Objectives: To determine changes in the prevalence of sexually transmitted infection (STI)/HIV in female sex workers (FSWs) after a community HIV prevention intervention project in five border provinces of Vietnam. Methods: The project focused on providing user-friendly STI services for FSWs using mobile teams operating at multiple sites depending on local client preferences. 911 FSWs were enrolled at baseline and 982 in the exit survey. Study participants were interviewed about sociodemographic characteristics, sexual behaviour, history of STIs and selected features of their husbands or cohabiting partners, and were tested for STIs. Results: The overall prevalence rates of HIV, syphilis, herpes simplex virus 2 (HSV-2) antibodies, gonorrhoea (GC), Chlamydia trachomatis (CT), and GC and/or CT among FSWs in the five border provinces in 2004 were 3.6%, 12.9%, 24.9%, 2.9%, 9.1% and 11.3%, respectively. Compared with baseline values, GC and/or CT decreased significantly from 19.9% to 11.3%, GC from 10.7% to 2.9% and CT from 11.9% to 9.1%. HIV decreased from 4.5% to 3.6%, and HSV-2 antibodies from 27.7% to 24.9%. After adjustment for possible confounders, a significant overall decrease in having GC and/or CT (OR = 0.46, 95% CI 0.33 to 0.65; p,0.001) and GC alone (OR = 0.22, 95% CI 0.13 to 0.37; p,0.001) was found, and the overall prevalence of syphilis increased significantly (OR = 1.55, 95% CI 1.11 to 2.17 p = 0.011). A marked increase in syphilis from 1.0% to 14.1% was identified in the Lai Chau province. Conclusions: Implementation of the project was associated with a reduction in GC and/or CT infections in FSWs, more so with GC than with CT. A notable increase in syphilis in Lai Chau was identified. HIV/STI interventions in FSWs can be implemented by government services and should be intensified and expanded to other provinces.
Little information is available on the prevalence of herpes simplex type-2 (HSV-2) antibodies among groups at potential high risk of HIV in Asia. This study was carried out to determine the prevalence of HSV-2 antibodies and correlates of HSV-2 infection in female sex workers (FSWs) in border provinces of Vietnam. Nine hundred and four FSWs in five border provinces of Vietnam were interviewed about selected sociodemographic and behavioural characteristics, and information about partners by a standard interview schedule. Serological samples were collected for HSV-2 antibodies, syphilis and HIV. The overall prevalence of HSV-2 antibodies was 27.7% (95% confidence interval [CI]: 24.8-30.7%). The prevalence of HSV-2 in southern provinces (Dong Thap 32.3%, An Giang 33.3% and Kien Giang 29.9%) was higher than that in the central (Quang Tri 20.8%) and northern border areas (Lai Chau 5.0%). In multivariate analysis, Kinh ethnicity (odds ratio [OR] = 2.59, P = 0.02), direct sex work (OR = 1.61, P = 0.01), >/=9 clients/week (OR = 2.11, P = <0.001), ever worked outside Vietnam (OR = 2.12, P = 0.05), >1 pregnancy termination (OR = 1.58, P = 0.05), syphilis (OR = 5.19, P = <0.001) and HIV (OR = 2.68,P = 0.01) were associated with HSV-2. Age =20 (OR = 0.65, P = 0.05) and current oral contraceptive use (OR = 0.55, P = 0.01) were protective for HSV-2 antibodies. A significant proportion of FSWs in border provinces have HSV-2 antibodies, more so in the southern region. FSWs should be educated about recognition of signs and symptoms of genital herpes and the role this infection has in facilitating HIV transmission.
Introduction Monitoring the population‐level emergence and transmission of HIV drug resistance (HIVDR) is necessary for supporting public health programmes. This study provides a nationally representative prevalence estimate of HIVDR in people initiating antiretroviral therapy (ART) and estimates of acquired HIVDR and viral load (VL) suppression in people who have received it for 12 or ≥48 months in Vietnam. Methods The study was conducted between September 2017 and March 2018 following World Health Organization guidance. Thirty ART clinics were randomly sampled using probability proportional to size sampling from a total of 367 ART clinics in the country. Results and Discussion In total, 409 patients initiating ART were enrolled into the survey of pre‐treatment HIVDR. The prevalence of any pre‐treatment HIVDR was 5.8% (95% CI 3.4–9.5%), and the prevalence of non‐nucleoside reverse transcriptase inhibitor resistance was 3.4% (95% CI 1.8–6.2%). Four hundred twenty‐nine patients on ART for 12±3 months and 723 patients on ART for ≥48 months were enrolled into the surveys of acquired HIVDR. The prevalence of VL suppression (defined as <1000 copies/ml) in patients on ART for 12±3 and ≥48 months was 95.5% (95% CI 91.3–97.8%) and 96.1% (95% CI 93.2–97.8%), respectively. Among individuals with viral non‐suppression, any HIVDR was detected in 11/14 (weighted prevalence 74.3%) of those on ART for 12±3 months and in 24/27 (weighted prevalence 88.5%) of those receiving ART for ≥48 months. Conclusions This nationally representative study of HIVDR found high levels of VL suppression among those on ART for 12 and ≥48 months. Overall, high levels of VL suppression at both time points suggested good adherence among patients receiving ART and quality of treatment services in Vietnam. Clinical Trial Number Not applicable
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