Vietnam's president visited an HIV/AIDS hospital ward in Hanoi on Wednesday in a bid to reduce the stigma surrounding the disease and prove that the communist country's leaders are committed to tackling it. President Tran Duc Luong spoke with several HIV/AIDS patients in Bach Mai Hospital before addressing a room full of medical workers and international representatives about the need for HIV/AIDS prevention, care and education. "All of us should have a correct attitude and not discriminate against HIV/AIDS carriers," Luong said. "They should be able to enjoy all legitimate rights like other ordinary people." Minister of Health Tran Thi Trung Chien said discrimination and fear surrounding HIV/AIDS have become so widespread in Vietnam that hospital workers are afraid to tell their friends and families that they care for patients infected with the virus. The disease has largely been confined in Vietnam to high-risk groups such as sex workers and intravenous drug users. However, health experts say the epidemic is on the brink of exploding into the general population with infections on pace to increase eightfold to 1 million by 2010. HIV/AIDS often gets lumped in with Vietnam's so-called "social evils" which also include drug use and prostitution. International aid workers say they are working to change that. "HIV is a disease, not a social evil," said Jordan Ryan, head of the U.N.Development Program in Vietnam. "HIV can affect people who engage in high-risk behaviors, but it also affects children, faithful spouses and young couples." Vietnam has recorded more than 81,000 HIV-positive cases, according to the Ministry of Health. Health officials, however, believe the number of HIV-infected people is closer to 200,000.

The Vietnamese Ministry of Health announced Tuesday that in 2003 the country diagnosed 16,980 new HIV infections, up 11 percent from 2002. Vietnam has reported a total of 76,180 HIV infection cases, of which 11,659 developed AIDS and 6,550 died by the end of 2003, the ministry said. Localities with the most HIV/AIDS cases include the capital city of Hanoi, Ho Chi Minh City, northern Hai Phong city and northern Quang Ninh province. Most of those infected are sex workers and drug addicts. Vietnam plans to focus on disseminating HIV/AIDS education and prevention information among local people, especially those in high-risk groups. The government also plans to spend 80 billion dong (US $5.1 million) on national HIV/AIDS prevention projects for 2004, 20 billion dong (US $1.3 million) higher than last year.

On 01 December 2003, the first HIV/AIDS out-patient clinic in Vietnam was opened in the Clinical Institute for Tropical Diseases, Bach Mai Hospital in Hanoi. The clinic is to provide HIV test monitor and provide medicine to the infected persons; and conduct counseling on prevention of the epidemic. It is estimated that the clinic can conduct tests and provide counseling services for about 100 persons and this model will be applied in at least 40 cities and provinces in the time to come. In Ho Chi Minh City, the biggest Community Support and Counseling Center for people living with HIV/AIDS in Vietnam was also opened on 29 November.

People infected with HIV in Vietnam face workplace discrimination that must be overcome in order to combat the epidemic, according to a UN International Labor Organization report released today in Hanoi. ILO consultants, convened in the Vietnamese capital for a workshop on HIV/AIDS discrimination, said ignorance about the disease is fueled by the communist government's policy of stereotypically linking it to "social evils" such as drug abuse and prostitution. The ILO survey of 200 workers revealed that 70 percent believed their companies should not employ HIV-infected employees, and 62.5 percent supported isolating such employees in separate work units. "In a supportive workplace, workers may be more willing to learn about HIV/AIDS and to get voluntarily tested," said ILO Hanoi Director Rosemarie Greve.

UN and international health experts warned on Oct. 13 that Vietnam has a serious, fast-growing HIV/AIDS epidemic, and they asked the government to take a more liberal approach to control it. Particularly, they urged that Vietnam lessen the stigma and discrimination against HIV-infected people, ensure their access to health care, and improve testing and counseling services. "This is a late epidemic," said Mary Kamb, CDC's director in Vietnam. "The country has been spared HIV for many years and so in many ways the things Vietnam is experiencing now are quite similar to what was experienced in North America, Europe and many parts of the world like sub-Saharan Africa 20 years ago. The challenge for Vietnam is to learn from the lessons that these other countries have had or may be able to offer." Ministry of Health figures show that since the first HIV case was reported in December 1990, 71,530 people have contracted the virus. Reported cases are increasing at roughly 1,300 per month, according to Nancy Fee, country coordinator for UNAIDS. True numbers could be much higher than official figures, with some estimates putting the number between 160,000-300,000 cases. Injection drug users account for about 60 percent of Vietnam's HIV cases, but that is partly because they are automatically tested when they are arrested and put into rehabilitation camps, Fee said. Repeat IDU offenders go to detention or detoxification centers for 24 months. Prostitutes go to similar camps for three- to nine-month sentences. HIV is spreading rapidly into Vietnam's general population. The state-controlled media downplays this fact, blaming HIV on drug users and prostitutes, a "social evils" approach that the UN, Western governments and international AIDS organizations are trying to convince Vietnam to abandon.

Vietnam says more than 900 people died of AIDS-related illnesses in the country during the first seven months of 2003. This represents an increase of nearly 100 per cent compared to the same period last year. Ministry of Health figures say 8,800 new cases of HIV infection had been registered in this year, increasing the nationwide number of infections to 69,000. However, international health experts believe the true level of HIV infection may be several times higher than the official figures, with estimates ranging up to 300,000.

Vietnam reported 1,299 HIV cases in the first half of this year, raising the total number to 67,100, a source from the Ministry of Health said Monday. The country now has 10,200 AIDS cases, and more than 5,700 people have died from the disease. In order to curb the spread of HIV/AIDS, the Vietnamese government is establishing a national strategy, taking tougher measures against prostitution and drug trafficking, producing low-cost AIDS medicines, working with foreign countries, and raising HIV/AIDS awareness among citizens.

The United States launched a $600,000 program to promote HIV/AIDS education in the workplace. "Part of the program is to try to decrease the discrimination and stigma of HIV and AIDS," said Jennifer Bacchus, a representative of the US Department of Labor. Program workers will explain to employers that "just because somebody is HIV-positive, it doesn't mean they cannot work. They need to come up with a way to support them. And that doesn't mean firing them, but helping them get the help they need." In the early 1990s, several workers in Vietnam were fired after testing HIV-positive. Many infections went undetected as a result, because people did not want to be tested for fear of being ostracized. The United States funds similar programs in the Dominican Republic, Haiti, Nigeria, Zimbabwe and the Ukraine.

As part of a government campaign to stamp out the "social evils" that spread AIDS, a prostitute named Trang was sent last year to a state facility for sex workers and intravenous drug users. But like so many of the Communist government's misplaced efforts to control HIV/AIDS, this one didn't work. The rehabilitation center did little to reform Trang -- who at the time she was arrested did not have HIV -- or about 250 other women being held there, she said. Classes about AIDS focused solely on the anti-social nature of prostitution. Vocational training consisted of making tablecloths nine hours a day. After three months, the 27-year-old Trang -- who wouldn't give her complete name for fear of being picked up again -- was released and returned to the streets after failing to find a job making tablecloths. "I don't have a good education," she says, "so there is no other place for me to work." In 1990, there was only one known case of HIV in this country of 78 million. Now, the government estimates there are 107,000 cases -- local AIDS workers say the figure is at least 200,000 -- and concedes that the number will double by 2005. The government contends that the chief source of the epidemic is heterosexual sex and points to the nation's estimated 40,000 prostitutes. But AIDS workers say that up to 70 percent of those infected are drug users, addicted to readily available heroin and methamphetamines. Regardless of the source of the epidemic, AIDS workers say Hanoi's policy of arresting sex workers and drug users under the guise of social rehabilitation only makes the problem worse. Drug users and prostitutes "are more at risk because (it drives) everything underground," said Laurent Zessler, the United Nations AIDS (UNAIDS) program adviser in Vietnam. "(The government) associates AIDS with social evils. We call it a health issue." Zessler and other nongovernmental agency officials have urged the government to integrate the state rehabilitation centers into a broader campaign that includes AIDS education, condom distribution, needle exchange and other forms of prevention. So far, their recommendations have been to little avail. Vietnam spends just $3 million a year on AIDS programs and has about 100 health centers handling HIV/AIDS patients. Even the state rehabilitation centers receive a "meager amount" of funding, according to Thomas Kane, director of Family Health International, a North Carolina-based organization that works with AIDS victims in Vietnam. Chris Harick, special program director in Vietnam for the Christian relief agency World Vision, said the government must move beyond its "social evils" campaign and focus on all high-risk groups. Harick is particularly concerned about migrant workers and truck drivers who have sex with prostitutes and then pass the disease to their wives. "There is this idea that it is mainly spread through intravenous drug users and prostitutes instead of married couples," said Harick. According to a survey by Family Health International (FHI), 39 percent of truck drivers in the port city of Can Tho and 20 percent of migrant workers in the port city of Hai Phuong said they had slept with a prostitute in the past year. "Rural people travel to urban areas to get money," said Vu Ngoc Bao of Population Council, a nonprofit group. "They lack knowledge of HIV/AIDS and then adopt the city lifestyle." Experts say the government also must manufacture more condoms and cheap generic drugs. The high cost of AIDS treatment has prompted many poor people to turn to herbal medicines that have no known effectiveness. But there are signs of change. From 1997 to 1999, Hanoi spent nothing on condom distribution, according to UNAIDS. But in 1999, the state produced 104 million condoms; most of them were marketed to married couples. The nonprofit DKT International, targeting locations where prostitutes and their customers meet -- discos, karaoke bars, massage parlors and hotels -- sold 43 million of their Trust and OK brands of condoms last year at a subsidized rate. DKT expects to sell 50 million this year. "We know people are going to have sex, and it is going to be risky sex," said Larry Holtzman, director of DKT International in Vietnam. In recent months, the government has made hints that it is rethinking its "social ills" campaign. Le Thuy Lan Thao, an official of the government AIDS office in Ho Chi Minh City, conceded that the state could not guarantee that lives will change after a three-month stint in a rehabilitation center. "We don't follow them and do not know if (the prostitutes) stay at their work or if (the intravenous drug users) stop using drugs. But a lot come back to the centers again." The government is also beginning to allow independent and private agencies to work at the rehabilitation centers and with local officials. In the central province of Binh Dinh, FHI employees have organized cultural events and given speeches about HIV/AIDS, according to Kane. The Population Council, FHI, World Vision and other international organizations have been distributing information pamphlets and condoms through taxi drivers, shoeshine boys and barbers, with the help of local officials. Still, Trang and many other Vietnamese continue to put their lives at risk. "If a man asks to have sex without a condom, I usually refuse," she said. "But sometimes, we have sex without a condom."

The estimated number of HIV-infected people in Vietnam will exceed 154,000 by the end of this year, a Ministry of Health official said Wednesday. The actual figure of those testing HIV- positive is 56,495 people. The number of people with AIDS is expected to surpass 23,600, with an estimated 20,000 AIDS-related deaths by the end of this year, the official said. The confirmed number of people with AIDS is 8,500, with about 4,600 AIDS- related deaths since the disease was first detected in Vietnam in 1990. The official said there would be an estimated 200,000 HIV- positive Vietnamese by the end of 2005. Intravenous drug use is believed to be the main source of HIV transmission in Vietnam.

In Hanoi yesterday, international experts said HIV/AIDS could severely erode Vietnam's economic development and its fight against poverty unless the government changes it approach to the epidemic. "HIV has the potential of reversing all the development gains over the past 15 years since Vietnam began its economic reforms," said Jordan Ryan, the UN Development Program's representative to Vietnam. Ryan made his remarks at the opening of a World Health Organization conference aimed at encouraging China, Indonesia, Myanmar and Vietnam to address the HIV/AIDS crisis among injection drug users. "IDUs play a critical role in the dynamics of the epidemic," said Andrew Ball, a WHO expert on HIV/AIDS. "If we don't address it, it will be very difficult to control the epidemic in these four countries and elsewhere in the region." "There needs to be a separation of HIV/AIDS from social evils. HIV/AIDS is not an evil, it is a virus," Ryan said. "Social evils" is the term used by the Vietnamese government to refer to drug addicts and prostitutes. Health experts have long criticized the government for focusing on AIDS as an affliction of these two groups, rather than raising awareness about the epidemic among the wider population. "Harm reduction programs should be introduced if we want the epidemic not to spread quickly," said Pascale Brudon, the WHO's representative to Vietnam. "We have more and more good evidence coming from the rest of the world that things need to change here." That transformation is underway, Ryan said. "The mindset of the government is beginning to change. Awareness is coming home to roost, but now the focus has to be on implementation." While Vietnam acknowledges 54,640 HIV cases, the real number is at least 200,000, experts say.

Vietnam has unveiled a plan to stem escalating HIV infection rates by boosting condom usage among its sexually active younger population, an official said Tuesday. The campaign, which will commence in October, aims to sell 170 million condoms each year through 2005, said Phan Song, director of Vietnam's Family Planning Association. Many Vietnamese men do not use condoms, primarily because of ignorance about HIV/AIDS/STDs. Embarrassment about buying contraceptives in Vietnam's deeply traditional society also remains a factor, sociologists say. The VFPA estimates that only one in 2,000 men use condoms when having sex with prostitutes. Prostitution is rife in Vietnam. "This campaign not only aims to serve family planning issues but more importantly is to protect people against HIV/AIDS, given that 58.7 percent of HIV carriers in Vietnam are aged between 13 and 29," Song said. The government says more than 51,500 people are HIV-positive but the real figure is thought to be at least 200,000 because of the limited scope of testing and a reluctance to admit the full extent of the impact of the global pandemic. Song said the VFPA had been allocated a target of selling 60 million condoms over the three-year period. The World Health Organization warned last month that the virus could spread rapidly among younger generations as a result of widespread ignorance over sexual health matters and condom use.

Just over 9,000 new cases of HIV infection were logged in Vietnam during the first seven months of this year, bringing the total number of HIV patients in the country to more than 50,000, official media reported Thursday. The 9,024 people testing positive for HIV through July represented a 57 percent increase over the same period last year, the Tuoi Tre (Youth) newspaper said. Total infections in the country stand at 52,434. The newspaper said that since January, 1,146 HIV patients developed AIDS - a 40 percent increase over the previous year. The disease caused 633 deaths, a 27 percent increase from the same period last year. Southern Ho Chi Minh City, the nation's commercial hub, remains at the top of the list for the number of people with HIV, followed by the northern province of Quang Ninh, northern port city of Hai Phong and Hanoi, the newspaper said. Intravenous drug use is believed to be the primary source of HIV transmission in Vietnam. Health experts said the actual number of HIV-positive Vietnamese could be as high as 135,000 - more than twice the official figure.

HIV positive people in Viet Nam can now get their hands on a locally-produced drug which impedes the development of the virus. HCM City-based MST Pharmaceuticals started rolling out Lamizidivir through local pharmacies this month, following approval from the Viet Nam Drugs Management Department. The drug, which costs VND 19,500 per tablet, must be taken twice a day according to doctors’ instructions costing a patient US$600 in the first year. MST says the price of this drug will fall to some $400 a year once the production process is running smoothly. Luu Thi Minh Chau, deputy chief of the National Bureau of AIDS Control, said more testing was required before Lamizidivir could be accepted as an official medication in the National AIDS Control Programme. Chau said the copyright issues relating to internationally patented medicines had not yet been solved in Viet Nam. "The international community allows poor nations to disregard patents on life-saving drugs in emergency situations, but these nations must meet certain criteria such as having 10 per cent of the population affected by HIV/AIDS," Chau told Viet Nam News. "Viet Nam’s HIV/AIDS rate is around 1 per cent," she said. The National AIDS Control Programme presently imports 20 different AIDS medications from other countries, some of which are very expensive. AIDS has already killed 3,300 Vietnamese and a further 40,000 people are HIV positive.

Vietnam has set up a state AIDS control strategy for the 2001-2005 period to curb the spread of HIV/AIDS in the country. Under the strategy, as many as 40 provinces and cities will be able to evaluate and provide information about HIV/AIDS infection in their localities. The strategy, with a minimum investment of 714 billion Vietnamese dong ($47.1 million), also includes screening all blood for HIV before it is transfused. By 2005, 90 percent of infected patients and all infected pregnant women are to receive care and counseling. Pilot centers will be set up for HIV-infected children, initially in provinces where there are more than 1,000 cases. Vietnam's total number of HIV cases rose to 46,344, of which 6,708 have AIDS. It is estimated that by 2005 the number of Vietnamese infected with HIV will reach 200,000, of which more than 50,000 will have developed AIDS and 45,000 will have died.

Vietnam has 41,030 people who have tested positive for HIV, a health ministry official said Monday. As of the end of September, 6,138 people were known to have AIDS while another 3,372 had died from the disease since the first HIV case was detected in 1990. The official said 7,047 people were found to be HIV-positive in the first nine months of this year, while there were 941 new AIDS patients and 521 deaths from the disease during the period. About 60 percent of the confirmed HIV patients are drug users. The government spends about $4 million a year to fight AIDS. The money is being used to buy test kits, ensure safe blood transfusions and raise public awareness.

In Vietnam, intravenous drug users and sex workers are most likely to contract the disease. Official figures show around 40,000 people were HIV-positive as of June 2001, but health workers say the total is more than three times that number. The widespread drug problem in Haiphong, as in many other parts of Vietnam, means the infection spreads rapidly. Some 70 percent of intravenous drug users in Haiphong are HIV-positive and the government, together with FHI, has now set up drop-in centers where users can pick up clean needles and learn about the health risks they face. One such shelter opened in October. In addition to getting free condoms and health information, those who drop by can also play table tennis and visit consulting rooms.

Vietnam has 37,111 people who have tested positive for HIV. However, the actual number of people infected with HIV could be as many as 137,000, officials of the Ministry of Health's AIDS Committee said Tuesday. The number of confirmed cases of HIV stood at 28,611 at the end of last year. The government has allocated $4.2 million this year to fight the disease. The money is being used to buy test kits, ensure safe blood transfusions and raise public awareness.

Viet Nam's total number of HIV/AIDS patients is far lower than the figure forecast five years ago, Health Minister Do Nguyen Phuong announced on Thursday in Ha Noi. Addressing a meeting reviewing Viet Nam s efforts over the last decade to combat HIV/AIDS, Health Minister Phuong, said that by the end of last year 28,661 persons had been found to have contracted HIV. Some 4,728 persons had developed full-blown AIDS, and 2,510 had died from the disease, he said. As grim as these figures are, Phuong added, they are more heartening when one considers that, in 1996, it was predicted that Viet Nam would have 278,600 HIV patients by the end of the year 2000. Phuong attributed these lower infection rates to the successful nation-wide launch of an HIV/AIDS public awareness campaign, coupled with stricter controls on high-risk groups, including prostitutes and drug addicts. He said the programme has improved public understanding of the disease a great deal, with approximately 60 per cent of the general public understanding basic HIV/AIDS prevention measures, and 70 per cent of those people in the 19-49 age bracket. Phuong said that condom use has now become common practice among 18 per cent of the general population, and among 98 per cent of prostitutes. Furthermore, sale of condoms has risen sharply, from 3.5 million in 1991 to 92 million condoms nine years later. Currently, analysts say, the disease is concentrated among young drug addicts and prostitutes.

A new report reveals that over one-fifth of commercial sex workers in Vietnam are infected with HIV, up significantly from just two years ago. The findings are based on a survey conducted late last year by the Vietnamese ministry of labor and social affairs on 13,600 prostitutes.

New figures from Vietnam's Health Ministry forecast that unless aggressive measures are taken, more than 46,000 people will die from AIDS and another 200,000 will be diagnosed with HIV within five years. The statistics are in sharp contrast to the nearly 2,400 AIDS deaths and the 27,000 HIV infections the ministry previously reported. A report in Wednesday's official Vietnam News newspaper quoted the ministry as declaring the nation to be in the first stages of an epidemic of HIV and AIDS. UNAIDS estimates that 107,000 people in Vietnam are infected with HIV, nearly two-thirds of whom are injection drug users.

Vietnam's first needle exchange cafe, the Hy Vong, or Hope Cafe, offers clean needles in exchange for used ones. Prostitutes and drug users enter the Hope Cafi, which is sponsored by the Canadian and Vietnamese governments, and can also have their clothes washed, take a shower, and obtain free condoms. A "safe zone" area near the cafe allows addicts to inject drugs without being arrested. Vietnam has seen drug use increase rapidly among youths, especially heroin use. Vietnam's booming sex industry also contributes to the spread of HIV, as prostitutes have sex with tourists. A new advertising campaign promotes safe sex with billboards and ads, but discrimination against people with HIV continues. A lack of funding keeps the Vietnamese government from starting more programs, but some innovative programs--including "Condom Cafes" in Ho Chi Minh City and Hanoi--are working to stop HIV's spread.

Japan has increased Vietnam's budget for HIV prevention with a grant of up to $3.6 million for screening and education programs in Ho Chi Minh City and nine nearby provinces. Ho Chi Minh City has hundreds of bars and brothels, and officials note the added risk of infected prostitutes who return to the city after working in Cambodia. According to health ministry statistics, more than 20,000 people have tested positive for HIV in Vietnam and over 1,800 have died from AIDS; however, they warn that the actual number of infections could be much higher, since testing is primarily done on convicted drug users, prostitutes, military recruits, and pregnant women.

Over 20,000 people in Vietnam are HIV-positive, according to an official from the National Committee for AIDS Prevention. The official noted, however, that the number of people who tested positive is much less than the actual number of infections. Nearly two-thirds of the infections are among drug addicts, and local health experts noted there is also a risk of contracting HIV from prostitutes returning to the country from Cambodia.

According to Vietnamese health authorities, the number of HIV-infected people increased by 51 percent last year, with over 5,800 new cases reported in Vietnam. Western experts, however, believe at least 100,000 Vietnamese are infected with HIV.

New rules from Vietnam's Labor Ministry will prevent HIV-infected individuals from serving as hotel workers, kindergarten teachers, or in restaurants, health care centers, vaccine production, cosmetic surgery, and beauty salons. The ban affects Vietnamese nationals only, a Labor Ministry official noted. A report in the official Thanh Nien newspaper on Monday indicated that the number of HIV-infected people in Vietnam is greater than 16,000, including about 2,900 cases of AIDS.