Viet Nam's AIDS epidemic yet to peak
Experts have warned that Viet Nam could soon face a serious AIDS epidemic. The HIV epidemic is still at an early stage, and will reach a peak in 10 years time. This was the conclusion of a recent consensus report by the World Health Organization (WHO) and Viet Nam's Ministry of Health (MOH).
The report estimated current HIV infections to be 122 350.
Evidence has shown that the epidemic is slowly spreading to the general population, after long being contained among injecting drug users. In May 2001, injecting drug users accounted for about 61% of reported infections of HIV.
While injecting drug users still remain vulnerable to HIV, infections arising from commercial sex are rising, particularly in the south and Mekong Delta area. Moreover, some sex workers are also injecting drugs - presenting a means for HIV to cross over between these groups.
Through commercial sex, HIV can spread across the whole population, with male clients of sex workers infecting their wives, who then infect their unborn children. This pattern of transmission has already been seen in Thailand and Cambodia.
In recent years, Viet Nam's sex industry has rapidly expanded, due to economic liberalization, consumerism and migration. According to local estimates, there are 300 000 sex workers in the country.
However, prostitution in Viet Nam is hidden, and is mainly not brothel-based, concludes a recent report Sex Work in Asia.
Instead, about 70% of the market comprises sex workers, who sell sex part-time, and in venues such as massage parlours, karaoke bars, hairdressing salons, dancing clubs. Sex work can also be found near transportation hubs such as Highway One, through call-girl networks and on the street.
Customers are often men who travel for a living, - truck drivers, traders, businessmen and construction workers.
Some sex workers are very mobile, moving to avoid the control of the authorities. Many do not see themselves as sex workers and are less likely to use condoms than brothel-based sex workers, believing wealthy clients will not be infected with HIV.
Studies found that sexually transmitted infections (STI), were reported in more than 30% of sex workers surveyed in three cities (Ha Noi, Ho Chi Minh City and Can Tho).
The WHO/MOH report estimates there are currently about 1 million cases of STI in Viet Nam, about a third of which are syphilis and gonorrhoea cases.
High levels of STI indicate unsafe sex is being practised and thus there is potential for HIV infections. STI often show no symptoms in women. Also, genital ulcers or lesions from STI can greatly increase the risk of contracting HIV during sexual intercourse.
The WHO/MOH report recommended that more efforts be put into the monitoring and prevention of STI, including HIV.
Providing medical care to sex workers where they are not afraid to seek treatment is crucial to controlling HIV in Viet Nam.
The report also said that by 2005, it is projected that there will be 11 500 new AIDS cases and 11 000 AIDS deaths per year. Number of HIV infections would be many times higher. Since 1994, the annual reported number of HIV infections has roughly doubled every year. Most of those infected are young, with about half (50.4%) in their twenties.
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