RISING HIV-INFECTION RATES IN HO-CHI-MINH CITY HERALD EMERGING AIDS EPIDEMIC IN VIETNAM

Objective: To describe the epidemiology of HIV in Ho Chi Minh City in the context of current surveillance data from Vietnam. Methods: Since the late 1980s, HIV surveillance data have been collected in Ho Chi Mi nh City from centers for the treatment of venereal disease and tubercu losis, centers for the rehabilitation of injecting drug users and sex workers, prenatal clinics, blood banks and other sites. Results: The f irst case of HIV infection in Vietnam was identified in 1990 in Ho Chi Minh City. The cumulative number of reported HIV infections in this c ity at the end of 1996 was 2774, about half of the number of cases in the country; 86% of infections were among men, 86% among injecting dru g users, 2.5% among patients with sexually transmitted diseases and 2. 5% among sex workers. The first HIV infection among antenatal women wa s detected in 1994. The prevalence of HIV among injecting drug users r ose dramatically from 1% in 1992 to 39% in 1996, compared with 1.2% am ong sex workers, 0.3% among blood donors and 1.3% among tuberculosis p atients in 1996. The populations of injecting drug users and sex worke rs in Ho Chi Minh City are estimated to be 30000 and 80000, respective ly, and rates of sexually transmitted diseases are 2-3 per 1000 person s per year. By the end of December 1996, 42 out of 53 provinces had re ported HIV infections, and border areas near China and Cambodia began identifying large numbers of HIV-seropositive people. Conclusions: Ho Chi Minh City is at the forefront of a new HIV epidemic in Vietnam. Th is epidemic shows similarities to that in Thailand nearly a decade ago , with rapidly rising HIV rates among injecting drug users and infecti on already established among sex workers. Prevention efforts should in clude the targeting of injecting drug users and sex workers outside re habilitation centers, the availability of sterile needles and condoms, the establishment of anonymous testing sites, the control of sexually transmitted diseases and the coordination of programs within southeas t Asia.