Epidemiology of HIV-associated risk factors and acquisition of HIV among high-risk women in southern Vietnam

Abstract

Background: HIV epidemic is rapidly increasing in Vietnam. Although injecting drug use is still the major mode of transmission countrywide, sexual transmission is becoming increasingly important, particularly in the southern provinces. Objectives: To measure HIV-associated risk factors and HIV prevalence among high-risk women in southern Vietnam. Methods: Two cross-sectional surveys were conducted in 2000 and 2002 among high-risk women in two southern provinces bordering with Cambodia. After geographical and social mapping was conducted to develop a sampling frame, 803 women in 2000 and 801 women in 2002 were interviewed for HIV associated risk factors. Serum specimens were also collected for HIV testing. Major Results: Condom use with the last commercial client remained at the same level at 85% from 2000 to 2002 (p>0.05). However, more respondents in 2002 (71.8%) worked everyday than in 2000 (40.9%) (p<0.01) and the percentage who had seven or more clients increased from 7.5% to 18.7% (p<0.01). Consistent condoms use with the non-commercial partners declined from 35.5% to 12.1% (p<0.0l). Factors associated with condom use varied based on the type of partners. Although still fairly low compared with other cities in Vietnam, injecting drug use in these southern provinces increased from 0.4% to 3.8% (p<0.01). No change was observed in HIV prevalence from 4.0% in 2000. Positive HIV serological status was firmly associated with visits to Cambodia (odds ratio=15.9) than with injecting drug use (odds ratio=5.5) in this population. Discussion: Although condom use was high, these results imply that sexual transmission of HIV is important in this population. HIV prevalence was more strongly associated with high-risk sex work in Cambodia than injecting drug use.