HIV infection, risk factors, and preventive services utilization among female sex workers in the Mekong Delta Region of Vietnam.

BACKGROUND: Risk behaviors among female sex workers (FSW) are considerable drivers of HIV infections in Vietnam, especially transmission between high-risk and low-risk groups. We assessed HIV prevalence and its correlates among FSWs, and the use of preventive services among this community in the Mekong Delta region, southern Vietnam. METHODS: A cross-sectional survey of 1,999 FSWs was carried out in five provinces including Ben Tre, Hau Giang, Kien Giang, Tien Giang, and Vinh Long between June, 2006 and June, 2007. We interviewed participants face-to-face in order to elicit information about their lives and potential risk factors, and we tested their sera to determine their HIV status. We then performed multivariate logistic regression analyses to investigate factors associated with HIV infection. RESULTS: Seventeen percent of the participating FSWs were street-based sex workers (SSWs) and the rest (83%) were entertainment establishment-based sex workers (ESWs). Unprotected sex with regular and casual clients in the past month was frequent among study participants (40.5% and 33.5% respectively). However, few respondents (1.3%) had ever injected drugs. Only 2.1% (95% confidence interval (CI): 1.6%-2.8%) of FSWs were found to be infected with HIV. HIV prevalence among SSWs was greater than among ESWs (3.8% vs. 1.8%, p = 0.02, respectively). Increased risk for HIV infection was significantly associated with the number of clients per month (adjusted odd ratio (aOR) = 2.65, 95% CI: 1.26-5.59). CONCLUSIONS: Interventions to reduce unsafe sex and drug injection, and to increase uptake of HIV testing among FSWs are necessary. Differences in HIV prevalence and its correlates by type of sex work emphasize the importance of constrained contexts in shaping risk behaviors among FSWs; that should be considered in designing HIV prevention programs.

Prevalence of HIV/STIs and associated factors among men who have sex with men in An Giang, Vietnam.

BACKGROUND: The prevalence of HIV and sexually transmitted infections among men who have sex with men (MSM) has increased substantially in Vietnam. This study aimed to estimate the prevalence of HIV, syphilis, urethral gonorrhoea, and urethral chlamydia, and determined correlates of HIV infection among MSM in An Giang, Vietnam. METHODS: A group of 381 MSM were recruited in a community-based cross-sectional survey between August and December 2009. Face-to-face interviews were conducted for collecting data on sociodemographics, behaviors, and access to HIV prevention programs. Serological tests for HIV and syphilis and polymerase chain reaction for gonorrhoea/chlamydia were performed. Multivariate regression analyses were used to investigate the correlates of HIV infection. RESULTS: The prevalence of HIV, syphilis, gonorrhoea, chlamydia, and gonorrhoea/chlamydia were 6.3%, 1.3%, 1.8%, 3.2%, and 4.7%, respectively. HIV prevalence among 63 injecting MSM was significantly higher than that of 318 noninjectors (20.6% vs. 3.5%, P < 0.001). Approximately 40.4% identified as heterosexual and 42.8% had ever had sex with females. The rate of unprotected anal intercourse with another male in the last month was substantially high (75.3%). Injecting drugs (adjusted prevalence ratio [aPR] = 2.88, 95% confidence interval [CI]: 1.12-7.42), being transgender (aPR = 4.27, 95% CI, 1.17-15.57), and unprotected sex with a female sex worker (aPR = 4.88, 95% CI: 1.91-12.50) were significantly associated with HIV infection. The infection risk increased with age to a peak of 25 years and then decreased. CONCLUSIONS: Although prevalence levels are lower in An Giang, Vietnam than in some other comparable locations, HIV/sexually transmitted infections prevention, and sexual health promotion targeting MSM are highly important in this location.

Correlation between HIV and sexual behavior, drug use, trichomoniasis and candidiasis among female sex workers in a Mekong Delta province of Vietnam.

To determine the prevalence of HIV and correlates of HIV infection among female sex workers (FSWs) in Soc Trang province, Vietnam, a survey of 406 FSWs in Soc Trang province was conducted between May and August, 2003. The participants were interviewed, using a standardized interview, to obtain information about socio-demographic and behavioral characteristics, and gynecologic and sexually transmitted infection (STI) history. The prevalence of HIV was 3.3%. An increased risk for HIV was associated with ever using illicit drugs, direct sex work, early sexual debut, age of FSWs, and infection with candidiasis and trichomoniasis. Reduced likelihood of HIV was only associated with withdrawal as a contraceptive method. A strong association of HIV with drug use and candidiasis and trichomoniasis infection among FSWs was found. Needle/syringe exchange, STI treatment, and methadone programs targeting FSWs should be implemented, and should include 100% condom use promotion.