Abstract
The first systematic epidemiological surveys in Viet Nam of sex workers and injecting drug users in rehabilitation camps patients attending sexually transmitted disease (STD) clinics tuberculosis patients and prenatal women were undertaken as part of a process leading to formulation of a new Vietnamese policy on human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS). 6 areas were covered including Hanoi Hai Phong Nha Trang An Giang Danang and Ho Chi Minh City. 153407 persons were screened by November 26 1993; 57% of HIV-positive individuals were in Saigon and 3 seropositive persons were found in the North. While 87% of seropositive persons were injecting drug users 77% (20/26) of those in An Giang province were sex workers. Of a cumulative total of 957 reported cases of HIV (945 were identified in the first 11 months of 1993) 57 had AIDS; 18 of these died. The first reported case of HIV in Viet Nam occurred in Saigon in 1990. There were no reported cases the following year but 11 cases were found in the South in 1992. Of these 8 were patients with STDs. An open door policy adopted in 1989 led to an increase in sex workers (now approximately 300000 in number). Injecting drug users number approximately 100000 (30000 in Saigon). Past policy has emphasized warnings about infection by foreigners and campaigns against prostitutes and drug users. However the seroprevalence of HIV in rehabilitation centers for drug users has increased (0 to 95% in 1 center in Nha Trang) because of weekend leave drug smuggling and unsafe behavior due to a shortage of needles. Merging programs controlling prostitution drug use and AIDS has resulted in stigmatization of HIV-positive individuals and confusion at the local level. Local initiatives to provide clean needles to drug users or condoms to sex workers are discouraged. As long as persons are treated as social deviants at constant risk of arrest and isolation they will avoid participation in sexual and HIV educational and surveillance programs.
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