Estimating HIV Incidence Among Female Sex Workers: Results from The Pilot of Integrating Short Behavioral Survey into The Routine HIV Sentinel Surveillance

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Backgrounds § HIV sentinel surveillance is conducted annually among 6 key populations in 39 provinces in Vietnam. § To obtain trends of key national and global indicators and HIV infection, some behavioral questions were added to the serosurveys in seven provinces in 2010. § This aims to determine HIV prevalence, risk behaviors, and coverage of prevention services among men who have sex with men (MSM). Methods § Cross-sectional surveys were conducted. Participants were selected based on geographic mapping exercise and through peer educators. § A short questionnaire consists of 23 behavioral questions were added to the serosurveys among MSM in four voluntary provinces including Ha Noi, Hai Duong, Ho Chi Minh city, and An Giang in 2010. Results § 1009 MSM provided blood and interviews. § Median HIV prevalence among MSM and drug injecting-MSM were 6.0% (range: 0.0%-16.0%) and 11.1% (0.0%-50.0%), respectively. § Median of MSM ever injecting drug was 12.3% (range: 0.0%-20.5%). The proportion of using clean needles in the most recent injection was low, median of 85.7% (range: 73.6%-91.6%). § Median of MSM reporting condom use during anal sex with most recently male partner was 73.4% (range: 66.5%-85.8%). Percentage of consistent condom use through anal sex with male partners in the past month in Hanoi the highest (72.0%), other provinces are below 50%, especially in HCMC was only 29.6%. § Median of MSM selling sex in the last 12 months was 35% (range: 0.8%-47.3%). § Medians of MSM receiving free condoms and syringes in the last month were 55.6% (43.4%-77.7%) and 36.9% (27.8%-86.2%), respectively. § Median of MSM receiving sexually transmitted infections screening in the last 3 months was 13.2% (6.2%-31.6%). § HIV testing in the past year and knowing the result was a median of 20.7% (4.4%-39.6%). Conclusions § HIV prevalence was high among drug injecting-MSM and varying among provinces. § MSM practiced high risk for HIV transmission. § Access to HIV prevention services was very low and varied by service and province. § Although mapping was recommended, however, this was at core a convenience sample. § The integrating a short behavioral questionnaire into current HIV sentinel surveillance program can be done and routinely implemented annually. Recommendations § Access to HIV prevention efforts needs to be broadened with a focus on drug injecting-MSM to prevent further HIV transmission from injection drug users to general MSM and their partners. § Investigation of methods to increase accessibility of HIV/STI services to MSM. § Increasing services to address needs of MSM selling sex where it is identified as a significant issue. § Improvement of the sampling of sentinel surveillance is a key next step to achieve more representative samples. § Expand the application of the brief behavioral questionnaire to routine sentinel surveillance. Poster for ICAAP conference "The 10th International Congress on AIDS in Asia and the Pacific, Busan, Korea, 24 August 2011" Estimating HIV Incidence Among Female Sex Workers: Results from The Pilot of Integrating Short Behavioral Survey into The Routine HIV Sentinel Surveillance in Vietnam Duong Cong Thanh¹, Keith Sabin², David Jacka², Nguyen Thanh Long³, Vo Hai Son³, Bui Hoang Duc³, Nguyen Tran Hien¹, and Nguyen Anh Tuan¹. ¹ National Institute of Hygiene and Epidemiology, Viet Nam; ²World Health Organization Representative Office in Viet Nam; ³Viet Nam Administration of HIV/AIDS Control. Backgrounds § HIV sentinel surveillance is conducted annually among 6 key populations in 39 provinces in Vietnam. § To obtain trends of key national and global indicators and HIV infection, some behavioral questions were added to the serosurveys in seven provinces in 2010. § This aims to determine HIV prevalence, estimated incidence, risk behaviors, and coverage of intervention among female sex workers (FSW). Methods § Cross-sectional surveys were conducted. Participants were selected based on geographic mapping exercise and through peer educators. § A short questionnaire consists of 18 behavioral questions were added to the serosurveys among FSW in seven voluntary provinces including Ha Noi, Hai Duong, Thanh Hoa, Hue, Da Nang, Ho Chi Minh city, and An Giang in 2010. § Assumptions for HIV incidence density: All sex workers were negative before initiation of selling sex, HIV infection occurred midpoint from initiation of selling to the time of the survey, and ignoring the possibility of being infected through other risks. Results § Median HIV prevalence among overall-FSW and less than 25 years-FSW were 4% (range: 0.0%-29.3%) and 2.4% (0.0%-25%), respectively. § Median of FSW those less than 3 years duration of selling sex was 2.8% (range: 0.0%-26.3%). § Median estimated HIV incidence density among injecting-FSW and non-injecting-FSW was 0.0 (0.0-16.7) and 0.2 (0.0-1.0) per 100 person-months at risk, respectively. § Median of FSW reported ever share needle and inconsistent condom use in the last months was 24.7% (range: 0.0%-60%) and 16.1% (range: 4.1%-46.1%). § Medians of FSW receiving free sexually transmitted infections screening including testing and physical examination in the last 3 months were 47.3% (18.6%-75.3%). § Medians HIV testing in the past year, more than one year, and never were 50.0% (range: 9.3%-68.6%), 18.6% (4.0%-24.6%), and 35.3% (20.6%-72.0%). Conclusions § Estimated HIV incidence suggests that HIV infection occurs quickly among young FSW and new to sex work. § HIV transmission among FSW is closely related to drug injection in some provinces. § Access to HIV prevention services was very low and varied by service and province. § Although mapping was recommended, however, this was at core a convenience sample. This might capture a very high risk population but it is not necessary representative sample. § The integrating a short behavioral questionnaire into current HIV sentinel surveillance program can be done and routinely implemented annually. Recommendations § HIV prevention efforts should increase focus on FSW who are young, new to sex work, and injecting drugs. § Improvement of the sampling of sentinel surveillance is a key next step to achieve more representative samples. § Expand the application of the brief behavioral questionnaire to routine sentinel surveillance. Poster for ASHM conference "Australasian HIV/AIDS Conference 2011 (23rd Annual ASHM Conference) - Canberra, Australia, 20 September 2011"	Download Journal of Preventive Medicine Center for Preventive Health Care and Technical Scientific Service (CPHTS) Advertisement
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