ABSTRACT
ObjectivesHealth care system of many countries are facing a surging burden of COVID-19. Although Vietnam has successfully controlled the COVID-19 pandemic to date, there is a sign of initial community transmission. An estimate of possible scenarios to prepare health resources in the future is needed. We used modelling methods to estimate impacts of mitigation measures on the COVID-19 pandemic in Vietnam. MethodsSEIR model built in the COVIDSIM1.1 tool was adopted using available data for estimation. The herd immunization scenario was with no intervention implemented. Other scenarios consisted of isolation and social distancing at different levels (25%, 50%, 75% and 10%, 20%, 30%, respectively). Outcomes include epidemic apex, daily new and cumulative cases, deaths, hospitalized patients and ICU beds needed. ResultsBy April 8, 2020, there would be 465 infected cases with COVID-19 in Viet Nam, of those 50% were detected. Cumulatively, there would be 1,400 cases and 30 deaths by end of 2020, if 75% of cases was detected and isolated, and 30% of social distancing could be maintained. The most effective intervention scenario is the detection and isolation of 75% infected cases and reduction of 10% social contacts. This will require an expansion of testing capacity at health facilities and in the community, posing a challenge to identify high-risk groups to prioritized testing. ConclusionsIn a localized epidemic setting, the expansion of testing should be the key measure to control the epidemic. Social distancing plays a significant role to prevent further transmission to the community.
ABSTRACT
BACKGROUND: The number of people living with HIV (PLWH) in Vietnam was estimated to rise from 156,802 in 2009 to 256,000 in 2014. Although the number of new HIV reported cases has decreased by roughly 14,000 cases per year from 2010 to 2013 a concerning increase in HIV prevalence has been identified among men who have sex with men (MSM) from 1.7 % in 2005 to 2.4 % in 2013. There are signs of increased HIV (+) prevalence among MSM in a number of cities/provinces, especially in the two largest cities, Ho Chi Minh City (HCMC) and Hanoi. HCMC is the country's major "hot spot" for HIV/AIDS, with over a third of the total national AIDS patients. This paper is based on a secondary analysis of Integrated Biological and Behavioural Surveillance (IBBS) data collected in Vietnam in 2009 to examine the research question "Do behavioural risk factors contribute to HIV infection among the MSM population in HCMC?". METHODS: A cross-sectional design was employed to sample males aged over 15 from communities in HCMC, who reported having any types of sex with another man at least once during the last 12 months. Participants (399) were recruited using the respondent driven sampling (RDS) method and provided both biological data (specimens) and behavioural data collected through a questionnaire survey. RESULTS: The study found high HIV prevalence (14.8 %) among the MSM sample from HCMC. Multivariate analysis found age and level of formal education completed, to be significantly associated with HIV infection. MSM aged over 25 were more likely to be HIV (+) than the younger group (OR = 7.82, 95 %CI = 3.37-18.16, p < 0.001); as were participants who had low educational (OR = 2.74, p < 0.05) and medium educational levels (OR = 2.68, p < 0.05). In addition, those participants who had anal sex with male partners (OR = 2.7, p < 0.05) and whose sexual partners injected drugs (OR = 2.24, p < 0.05) and who felt at risk of HIV infection (OR = 2.42, p < 0.01) had a higher risk of HIV infection. CONCLUSIONS: The high proportion of HIV (+) MSM in our sample from HCMC indicates that we need a better understanding of MSM behaviour patterns, risk practices and social networks as well as improved HIV prevention and control measures. More targeted and relevant HIV prevention programs for older and less educated MSM are urgently needed to address the key risk factors we have identified. MSM engaging in drug-related risk behaviours require multi-strategy HIV interventions relating to both sex and drug behaviour among MSM and their partners who engage in drug use. Further work is needed to identify locations and strategies where these high-risk individuals can be accessed as well as to reduce barriers related to social discrimination and stigma. Targeting high risk individuals and groups should supplement existing efforts aimed at the MSM population in HCMC.