehabilitation practitioners in research centers:
3.1.2.1. The situation of drug use before students at the center:
Nearly 40.4% of participants was in the drug rehabilitation center over 36 months, the rate of students
in the drug rehabilitation center from 12-36 months was 35.7% and less 12 months was 23.9%. The average
time was 33.7 ± 7.6 months.
3.1.2.2. Health situation of drug rehabilitation students in centers:
Number of times per month illness of DR students at the center was 0.8 times, the rate of 1 time sick
was 2.7%; 2 sick time was 1.1%, 3 sick time was 0.5%, 4 sick time was 0.3%, the sick time over 5 was 0.5%.
In interviews with students, 31.3% of participants with test results HIV/AIDS (+), highest in Phu
Van Center (44.5%) and lowest in Binh Duc Center (23.4 %). There was 46.9% of participants with test
results HIV/AIDS (-) and 21.8% of participants did not know/no answer (DK/NA).
8
There are 25.0% of participants in the drug rehabilitation center demanded for alternative medicine,
which is the highest in the Youth 2 Center (38.8%) and lowest in Duc Hanh Center (18%). Rate of students
not wishing to use alternative medicine was 61%, with 14% of participants did not know/no answer.
There are 28.1% of participants said that their health was slightly better, 15.6% of participants said
that much better. There was 20.8% for practitioners health remain the same. Especially, 30.4% of
participants said that health deteriorated.
By outpatient examination in 2006: There were 38.2% of the total number of drug rehabilitation
student visits sick, Binh Duc highest (85.5%), lowest in Duc Hanh (22.5%). In 2007, this ratio was 52.7%,
the highest still in Binh Duc (89%), Binh Phuoc lowest (28.8%).
3.1.3. Use of medical services of drug rehabilitation practitioner in the drug rehabilitation center:
1 month before the survey, the nearest sick: 41.3% students needed medical station, 39.4% to the
health facility, 5.1% received help from friends; 5.1% self treated, while 4.2% did not do anything.
When HIV infection was suspected, students in the drug rehabilitation center were treated as follows:
52.1% of participants would like to do voluntary testing, 18.2% of participants to the health facility for
advice, in contrast with 9.8% of participants did not handle anything, and 19.9% of participants didn’t
know/no answer.
Through medical statistics and activities of the centers, the percentage of students at the center Test –
Kit HIV result (+) was 39.4% (rapid test), in which the proportion of positive the fact that 92% (reaffirmed in

Ho Chi Minh City Preventive Health Center).
Only 59.3% of participants in the drug rehabilitation center has conducted HIV testing, Duc Hanh
Center was the highest (69%), followed by Bo La Center (68.2%) , the lowest was Binh Duc (41.8%). Up to
34.5% of participants did not have HIV test.
9
In 2006, on average each month at 1 center organized 1 health education session, 2 sessions was
highest (Binh Duc Center). However, Phu Duc, Bo La did not held any meeting. In 2007, on average each
month at 1 center was 1.5 health education session, Binh Duc highest (2.5 times).
Table 3.18 shows that 29.4% of participants was consulted regularly every ill; 45.1% of the students
being consulted but not often, 14.1% was not consulted and 11.1% did not know/no answer.
Number of outpatient on average/year of students in centers were various: in Phu Duc highest (28.4
times/person/year) and lowest in Phu Van (8,8 times/student/ year).
Average of the inpatient students in centers were different: Highest rate in Binh Duc (5.9
times/person/year), followed by Youth 2 center (4.9 times/person/year) , Phu Duc was lowest (0.4
time/person/year).
3.1.4. The ability to meet of the health centers on the health care needs of drug rehabilitation students:
Status of the students/staff at the research center: in 2006 and 2007: every 7.7 students get 1 officer,
including 1 participant/61,8 health staffs.
Health staff at the center: highest rate was asistant doctor (54.9%), followed by primary nursing
school (22.1%), nursing (7.2%), doctors only 4.1%.
In 2 years (2006, 2007) at 7 research centers 3.1% of health workers were trained on drug
rehabilitation and 20.5% of health staffs were trained on treating AIDS.
Medical equipment rate of drug rehabilitation center being used overall 2 years (2006, 2007) the
average was 84.1%. The highest was in Bo La (96.5%) and lowest in Phu Duc (60.8%).
52.3% of participants assess the quality of health services at the research center in average level,
good level of 27.9%, 7.7% is very good. However, 6.8% of participants said that the health service was poor
and 5.3% of participants DK/NA.
10
Satisfaction ‘s student on the quality of health services at centers: 41.7% of participants satisfied at
moderate level, 21.9% are very satisfied. However, there are 10.4% of the students were not satisfied and

16% students less satisfied, with 9.6% of participants didn’t know/no answer.
Regarding the ability of health services to meet the demand: 63.3% of participants said at the
medium level, high level response was 12.8% lower response level was1.7%, no response was 6.9%.
3.2. Assess the effectiveness of some measures to strengthen health care for drug rehabilitation people
in centers:
3.2.1. Results of the implementation some interventions in Phu Van:
Table 3:28. Results of health staffs training in drug rehabilitation at Phu Van Center
Content
In 2008
(n = 41)
In 2009
(n = 45)
In 2010
(n = 45)
Quantity % Quantity % Quantity %
Drug rehabilitation Process 38 92.7 41 91.1 42 93.3
The drug detoxification support for
drug rehabilitation people
35 85.4 42 93.3 42 93.3
The alternative medicine 41 100 44 97.8 45 100
Recovering health care for drug
rehabilitation people
36 87.8 40 88.9 41 91.1
Table 3:29. Results of health staff training on treatment and health care for AIDS patients in Phu Van
Content
In 2008
(n = 41)
In 2009
(n = 45)
In 2010

(n = 45)
Quantity % Quantity % Quantity %
11
Treatment of patients with AIDS 35 85.4 39 86.7 41 91.1
Treatment of opportunistic infections 36 87.8 38 84.4 40 88.9
Health Care Patient with AIDS 39 95.1 40 88.9 39 86.7
Table 3.30. Results of health staffs training on Communication-Health Education in Phu Van
Content
In 2008
(n = 41)
In 2009
(n = 45)
In 2010
(n = 45)
Quantity % Quantity % Quantity %
Forms of Communication-Health
Education
40 97.6 42 93.3 42 93.3
Skill for Communication-Health
Education
38 92.7 40 88.9 42 93.3
Use media for C-HE
37 90.2 42 93.3 41 91.1
The content needs to C-HE for DRP
39 95.1 39 86.7 40 88.9
Plan and organize a C-HE session 40 97.6 41 91.1 42 93.3
Table 3.31. Result of indirect communication for Drug Rehabilitation People behavior change in Phu
Van
Content In 2008 In 2009 In 2010
12

Loudspeaker of centers (lessons) 30 35 42
Panels, posters (units) 54 63 63
Leaflets (pages) 1,500 2,100 2,100
Table 3.32. Results of direct communication for Drug Rehabilitation People behavior change at Phu Van
Content In 2008 In 2009 In 2010
No. of
session
No.of
people
No. of
session
No.of people
No. of
session
No.of people
CHE for organization 10 3,950 13 4,860 13 5,020
CHE for group 35 535 40 616 42 605
CHE for individuals 850 942 965
CHE: Communication-Health Education
13
Table 3.33. Results of psychological therapy, recreation for students in Phu Van
Content
In 2008 In 2009 In 2010
No. of
session
No.of
people
No. of
session
No.of

people
No. of
session
No.of
people
Individual psychological therapy 320 318 345
Comunity art contest 3 250 4 320 4 325
Newspaper contest 2 3 3
Watch movie 10 16,200 12 18,400 12 18,600
Watch TV In the evening everyday
3.2.2. Effect of some interventions to improve health care activities for Drug Rehabilitation People in Phu
Van center:
Table 3.34. Percentage of students self-assess the health situation in center 3 months after intervention
(AI) and before intervention (BI)
Indicators
Intervention center Control center IE
(%)
BI
n = 362 (1)
AI
n = 300 (2)
BI
n = 434 (3)
AI
n = 300 (4)
n % n % n % n %
Still the same 68 18.8 83 27.7 100 23.0 86 28.7
Worse 137 37.9 48 16.0 162 37.3 103 34.4
Slightly better * 95 26.2 120 40.0 84 19.4 64 21.3 42.7
Much better ** 32 8.8 46 15.3 27 6.2 28 9.3 23.9

14
Did not Know
/No Answer
30 8.3 3 1.0 61 14.1 19 6.3
Compare p
1,2 (*)
<0.001; p
2,4(*)
<0.001
p
1,2 (**)
<0.05; p
2,4(**)
<0.05
The table 3.34 showed the results: Percentage of students self-assessment of their health status were
better after coming to DRC has increased after intervention was statistically significant:
- Percentage of students assessed health slightly better was increased from 26.2% before the
intervention to 40.0% after intervention with p <0.001 and higher than controls (40.0% compared with
21.3%), the difference was statistically significant with p<0.001, effective interventions to reach 42.7%.
- Percentage of students assessed much better health was increased from 8.8% before the
intervention to 15.3% after intervention with p <0.05, and higher than controls (15.3% compared with 9.3%)
with p <0.05, intervention efficiency to reach 23.9%.
Table 3.35. No. of sick times 1 month before investigation by Drug Rehabilitation People BI and AI
Indicators
Intervention center Control center Compare
(p)
BI, n=362 (1) AI, n=300 (2) BI, n=434 (3) AI, n=300 (4)
n % n % n % n %
1 time sick 11 3.0 11 3.5 14 3.2 11 3.6
2 times sick 4 1.2 2 0.8 5 1.1 3 1.0

3 times sick 1 0.3 1 0.3 3 0.6 2 0.8
4 times sick 1 0.3 1 0.3 2 0.4 1 0.3
5 times sick 3 0.8 1 0.3 6 1.4 2 0.8
Times sick
average
0.8 0.5 1.0 0.9 P
1,2
<0.01,P
2
,
4
<0.01
15
Table 3.35 showed, the proportion of students got the sick times in month high (5 times or more)
was lower than before intervention (0.3% compared with 0.8%) and lower than the control (0.3% compared
with 0.8%). Average number of sick time in a month before the survey was lower than before intervention
(0.5 time compared to 0.8 time) with p <0.001 and lower than controls (0.5 time to 0.9 time) with p <0.001.
Table 3.36. The rate of Drug Rehabilitation People through outpatient examination at center BI and AI
Indicators
Intervention center Control center
EI
(%)
BI n=362 (1) AI n=300 (2) BI n=434 (3) AI n=300 (4)
n % n % n % n %
Incidence Rate 251 69.4 128 42.7 339 78.2 207 69.0 26.5
Without disease Rate 111 30.6 172 57.3 95 21.8 93 31.0
Compare p
1,2 (*)
<0.001; p
2,4(*)

<0.001
Results Table 3.36 shows: Incidence of Drug Rehabilitation People through outpatient examination
at centers, after intervention was lower than before intervention and lower than the control centers, in details:
reduced from 69, 4% before the intervention to 42.7% after the intervention (at intervention center) with p
<0.001. This rate in the intervention center was also lower than that in the control center (42.7% compared to
69.0%), the difference is statistically significant with p <0.001, effective intervention at 26.5%.
Table 3.37. Ratio of staff and participant in the DRC before and after intervention
Indicators Intervention center Control center
BI (1) AI (2) BI (3) AI (4)
16
Number of Students/1 staff (people) 8.3 8.5 6.9 8.2
Number of Students/1 health staff (people) 30.5 28.6 62.2 40.5
Number of student/health staff at intervention center and control center after intervention were also
reduced compared to the time before intervention: At intervention center was 30.5 students/1 health staff
(before intervention) compared with 28.6 students/1 health worker (after intervention), at control center
correspond figures were 62.2 students/1 health staff and 40.5 students/1 health staff.
Table 3.38. Rate of students assess the quality of health services BI and AI
Indicators
Intervention center Control center
EI
(%)
BI
n=362 (1)
AI
n=300 (2)
BI
n=434 (3)
AI
n=300 (4)
n % n % n % n %

- Poor 41 11.3 18 6.0 33 7.6 28 9.3
- Medium 171 47.2 103 34.3 195 44.9 105 35.0
- Good (*) 106 29.4 137 45.7 150 34.6 110 36.7 49.3
- Very good (**) 15 4.1 32 10.7 41 9.4 45 15.0 101.4
- DK/NA 29 8.0 10 3.3 15 3.5 12 4.0
Compare p
1,2 (*)
<0.001; p
2,4(*)
<0.05; p
1,2 (**)
<0.01; p
2,4(**)
>0.05
Results Table 3.38 shows: Percentage of students assessed the quality of the health service was good
and very good after intervention higher than before intervention and higher than the control, in details:
17
- Percentage of students rated health services quality was good increased from 29.4% to 45.7% with
p <0.001 and higher than controls (45.7% compared to 36.7%) with p <0.05, effective interventions to reach
49.3%.
- Percentage of students rated as very good quality health services increased from 4.1% to 10.7%
with p <0.01, but this rate was still lower than in controls (10.7% compared to 15.0%), the difference is not
statistically significant with p > 0.05, effective interventions to reach 101.4%.
Table 3.39. Satisfaction rate of students for health services quality before and after intervention
Indicators
Intervention center Control center
EI
(%)
BI
n=362 (1)

AI
n=300 (2)
BI
n=434 (3)
AI
n=300 (4)
n % n % n % n %
Not satisfied 56 15.5 22 7.3 111 25.6 82 27.3
Satisfied a bit 62 17.1 48 16.0 109 25.1 70 23.3
Satisfied moderate* 146 40.3 151 50.3 113 26.0 102 34.0 17.1
Very satisfied ** 59 16.3 71 23.7 15 3.5 20 6.7 25.4
Did not know/No answer 39 10.8 8 2.7 86 19.8 26 8.7
Compare p
1,2 (*)
<0.05; p
2,4(*)
<0.001
p
1,2 (**)
<0.05; p
2,4(**)
<0.001
The table 3.39 showed the results: Practitioners satisfaction on the quality of health service in center
after intervention significantly improved compared with before intervention and compared to control:
- Satisfaction average increased from 40.3% to 50.3% after intervention with p <0.05 and higher
than controls (50.3% compared to 34.0%) with p <0.001, intervention effectiveness was 17.1%.
18
- Satisfaction level was increased from 16.3% before the intervention to 23.7% after intervention
with p <0.05 and higher than controls (23.7% compared with 6.7%) with p <0.001, effective interventions to
reach 25.4%.

Table 3.40. Proportion of health staffs were trained to improve professional before and after
intervention
Indicators
Intervention center Control center EI
(%)
BI
n=41 (1)
AI
n=45 (2)
BI
n=25 (3)
AI
n=28 (4)
n % n % n % n %
DR Training 0 0 42 93.3 0 0 0 0
AIDS Treatment Training (*) 10 24.4 40 88.9 7 28.0 10 35.7 236.8
Communication-Health
education training
0 0 41 91.1 0 0 0 0
Compare p
1,2 (*)
<0.001; p
2,4(*)
<0.001
Results Table 3.40 shows: After intervention, rate of health staffs were trained in the advanced
professional levels content increased significantly: The DR content and P-HE before the intervention without
training, after intervention they were trained with proportion were 93.3% and 91.1%. Content on treating
AIDS patients rate health workers are trained before the intervention increased 24.4% to 88.9% after
intervention with p <0.001. This ratio was also higher than controls (88.9% compared to 35.7%) with p
<0.001, effective interventions to reach 236.8%.

Table 3.41. Status of student had health counseling at center before and after intervention
Indicators Intervention center Control center EI
(%)
BI AI BI AI
19
n=362 (1) n=300 (2) n=434 (3) n=300 (4)
n % n % n % n %
- not be advised 52 14.4 12 4.0 93 21.4 52 17.3
- be advised but not often 190 52.5 41 13.7 154 35.5 137 45.7
- be advised every sick time
(*)
79 21.8 242 80.7 75 17.3 55 18.3 264.4
- DK/NA 41 11.3 5 1.7 112 25.8 56 18.7
Compare p
1,2 (*)
<0.001; p
2,4(*)
<0.001
Table 3.41 Results showed that rate of students had health advice often every sick time was
increased from 21.8% before the intervention to 80.7% after intervention with p <0.001. This ratio is also
higher than controls (80.7% compared to 18.3%), the difference is statistically significant with p <0.001,
effective interventions 264.4%.
20
Table 3.42. The situation of HIV testing in centers of practitioner before and after intervention
Indicators
Intervention center Control center EI
(%)
BI
n=362 (1)
AI

n=300 (2)
BI
n=434 (3)
AI
n=300 (4)
n % n % n % n %
- Bever before 107 29.6 0 0 161 37.1 115 38.3
- Have ever (*) 236 65.2 300 100 216 49.8 156 52.0 49.0
- Did not know/No answer 19 5.2 0 0 57 13.1 29 9.7
Compare p
1,2 (*)
<0.001; p
2,4(*)
<0.001
Table 3.42 The results showed that 100% participants were tested after intervention for HIV compared with
65.2% before the intervention with p <0.001. This ratio is also higher than the control (100% compared to
52.0%), the difference was statistically significant with p <0.001, effective interventions to reach 49.0%.
Table 3.43. Demand for alternative medicine of practitioners in centers before and after intervention
Indicators
Intervention center Control center EI
(%)
BI
n=362 (1)
AI
n=300 (2)
BI
n=434 (3)
AI
n=300 (4)
n % n % n % n %

- No need 167 46.1 54 18.0 198 45.6 141 47.0
- Need (*) 138 38.1 221 73.7 101 23.3 122 40.7 18.0
- Did not know/No answer 57 15.8 25 8.3 135 31.1 37 12.3
Compare p
1,2 (*)
<0.001; p
2,4(*)
<0.001
Table 3.43 shows: Percentage of students in need of alternative medicine use increased from 38.1% before
the intervention to 73.7% after the intervention, the difference is statistically significant with p <0.001. This
21
ratio is also higher than controls (73.7% compared to 40.7%), the difference is statistically significant with p
<0.001, effective interventions to reach 18.0%.
22
Table 3.44. Treatment of students suspected of being infected with HIV BI and AI
Indicators
Intervention center Control center EI
(%)
Before
interventio
n
n=362 (1)
After
interventio
n
n=300 (2)
Before
interventio
n
n=434 (3)

After
interventio
n
n=300 (4)
n % n % n % n %
Do not
handle
34 9.4 12 4.0 59 13.6 57 19.0
Consulting
at health
station *
88 24.3 118 39.3 37 8.5 28 9.3 52.3
Voluntary
test**
162 44.7 163 54.3 195 44.9 135 45.0 21.3
Did not
know/No
answer
78 21.6 7 2.4 143 33.0 80 26.7
Compare
p
1,2 (*)
<0.001; p
2,4(*)
<0.001
p
1,2 (**)
<0.05; p
2,4(**)
<0.05

The table 3.44 shows: When suspected HIV infection, the rate of students to advise at clinics and have
HIV testing were higher than before the intervention and control, in details:
- Percentage of students were consulted in medical station increased from 24.3% before the
intervention to 39.3% after the intervention, the difference is statistically significant with p <0.001. This ratio is
23
also higher than controls (39.3% compared to 17.3%), the difference was statistically significant with p <0.001,
intervention efficiency 52.3% .
- Percentage of students tested for HIV increased from 44.7% before the intervention to 54.3% after
the intervention, the difference was statistically significant with p <0.05. This ratio was also higher than
controls (54.3% compared to 45.0%), the difference was statistically significant with p <0.05, 21.3%
intervention efficiency.
24
Table 3.45. Status of health education, health counseling for students in centers BI, AI
Indicators
Intervention
center
Control center
EI
(%)
BI
n=427
(1)
AI
n=480
(2)
BI
n=583
(3)
AI
n=596

(4)
- Total health education
sessions /year
18 55 0 13
- Average sessions / month
(*)
1.5 4.6 - 1.1
- Times were consulted/year 392 965 2.962 2.530
- Times were
consulted/students/year (*)
0.9 2.3 5.1 4.3 139.9
Comparison p
1,2
<0.001
Table 3.45 shows: Indicators of health education and health counseling for students at centers after
intervention were higher than before the intervention and compared to control, especially:
- Average number of health education sessions/month increased from 1.5 to 4.6 sessions and the
higher than controls (4.6 sessions compared to 1.1 sessions).
- Total health counseling/student/year increased from 0.9 time to 2.3 times, the difference was
statistically significant with p <0.001, but still lower than the control (2.3 times compared to 4.3 times),
effective interventions to reach 139.9%.
CHAPTER 4
DISCUSSION
25