Factors Associated with Receiving Late HIV Testing Among Women Delivering at Hung Vuong Hospital, Ho Chi Minh City, Vietnam, 2014.

HIV testing during pregnancy facilitates timely antiretroviral treatment for HIV-positive women. This study identifies reasons for late HIV testing among pregnant women delivering at a hospital in Ho Chi Minh City. We conducted a case-control study in which 160 cases were women who were tested for HIV late (i.e., at labor and delivery) and 160 controls were women who were tested during antenatal care (ANC). In multivariable logistic regression analysis, six variables were associated with late HIV testing: age less than 30 years, nine or fewer years of education, working as a homemaker or worker/farmer, living 20 km or more from the hospital, having received ANC at a private clinic/hospital only, and not believing that HIV testing is important during pregnancy. We recommend that national programs should provide additional effort for HIV testing during pregnancy to young women, less educated women, homemakers, and those receiving ANC at private clinics and hospitals.

HIV in female sex workers in five border provinces of Vietnam.

OBJECTIVES: To determine the prevalence of HIV and associated risk factors among female sex workers (FSWs) in border provinces of Vietnam. METHODS: 911 FSWs in five border provinces of Vietnam (Lai Chau, Quang Tri, Dong Thap, An Giang, and Kien Giang) were enrolled in a cross sectional study. Subjects were interviewed using a standardised questionnaire about selected sociodemographic and behavioural characteristics, history of STIs, and information about their cohabiting partners (husbands or live-in partners). Serological tests were done for HIV and syphilis (TPHA+RPR) and urine tests (PCR) for chlamydia and gonorrhoea. Associations between HIV and selected features of FSWs and their partners were examined using univariate and multivariate logistic regression analysis. RESULTS: Overall, the prevalence of HIV among FSWs in the five provinces of Vietnam was 4.5%. The prevalence of HIV was higher in the southern border regions (4.0%-7.0%) than the northern (2%) and central (1%) regions. In multivariate analysis between HIV and selected features of FSWs, income < or =$33/month (OR 2.36, p = 0.04), age of first sex < or =15 (OR = 5.48, p = 0.005), and > or =9 clients per week (OR 2.80, p = 0.018) were associated with HIV infection. Positive syphilis serology achieved a borderline significant association with HIV (OR 2.30, p = 0.095). Having a regular non-paying partner (OR = 0.35, p = 0.060) was a borderline protective factor for HIV. CONCLUSION: Interventions to limit HIV transmission among FSWs in Vietnam should be implemented early and focus on young poor populations in these border areas.

Predictors of visits to commercial sex workers by male attendees at sexually transmitted disease clinics in southern Vietnam.

OBJECTIVES: To determine the HIV/sexually transmitted disease (STD) status of male patients at STD clinics and factors associated with frequent visits to commercial sex workers (CSW) in southern Vietnam. DESIGN: Cross-sectional survey. METHODS: Confidential interviews and physical and laboratory evaluation of 804 male patients at STD clinics in two semi-rural provinces in the Mekong delta. RESULTS: HIV seroprevalence was 0.5%. The prevalence of urethritis syndrome was 19.3%, gonorrhea 10.2% (Gram-stain positive) and syphilis 2% (reactive rapid plasma reagin test). All the men had visited CSW in the past and 58% had their first sexual experience with a CSW; 73% had visited a CSW in the last 3 years. Married men were equally as likely as single men to have casual partners or to have visited a CSW. The men recruited CSW more from the streets (45%) than from brothels (38%). Factors independently associated with visiting a CSW in the last 3 years included being single [odds ratio (OR), 2.2], age under 20 years (OR, 1.9), having first sexual intercourse with a CSW (OR, 2.1), not having a current girlfriend (OR, 2.1), using alcohol before sex (OR, 2.7) and drug use (OR, 1.8). Only 7% of men used condoms consistently; 70% had never used them. Only 37% had used a condom last time they had intercourse with a CSW. CONCLUSIONS: Prevention programs for men in Vietnam, particularly those who are young or single, need to focus on reducing drug and alcohol consumption and improving condom use with CSWs.

Prevalence of enteric hepatitis A and E viruses in the Mekong River delta region of Vietnam.

A study of antibody prevalence for hepatitis A virus (HAV) and hepatitis E virus (HEV) was carried out in southwestern Vietnam in an area adjacent to a known focus of epidemic HEV transmission. The purpose of this investigation was first to provide a prevalence measure of hepatitis infections, and second to determine the outbreak potential of HEV as a function of the susceptible population. Blood specimens collected from 646 persons in randomly selected village hamlets were examined by an ELISA for anti-HEV IgG and anti-HAV IgG. The prevalences of anti-HEV IgG and anti-HAV IgG were 9% and 97%, respectively. There was a significant increase (P < 0.01) in age-specific anti-HEV IgG. A notable increase in anti-HAV IgG prevalence (P < 0.0001) occurred between child populations 0-4 (64%) and 5-9 (95%) years of age. No evidence of familial clustering of anti-HEV IgG-positive individuals was detected, and household crowding was not associated with the spread of HEV. Boiling of water was found to be of protective value against HEV transmission. A relatively low prevalence of anti-HEV indicates considerable HEV outbreak potential, against a background of 1) poor, water-related hygiene/sanitation, 2) dependence on a (likely human/animal waste)-contaminated Mekong riverine system, and 3) periodic river flooding.

HIV infection and risk factors among female sex workers in southern Vietnam.

OBJECTIVES: To determine the extent of HIV infection among female commercial sex workers (CSW), to identify risk factors, and to provide baseline data for developing and targeting prevention measures. SUBJECTS AND METHODS: A total of 968 female CSW were enrolled in a cross-sectional study from August 1995 to October 1996. Information was obtained from confidential face-to-face interview, physical examination, and laboratory testing. RESULTS: A total of 65.5% of female CSW reported inconsistent condom use. Overall seroprevalence was 5.2%. The highest seroprevalence (9.5%) was detected in An Giang province, a border area adjacent to Cambodia. Out of seven HIV isolates in An Giang province, six were characterized as Thai subtype E and one as subtype B. Multiple logistic regression analysis showed an independent significant association between HIV seroprevalence and the following: age < or = 30 years [odds ratio (OR), 5.1; 95% confidence interval (CI), 1.7-15.2]; high frequency of sex (> 20 times per week; OR, 13.5; 95% CI, 3.6-50.2); inconsistent condom use (OR, 2.8; 95% CI, 1.01-8.0; sign of genital ulcers (OR, 18.1; 95% CI, 1.8-182); venereal warts (OR, 9.0; 95% CI, 2.5-33.0); brothels as sex venue (OR, 7.0; 95% CI, 2.0-24.3); and working at the border area (OR, 5.1; 95% CI, 2.4-11.0). Brothels as work-sites were significantly related to inconsistent condom use and the socioeconomic background of clients. Only 0.5% of CSW reported injecting drug use. CONCLUSIONS: Female CSW at brothels who reported inconsistent condom use and ulcerous sexually transmitted disease, particularly in the border area with Cambodia, had greater risk of HIV infection. Brothels were more frequently used as sex venues in the border area and were more likely to be visited by occasional clients who were difficult to access. Drug use among female CSW in this region was rare. The development of prevention measures should be based on these results.