MAY 2007 — The Vietnam Administration for AIDS Control (VAAC) of the Ministry of Health has published the results of the HIV/STI Integrated Biologic and Behavioral Surveillance (IBBS) that was conducted in seven provinces in 2005 and 2006. The IBBS utilized community-based sampling to estimate the prevalence of HIV and other sexually transmitted infections (STI) and to provide indicators of risk behaviors and intervention exposure among those at highest risk of contracting HIV—female sex workers (FSWs), injecting drug users (IDUs) and men who have sex with men (MSM).
 
Key findings of the IBBS surveys included the following:

• HIV prevalence among IDUs averaged the highest of all populations studied, but varied across provinces. The highest rates were in Hai Phong (66 percent) and Quang Ninh (59 percent) and the lowest was in Danang (2 percent) and An Giang (13 percent). The data showed evidence of rapid HIV transmission among a large, new, and young injecting population. For example, nearly half of IDUs in Ho Chi Minh City were under age 25 and nearly one-fourth had been injecting for less than one year. However, HIV was quick to spread among both of these groups, with 33 and 28 percent, respectively, already HIV-infected.
• More than 10 percent of FSWs were HIV-positive in five out of seven provinces, with street-based sex workers in most areas registering higher HIV prevalence than karaoke-based sex workers. HIV prevalence was highest among street-based sex workers in Can Tho (29 percent) and Hanoi (23 percent). HIV infection among sex workers was highly correlated with injection drug use, with injecting sex workers from 3.5 to 31 times more likely to be HIV-positive than non-injectors.
• HIV prevalence among MSM was 5 percent in Ho Chi Minh City and 9 percent in Hanoi, but this is not a statistically significant difference. Other STIs were also relatively common among MSM. For example, 12 percent of men in Hanoi were infected with rectal gonorrhea and 8 percent had rectal chlamydia. In total, 22 percent of MSM in Hanoi and 16 percent in Ho Chi Minh City had at least one STI.
• The surveys showed interventions programs are increasing their coverage, but improvement is still needed. Use of voluntary counseling and testing (VCT) services was highest among IDU in Hai Phong (40 percent) and FSW and IDU in Hanoi (35 percent and 34 percent, respectively). In Ho Chi Minh City, where VCT has been scaled up in recent years, approximately one in five people surveyed reported that they have been tested for HIV and know the results. However, more than three-fourths of those living with HIV in the measured groups did not know that they are HIV-positive. For example, 90 percent of HIV-positive MSM in Hanoi, 84 percent of HIV-positive IDU in Can Tho, and 82 percent of HIV-positive FSW in An Giang were unaware of their status.

The IBBS surveys will likely be repeated every two years to monitor trends in HIV, STIs, risk behaviors, and intervention exposure. Results will inform intervention planning and evaluation, and national HIV estimates and projections.

The surveys were conducted by the MOH National Institute for Hygiene and Epidemiology in collaboration with the VAAC, provincial AIDS centers and committees, and provincial centers for preventive medicine. Technical assistance was provided by FHI, the US Centers for Disease Control (CDC), and USAID, with funded from USAID through the President's Emergency Plan for AIDS Relief.