Abstract
BackgroundRisk 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.MethodsA 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.ResultsSeventeen 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).ConclusionsInterventions 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.
Highlights
Global efforts in the fight against HIV epidemics have resulted in a 25% reduction in HIV incidence [1]
We interviewed the participants and had their blood samples collected by female health care workers who were experienced in harm reduction programs
The prevalence of HIV among female sex workers (FSW) in Mekong Delta was low (2.1%), and higher among street-based sex workers (SSWs) than among establishment-based sex workers (ESWs) (3.8% vs. 1.8%, p = 0.02) (Table 2)
Summary
Global efforts in the fight against HIV epidemics have resulted in a 25% reduction in HIV incidence [1]. In many parts of the world, the burden of HIV remains high among high-risk populations, including female sex workers (FSWs), injecting drug users, and men who have sex with men [2]. Sex work places the clients and partners of FSWs at high risk of HIV infection as well, who can act as a bridge for the disease into the general population [4]. 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
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