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“The only thing necessary for these diseases to the triumph is for good people and governments to do nothing.”


Survey on STI among female sex workers in 5 border provinces of Vietnam


BACKGROUND: Little is known about the true magnitude of STIs among female
sex workers (FSWs) in Vietnam. This study was conducted to determine the
prevalence of selected STIs including HIV among FSWs in five border
provinces of Vietnam.

METHODS: A total of 911 FSWs in 5 border provinces of Vietnam (Laichau,
Quangtri, Dongthap, Angiang and Kiengiang) participated in a cross
sectional study between December 2002 and January 2003. The study subjects
were interviewed about selected socio-demographic and behavioral
characteristics, history of STIs and selected features regarding their
spouses (husbands or live-in partners) or lovers by a standard interview
schedule. Serum was tested for HIV (1SFD+2ELISA) and syphilis (RPR+TPHA)
and urine tested for gonorrhea and chlamydia using the Roche Amplicor
technique. Univariate and multivariate logistic regression analysis was
used to explore the association between STI/HIV and other variables among
FSWs and their spouses or lovers.


RESRULT: Overall, the prevalences of HIV, syphilis, gonorrhoea, Chlamydia
and gonorrhoea and or chlamydia among FSWs in the 5 border provinces of
Vietnam were 4.5%, 10.7%, 10.7%, 11.9% and 19.9%, respectively. The
respective prevalences of HIV, syphilis and either gonorrhoea or Chlamydia
in the five provinces was as follows: LaiChau 2.0%, 1.0%, 27.3%; QuangTri
1.0%, 12.9%, 32.7%; Dongthap 4.7%, 11.4%, 16.0%; Angiang 7.0%, 10.7%,
11.3% and Kiengiang 4.0%, 13.4%, 24.4%. The prevalence of HIV was higher
in the southern border region (>4.0%) while that of NG/CT was more
predominant in the northern and central regions (>27%). The prevalence of
syphilis was low in Laichau but higher than 10% in the other four border
provinces. Factors associated with NG/CT included, income
500,000VND/month, spouse's age <30 and spouse's complaint of burning or
pain during sex with OR of 2.98, 3.78 and 10.62, respectively. Factors
associated with HIV included age at first sex 15 (OR=11.13), syphilis
(OR=5.27) and spouse's age < 30 (OR=7.55).


CONCLUSIONS: STIs and HIV among FSWs are important public heath problems
in the border provinces of Vietnam although epidemic patterns appear
different between northern, central and southern regions. Presumptive mass
treatment for cervicitis among FSWs should be applied to areas where the
prevalence of NG/CT is greater than 20%. Interventions involving IEC, VCT,
100% condom use programme and management of STIs should be further
strengthened and expanded.