Epidemiologic trends of HIV infection in South Vietnam]

Southern Viet Nam (Ho Chi Minh City and 16 provinces) has been most affected by the HIV epidemic. The first case of HIV infection was detected in December 1990 in Ho Chi Minh City. By the end of 1995 the number of HIV-positive cases had increased to 2731 comprising 80% of reported HIV cases in Viet Nam. The Ho Chi Minh Pasteur Institute operates the HIV surveillance system established in 1992 in Viet Nam. The first province under HIV surveillance was An Giang which borders Cambodia. Other southern provinces surveyed include Can Tho where prostitution is very common and Kien Giang whose people are in contact with foreign fishermen. The surveillance system targets high-risk groups: intravenous (IV) drug users prostitutes and sexually transmitted disease (STD) patients. Assuming an HIV prevalence rate of 1% for the most affected groups the planned sample size is 400 for high-risk groups and 800 for other groups. Yet all subjects at risk of HIV undergo an HIV test. Since 1994 the Institute follows the World Health Organizations laboratory recommendations. In Ho Chi Minh City and in adjacent provinces IV drug use is a leading route of HIV transmission. HIV transmission by heterosexual intercourse is a key mode of HIV transmission in the provinces of the Mekong Delta presumably due to local prostitution and circulation of prostitutes with neighboring countries. During 1993-1995 the HIV prevalence rate among IV drug users increased significantly (25-42%). HIV prevalence among prostitutes in Ho Chi Minh City also increased significantly but at a lower rate (0.5-1.2%). In An Giang province the HIV prevalence rate increased from 5% to 8% among prostitutes and from 0.15% to 1.3% among STD patients. The overall HIV prevalence rate is 0.1% (in pregnant women). The Institute is conducting research on HIV risk factors in population groups in order for public health specialists to design interventions.