VISITS TO FEMALE COMMERCIAL SEX WORKERS (FSWS) BY MALE SEXUALLY TRANSMITTED DISEASE (STD) SERVICES ATTENDEES IN VIETNAM

Nguyen Thi Thanh Thuy*, Truong Hoai Phong**, Le Ngoc An***, Tran Van Dat ****,

Vo Tuyet Nhung* Tran Kim Phuong* & Ha Ba Khiem*.

*Pasteur Institute in HoChiMinh City

** Center for Preventive Medicine of Soc Trang Province

*** Dermato-Venereal Center of Soc Trang Province

**** Center for Preventive Medicine of Vinh Long Province

Background

The rising prevalence of HIV among FSWs contributes to increasing heterosexual HIV transmission in Southern Vietnam. We evaluated the HIV/STD status of male STD clinic attendees and factors associated with frequent visits to FSWs.

Method

804 male STD services attendees from 4 out of 6 STD services in two provinces in the Mekong delta were enrolled from March 96-March 97. The subjects completed confidential interviews, physical examinations and laboratory evaluation.

Result

The HIV seroprevalence was 0.5% (W. Blot), higher than that among young military recruits enrolled in sentinel sites in the same regions in 1996 (0.07%-0.12%). The prevalence of gonorrhea (GC) (by Gram Stain) was 9%; syphilis (by RPR) was 2% (RPR), and HbsAg was 7.5%. The frequency of FSW visits was characterized as: no visit in the past three years, infrequent (less than one visit per month), frequent (more than one visit per month). The HIV prevalence among each group was 0%, 0.7%, 0% respectively. The multivariate analysis showed that low educational level as «never in school» (OR= 11.8), being single (OR=5.3), first intercourse at £ 17 yrs. (OR=5.4), using drug by different routes (OR=44.3), having no sexual girlfriend (OR=4.5) were associated with frequent FSW visits vs. the remainder of the cohort. Young age £ 20 yrs. (OR=1.9), being single (OR=2.1), no sexually active girlfriend (OR=1.6), first sex with FSWs (OR=2.3), drug use (OR=5.5), alcohol use prior to seeing a FSW (OR=2) were associated with infrequent vs. no visit. Past histories of urethritis (OR= 20.4), GC (OR=9.4) and genital ulcer (OR=8.9) were associated with frequent FSW visits. Consistent condom use was low (7.7%).

Conclusion

Prevention programs for men in Vietnam, particularly those with low education, who are young or single, need to focus on reducing drug and alcohol consumption and improving condom use with FSWS.