Impact of a community sexually transmitted infection/HIV intervention project on female sex workers in five border provinces of Vietnam.
OBJECTIVE
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.
Vu Thuong
Nguyen
N
Pasteur Suite, Ealing Hospital, London, UK.
Van Nghia
Khuu
K
Phuc Hau
Tran
T
Thanh Long
Nguyen
N
Thi Bao Van
Cao
C
Hoang Duc
Bui
B
Thu Tram
Luong
L
Anh Tuan
Nguyen
N
Thi Kim Tien
Nguyen
N
Godwin
Peter
P
Fylkesnes
Knut
K
O'Farrell
Nigel
N
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D017280:Condoms / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control; D006293:Health Promotion; D006801:Humans; D015999:Multivariate Analysis; D015995:Prevalence; D011477:Sex Work / Q000706:statistics & numerical data*; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000517:prevention & control*; D047568:Unsafe Sex / Q000706:statistics & numerical data; D014744:Vietnam / Q000453:epidemiology