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Impact of a community sexually transmitted infection/HIV intervention project on female sex workers in five border provinces of Vietnam
  1. Nguyen Vu Thuong1,
  2. Khuu Van Nghia1,
  3. Tran Phuc Hau1,
  4. Nguyen Thanh Long2,
  5. Cao Thi Bao Van1,
  6. Bui Hoang Duc2,
  7. Luong Thu Tram1,
  8. Nguyen Anh Tuan3,
  9. Nguyen Thi Kim Tien1,
  10. Peter Godwin4,
  11. Knut Fylkesnes5,
  12. Nigel O’Farrell6
  1. 1Pasteur Institute, Ho Chi Minh City, Vietnam
  2. 2Vietnam Administration of HIV/AIDS Control, Ministry of Health, Hanoi, Vietnam
  3. 3National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
  4. 4Asian Development Bank, NCHADS, Phnom Penh, Cambodia
  5. 5Centre for International Health, University of Bergen, Bergen, Norway
  6. 6Pasteur Suite, Ealing Hospital, London; London School of Hygiene and Tropical Medicine, London, UK
  1. Correspondence to:
 Dr N O’Farrell
 Pasteur Suite, Ealing Hospital, Uxbridge Road, London UB1 3HW, UK; ofarrell{at}postmaster.co.uk

Abstract

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.

  • CT, Chlamydia trachomatis
  • DFSW, direct female sex worker
  • FSW, female sex worker
  • GC, gonorrhoea
  • HSV, herpes simplex virus
  • MOH, Ministry of Health
  • PPT, periodic presumptive treatment
  • STI, sexually transmitted infection
  • VND, Vietnam dong

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Footnotes

  • Published Online First 27 February 2007

  • Competing interests: None declared.

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