HIV infection, risk factors, and preventive services utilization among female sex workers in the Mekong Delta Region of Vietnam.
BACKGROUND
Risk behaviors among female sex workers (FSW) are considerable drivers of HIV infections in Vietnam, especially transmission between high-risk and low-risk groups. We assessed HIV prevalence and its correlates among FSWs, and the use of preventive services among this community in the Mekong Delta region, southern Vietnam.


METHODS
A cross-sectional survey of 1,999 FSWs was carried out in five provinces including Ben Tre, Hau Giang, Kien Giang, Tien Giang, and Vinh Long between June, 2006 and June, 2007. We interviewed participants face-to-face in order to elicit information about their lives and potential risk factors, and we tested their sera to determine their HIV status. We then performed multivariate logistic regression analyses to investigate factors associated with HIV infection.


RESULTS
Seventeen percent of the participating FSWs were street-based sex workers (SSWs) and the rest (83%) were entertainment establishment-based sex workers (ESWs). Unprotected sex with regular and casual clients in the past month was frequent among study participants (40.5% and 33.5% respectively). However, few respondents (1.3%) had ever injected drugs. Only 2.1% (95% confidence interval (CI): 1.6%-2.8%) of FSWs were found to be infected with HIV. HIV prevalence among SSWs was greater than among ESWs (3.8% vs. 1.8%, p = 0.02, respectively). Increased risk for HIV infection was significantly associated with the number of clients per month (adjusted odd ratio (aOR) = 2.65, 95% CI: 1.26-5.59).


CONCLUSIONS
Interventions to reduce unsafe sex and drug injection, and to increase uptake of HIV testing among FSWs are necessary. Differences in HIV prevalence and its correlates by type of sex work emphasize the importance of constrained contexts in shaping risk behaviors among FSWs; that should be considered in designing HIV prevention programs.
Hanoi Medical University, Hanoi, Vietnam.
Bach Xuan
BX
Tran
Pasteur Institute, Ho Chi Minh City, Vietnam.
Thuong Vu
TV
Nguyen
Pasteur Institute, Ho Chi Minh City, Vietnam.
Quang Duy
QD
Pham
Pasteur Institute, Ho Chi Minh City, Vietnam.
Phuc Duy
PD
Nguyen
Pasteur Institute, Ho Chi Minh City, Vietnam.
Nghia Van
NV
Khuu
University of Texas Health Science Center at Houston, Houston, Texas, United States of America.
Nhung Phuong
NP
Nguyen
Authority of HIV/AIDS Control, Ministry of Health, Hanoi, Vietnam.
Duc Hoang
DH
Bui
Authority of HIV/AIDS Control, Ministry of Health, Hanoi, Vietnam.
Huong Thu
HT
Thi Phan
Authority of HIV/AIDS Control, Ministry of Health, Hanoi, Vietnam.
Long Thanh
LT
Nguyen
D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control*; D006801:Humans; D015995:Prevalence; D012307:Risk Factors; D060386:Sex Workers; D011795:Surveys and Questionnaires; D014744:Vietnam / Q000453:epidemiology; D055815:Young Adult