Faced with a recent surge in the number of reported infections with the virus that causes AIDS, the government here is drawing up plans to help control the disease, including a campaign--still revolutionary in this prudish Communist state--to promote safe sex.
The draft drawn up by Vietnam’s National AIDS Committee warned that, if current trends continue, as many as 500,000 adult Vietnamese could be infected with the human immunodeficiency virus (HIV) in five years.
“Strong with this knowledge, the government of Vietnam has decided that it is now the time to act, because there is still a possibility to curb the rapid spread of HIV, thereby preventing many thousands of young women, men and children from becoming infected,” the draft said.
The report also contained startling statistics, considering Vietnam’s relative isolation and the still deeply held premise here that prostitution and drug use are serious crimes that should be punished by long prison terms.
Nguyen Hoang Ha, an AIDS committee program officer, said in an interview that estimates provided by the Interior Ministry show the country has about 300,000 prostitutes and 120,000 drug users who take narcotics, primarily opium, by injection. The number of prostitutes is equal to estimates for Thailand, long regarded as Asia’s most decadent country.
As recently as December, 1992, there were only 11 cases of HIV infection reported in all of Vietnam. But by this month, the number had increased by 1,000 new cases, 86% of them brought about through sharing of hypodermic needles, the draft report said.
While the overall number of infections is quite small, especially compared with Thailand’s estimated 400,000 HIV cases, Ha said current estimates are that by 1998, 570,000 Vietnamese will be HIV-positive, 7,000 will have developed full-blown acquired immune deficiency syndrome and there will have been a total of 15,000 deaths.
“It’s like fighting a forest fire. It’s no use spraying water on the fire, you need to get ahead of the problem and dig trenches. That’s what Vietnam needs to do about AIDS now,” said Barbara Franklin, a Los Angeles native who works as a consultant to CARE International in Hanoi.
Although drug use is the leading means by which HIV is spread here, Franklin and other experts believe that the disease will soon be spread mainly by heterosexual intercourse. She said that 54% of Vietnamese men surveyed recently reported having had two or more sex partners in the previous two weeks.
Franklin noted that the risk of becoming HIV-positive is just as great in Hanoi as in Ho Chi Minh City, the former Saigon, although Hanoi’s image is much more sedate than that of the city that was South Vietnam’s capital, where prostitutes openly congregate at discos and bars.
The Vietnamese government has recently increased its budget for AIDS prevention from $100,000 to $1 million and is soliciting donations abroad. A delegation from the UCLA School of Public Health is due in Hanoi soon to provide training.
If the draft proposal is accepted by the government, non-governmental groups will be encouraged to meet with commercial sex workers and lecture about condom use and treatment of sexually transmitted diseases. Workers in factories will also be visited and given safe-sex training by representatives of the Public Health and Labor ministries.
Another program will be aimed at young people. Radio, television and newspapers will be asked to join the anti-AIDS drive. One explicit pamphlet warned in a bold headline: “If You Don’t Have a Condom, Don’t Get Drunk.”
Open talk about casual sex is still taboo in polite society, and approval for this program will mean a fundamental break with the country’s traditions.
One problem acknowledged by the AIDS committee is that government efforts to stamp out prostitution and drug use may be indirectly contributing to the disease’s spread by forcing certain practices underground, where individuals cannot be reached by anti-AIDS messages. Non-governmental groups thus have been asked to reach out to these groups with education programs so there will not be fears of arrest or reprisals.
Another problem is that while condoms are generally available in Vietnam, they are mainly dispensed to married women as part of a nationwide birth-control program. Efforts will now be concentrated on getting condoms to commercial sex workers.