Human immunodeficiency virus (HIV) infection patterns and risk behaviours in different population groups and provinces in Viet Nam

The National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam.
Bulletin of the World Health Organisation (Impact Factor: 5.09). 02/2007; 85(1):35-41. DOI: 10.1590/S0042-96862007000100010
Source: PubMed


To study patterns and determinants of HIV prevalence and risk-behaviour characteristics in different population groups in four border provinces of Viet Nam.
We surveyed four population groups during April-June 2002. We used stratified random-cluster sampling and collected data concomitantly on HIV status and risk behaviours. The groups included were female sex workers (n = 2023), injecting drug users (n = 1391), unmarried males aged 15-24 years (n = 1885) and different categories of mobile groups (n = 1923).
We found marked geographical contrasts in HIV prevalence, particularly among female sex workers (range 0-24%). The HIV prevalence among injecting drug users varied at high levels in all provinces (range 4-36%), whereas lower prevalences were found among both unmarried young men (range 0-1.3%) and mobile groups (range 0-2.5%). All groups reported sex with female sex workers. Less than 40% of the female sex workers had used condoms consistently. The strongest determinants of HIV infection among female sex workers were inconsistent condom use (adjusted odds ratio [OR], 5.3; 95% confidence interval [CI], 2.4-11.8), history of injecting drug use and mobility, and, among injecting drug users, sharing of injection equipment (adjusted OR, 7.3; 95% CI, 2.3-24.0) and sex with non-regular partners (adjusted OR 3.4; 95% CI 1.4-8.5).
The finding of marked geographical variation in HIV prevalence underscores the value of understanding local contexts in the prevention of HIV infection. Although lacking support from data from all provinces, there would appear to be a potential for sex work to drive a self-sustaining heterosexual epidemic. That the close links to serious injecting drug use epidemics can have an accelerating effect in increasing the spread of HIV merits further study.

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    • "These studies were conducted in single locations or in a limited number of geographic regions and produced large variance on the measures of association. Previous studies have tended to focus on injection drug use and syringe sharing, but few studies have examined the role of non-injection drug use or reported a significant association between inconsistent condom use and HIV infection (Thuy et al., 1998; Tuan et al., 2007). In this study, we explore the extent to which FSW across Vietnam are at risk for HIV infection through unprotected sex and non-injection drug use and examine these effects in the context of the province and type of venue in which FSW work. "
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    • "Sex with female sex workers is reported frequently in male IDU populations (Go et al., 2011). In border provinces of Vietnam, sex with female sex workers and casual sex partners was found to increase the likelihood of HIV infection 3.4 times compared with IDUs who did not have non-regular sex partners (Tuan et al., 2007). "
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    ABSTRACT: Epidemiological data in Vietnam shows high HIV prevalence rates among injection drug users, especially in urban centres. However, there are limited data on specific practices used to prepare and inject drugs or on sexual practices among Vietnamese injectors. A street-based cross-sectional interview was conducted with 862 heroin injectors in Hanoi, Vietnam, to collect such data. Variability was seen in both injection and sexual risk, with 12.9% of current injectors reporting at least one unsafe method of drug sharing and 57.1% reporting unsafe sex in the past 30 days. These risks were strongly associated with those who engaged in unsafe injection significantly more likely to engage in unsafe sex (69.4% vs. 55.3%) and those engaging in unsafe sex significantly more likely to engage in unsafe injection (15.7% vs. 9.2%). These findings highlight the overlap of injection and sexual risk practices among Vietnamese heroin users and suggest the need for strong, broadly targeted HIV prevention activities among this population.
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    • "In contrast, HIV infection risk of the sex with casual partners was dose-dependent on condom use, where the people who have less condom use are more likely to be HIV positive. Studies in other countries have observed the association between sex with casual partners and HIV infection among IDUs [37]. These women may not have skills to negotiate for condom use, and even if the woman is aware of her HIV status, in casual relationships she may not feel responsible for preventing further transmission of HIV to this type of partner. "
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