AIDS cases 'exploding' in Vietnam

By Steve Sternberg
July 11, 2004

Hanoi — U.S. Ambassador Randall Tobias, head of President Bush's $15 billion global AIDS initiative, saw firsthand this weekend the multitude of challenges facing Vietnam, where one in every 75 households has been touched by the disease .

Orphans infected with the AIDS virus are cared for at a treatment center in Hanoi. Roughly 200,000 people in Vietnam have HIV. By Richard Vogel, AP

Bush recently added Vietnam as the only Asian nation among 15 countries eligible for his Emergency Plan for AIDS Relief. One-fourth of the 4.8 million new HIV infections reported in 2003 are in Asia.

Tobias chose Vietnam because HIV is spreading faster here than in India and China. It's driven by the country's young population, by high infection rates among injecting drug abusers and by a sex trade that caters to up to 15% of men each year. The only risk for most women to become infected is their husband's sex or drug abuse. Nearly 25% of women who seek HIV testing cite their partner's behavior as why they visit a clinic.

"Vietnam is a country where the disease is largely confined among sex workers and drug users but is on the verge of exploding into the general population," Tobias told a USA TODAY reporter accompanying him on a two-day official visit before continuing on to the 15th International AIDS Conference in Bangkok.

Sunday at the conference, Tim Brown of the East-West Center reported that Vietnam's pattern is repeated throughout Asia.

Unlike many countries, however, Vietnam has made a commitment to fight the epidemic, Tobias said. Although government officials are welcoming the additional $10 million in U.S. AIDS funding, forging a partnership with one of the world's last communist regimes will mean:

• Providing AIDS treatment in a country where fewer than 300 of roughly 200,000 people with HIV now get treatment. On a visit to Vietnam's biggest hospital, Bach Mai, which has 1,400 beds, Tobias stopped in wards with two AIDS patients per bed.

Like most of Asia, Vietnam lacks trained doctors, with only one for 11,250 AIDS patients, Kevin Frost of the American Foundation for AIDS Research reported at the Bangkok conference.

• Setting up prevention, care and treatment programs in walled rehabilitation camps where tens of thousands of drug addicts and sex workers, half of whom are HIV-positive, are warehoused for five years or more. Tobias said the United States will not finance one method for combating HIV transmission among drug addicts — needle-exchange programs, which swap clean syringes for dirty ones.

In Bangkok Sunday, Brown criticized that limitation and the administration's failure to strongly promote the use of condoms.

"In some ways, it's good that Vietnam was chosen" for the president's initiative, Brown said, "if the U.S. allows them to do what they need to do — needle exchange and heavy condom promotion, particularly among sex workers and their clients."

• Enlisting the several faith-based groups now working quietly in Vietnam to become more active in the country. Vietnam lacks religious freedom, and the government fears religious groups will gain power and thereby threaten the status quo.

"We hope we can encourage the government to allow (religious groups) to expand their activities going forward," Tobias said after meeting with representatives of eight religious groups, including Buddhists, evangelical Christians from World Vision International, and Daughters of Charity of St. Vincent de Paul, who run an AIDS hospice for abandoned and dying adults and children with AIDS.

Sister Nguyen Kim Thoa, of the Daughters of Charity, told Tobias that government officials she did not identify called her archbishop and asked that their Mai Hoa Center expand its activities to take care of even more dying patients.

"What I read into this is that it's a pressing need, and I suspect it's difficult to find people to do the work," Tobias said. "I think that's extremely encouraging."

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