Inter Press Service - November 2, 2001
Tran Dinh Thanh Lam

"I have been to Vietnam many times, but this is the first time that I was offered such a gift," Quang said, adding that this showed to him a significant change in Vietnamese attitude about sex, prostitution, HIV/AIDS and their related social problems.

Vietnam has been forced to change its perception on prostitution and drug use, the two factors behind the rapid expansion of the HIV/AIDS pandemic here. Officials have periodically launched nationwide crackdowns on social evils, but the results generally were of short-lived and the situation stayed the same or became worse.

The government has therefore decided to adopt a more comprehensive, aggressive approach. "As it is impossible to eradicate prostitution, one of the major causes of HIV/AIDS diffusion, the government decided to minimise its damage by promoting safe sex, " says Le Van Kien, a cadre at the National AIDS Committee (NAC), the organisation in charge of the prevention and control of the spread of HIV/AIDS.

The first HIV case was detected in Vietnam in the early 1990s. Since then, it officially has some 39,000 people living with HIV. Among these, nearly 6,000 developed full-blown AIDS and 3,000 have died. These figures underscore the health, social and development costs of the pandemic.

"AIDS has affected the country's socio-economic development in many aspects," Health Minister Do Nguyen Phuong told the Asia-Pacific Ministerial Meeting on HIV/AIDS and Development in Melbourne, Australia last month.

Vietnam's National AIDS Committee coordinates all activities -- preventive as well as protective -- to fight HIV/AIDS.

Preventive activities focus on disseminating information and education to improve public awareness, promoting HIV prevention and encouraging safe behaviour. One of NAC's earliest preventive activities is to encourage the use of condoms especially among sex workers and drug addicts, a measure that is not easy at all.

"The biggest task is changing people's attitudes," said Dr Ngo Thi Khanh, a programme officer at NAC.

At first, prostitutes did not realise the risks they were taking by having unprotected sex with multiple partners. But when they finally realised the danger, they remained too weak to seek a way to change their behaviour. Some prostitutes said they were willing to risk getting sexually transmitted diseases and the possibility of HIV/AIDS many years down the line, rather than face hunger now.

"Living conditions are difficult and some young girls cannot find a job and want to live well," conceded Dr Khanh.

With the lure of easy money in commercial sex work, many women dared not or could not insist on condom use if the customer disagrees. "Many people insisted that they liked it 'natural' and refused categorically the condom," recalled 26-year-old Lam Thi Van, who has spent eight years in the trade.

NAC and its social workers therefore decided to put men at the forefront of their safe sex campaign, knowing this could well alter the negotiating relationship between customer and client.

CARE Vietnam surveyed 255 men in southern Vietnam and found that 18 percent of respondents had sex with prostitutes and a similar percentage had practiced unsafe sex.

The non-governmental organisation launched a project with its campaign slogan 'I care. Do you?' to spotlight the ways men can influence the pattern of the HIV epidemic. "This includes making sure HIV is not brought into the family; caring for those infected within the family; talking to partners about sex and HIV prevention; and educating children about their sexual health," as Dr Peter Piot, executive director of the Joint United Nations Programme on HIV/AIDS (UNAIDS) put it.

In Vietnam 130,000 males have already become part of the programme in its first year of the four-year project.

"The situation is now better," Van pointed out, saying that these days she rarely has to persuade a client to use a "raincoat" -- the Vietnamese slang for a condom.

Only a decade ago, few Vietnamese knew what condoms were or understood how they could prevent sexually transmitted diseases and unplanned pregnancies. Now 18 percent of the public and 98 percent of sex workers use condoms.

Health services began to distribute free condoms in the late 1980s. NAC cooperated with the Youth Union to set up a network of "condom cafes" across the country to bolster education in safe sex practices. Condom sales have also risen sharply to 92 million in 2000, from only 3.5 million in 1991 and health officials even of a shortage next year.

A recent survey showed that more than 60 percent of the public now has knowledge on HIV/ AIDS, infection and protection measures.

Encouraged by the "condom cafe campaign" success, social workers and aid planners are turning to the country's major mass organisations -- the Confederation of Labour, Women's Union, Youth Union, Farmers' Association -- to get their messages across.

The Australian Red Cross and Vietnam Red Cross, for example, have organised 34 pilot workshops to raise awareness of safe sex and health issues among workers at 13 different work places, while the Population Council, a NGO, and Ho Chi Minh city AIDS Committee have joined the Labour Union to implement a workplace-based campaign on sexual health.

Here in Ho Chi Minh city, where recent statistics report nearly 1,200 new HIV positive cases and 521 new AIDS patients in the first nine months of the year, the campaign for safe and healthy sex is also underway.

The city now has 8,609 HIV cases and 3,044 people with AIDS, a third of them youths. The city's Cross Association and Australian Red Cross on Oct.18 certified 17 more HIV/AIDS educators, raising the number to 31 . Equipped with both knowledge of the disease and interpersonal skills, educators -- mostly university students -- will now work as social workers.

"We are focusing our operations on youth working at cafes, karaoke parlors, dancing clubs and hotels," said Nguyen Minh, one of 14 HIV trainers who graduated last year . "Our job is to instruct young entertainment workers on safe sex measures and train them to negotiate safer, healthier sex with their partners."

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