Content area
Full text
Because of concerns for HIV risks and need to plan effective programs, we assessed the number and risks of sex workers in Nha Trang City, Vietnam. Sex workers were contacted in streets, beaches, bars, and restaurants, and a capture-recapture method was used to estimate their number. An estimated 444 women worked on the streets and beach ("direct" sex workers) and 486 worked in bars and restaurants or other facilities ("indirect" sex workers). Direct and indirect sex workers engaged in sex work primarily to support their families. Direct sex workers were older and were more at risk for HIV risk than were indirect sex workers. Direct sex workers had more clients, were less likely to report always using condoms (67% vs. 81%), more likely to report a prior sexually transmitted infection (19% vs. 16%), and more likely to have clients who inject drugs (16% vs. 13%). This assessment has implications for planning programs to reduce sex work and its risks in Vietnam and potentially other countries.
The first reported case of HIV infection in Vietnam was diagnosed in 1990 in Ho Chi Minh City. By 1998, HIV/AIDS cases had been identified in the three other major urban areas, Hanoi, Hai Phong and Da Nang, and in all 57 provinces. To respond to the HIV epidemic, Vietnam implemented several national programs, including a sentinel surveillance system that is currently operating in 26 provinces and all four major urban areas. The sentinel populations included injection drug users (IDUs), commercial sex workers, antenatal women, patients from sexually transmitted disease (STD) clinics, and tuberculosis clinic patients.
Through December 2003, 76, 180 persons with HIV infection had been reported to the Vietnamese Ministry of Health. Of these persons, 11,659 had developed AIDS and 6,550 had died. To date, the dominant mode of HIV transmission has been through injection drug use. In recent years, however, surveillance has revealed a rising incidence of HIV among sex workers. The 2001 sentinel surveillance surveys found HIV among sex workers to be 22.5% in Ho Chi Min City and at least 5% in some provinces. Furthermore, sentinel surveillance activities in different regions of the country are increasingly finding sex workers who are also IDUs (Vietnam National AIDS Standing Bureau, 2001). The increased HIV prevalence driven...