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HIV arrived in Asia more than 20 years ago, has since infected a total of 9 million people, taken the lives of 3.5 million adults and 330,000 children, and is the leading cause of death (more than tuberculosis) among adults age 15-45, according to UNAIDS estimates. At the end of 2007, there are approximately 4.9 million people living with HIV in the region, with 440,000 new cases.

In Vietnam, the number of people with confirmed HIV infection is 124,000. This is likely the “tip of the iceberg.” Epidemiologic experts estimate the true prevalence to be in the vicinity of 300,000, although the true number may be higher still. The epidemic here has already been responsible for nearly 50,000 recorded deaths.

In Asia, the main driving forces of the epidemic are drug users sharing syringes and needles, men who have unprotected sex with men, and men who have unprotected paid sex. The latter group, constituted from mainstream society, is the largest in number and the most important factor (UNAIDS report). Men buying sex is a culturally accepted and widespread practice in many Asian countries, fueling demands for the thriving sex business. As they become infected, they will in turn infect their girlfriends, wives, and future wives. A significant portion of monogamous women will unknowingly be exposed to HIV, as are their children. In expatriate communities, both paid sex and serial short-term relationships put men and women at risk for acquiring HIV.

The rise of HIV cases and deaths led the Vietnamese to bestow upon it the name “disease of the century.” The situation was deemed dire enough that a whole new government entity was created to deal with HIV alone, called the Vietnam Administration for AIDS Control (VAAC). In 2008 the government passed a new law prohibiting discrimination against people living with HIV in their workplace, along with other progressive measures. Among them, condom distribution is now permitted in hospitality enterprises such as guest houses and hotels.

Despite many educational campaigns about HIV prevention, public awareness is low. Many underestimate their risks. While most educated people understand how HIV is transmitted, they don’t necessarily translate that knowledge to action, to protect themselves. Condom use is not 100% even in casual encounters. Whether this “disease of the century” will be brought under control will be dependent on not only government policies targeting affected groups but also the public doing its part of protecting itself. If the A (Abstinence) and B (Be faithful) cannot be followed, then the C (condom) should come with the tagline: “just use it.”

HIV is a treatable disease. Testing and treatment for HIV is readily available inVietnam.
Dr. Doanh Lu is an infectious disease and HIV specialist. Please make appointment to see her at the Stamford Clinic.



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