Pro-Life News

Vietnam looks to U.S. funds in fight against AIDS

Mercury News Vietnam Bureau

CAN THO, Vietnam - Displaying a model of a naked man is not the sort of thing polite women do in the Mekong Delta. But when it comes to fighting AIDS, Anh Thu believes in the direct approach.

``This is the way we put a condom on,'' said the 26-year-old health worker, holding up a lifelike wooden model matter-of-factly. ``Watch me.''

Thu spoke to about 15 prostitutes at the Women's Health Club, a gathering place for women from across the Mekong Delta, some of whom have the AIDS virus. Each took a turn unwrapping a latex ao mua -- or raincoat, as the Vietnamese sometimes refer to condoms -- and putting it on the model.

With the nation's AIDS epidemic threatening to spread into the general population, the Vietnamese are embracing an array of approaches to prevention. They hope that an infusion of money pledged recently by U.S. President George Bush will help them step up their efforts and provide better care to those who are living with AIDS.

Vietnam has an estimated 210,000 AIDS cases, and its HIV infection rate has risen tenfold in the past seven years. Without further intervention it is projected to increase eightfold by 2012 -- a rate of increase higher than that projected for India or China.

The United Nations delivered a bleak assessment of the disease Tuesday, reporting that HIV is spreading rapidly worldwide and that one in four new infections occurs in Asia.

In its new national AIDS strategy, the Vietnamese government has endorsed some controversial approaches the Bush administration will not fund, such as providing clean needles to drug users. But health advocates in Vietnam hope that the money can be used to support intervention programs like the one in Can Tho, which provides AIDS education to prostitutes and their customers.

At the heart of the effort is the Women's Health Center, part classroom, part job-training program, part support group.

On a recent morning, the women talked about sexually transmitted diseases, sewed handbags to sell and then danced to lift their spirits.

``Would someone volunteer to put a condom on?'' Thu asked, holding up the wooden model. ``If you put it on the wrong way, just throw it away and use a new one.''

By the time the group was finished, the floor was littered with latex.

At one point, a bellowing pimp barged in, demanding that his ``girlfriend'' get back to work. But the health workers ordered him to leave.

The Can Tho program is coordinated by local government officials and Family Health International, a private U.S. organization that receives funding from the U.S. Agency for International Development. USAID is spending $4.5 million a year on AIDS prevention in Vietnam, and Bush's new initiative could boost that by as much as $10 million.

Vietnam's epidemic started in the 1990s on two separate tracks: injected drugs in the north, commercial sex in the south. Now the routes are merging and HIV is beginning to move into the general population with men infecting wives and girlfriends and mothers passing the illness to their babies.

In Can Tho, the epidemic began through sexual transmission. The hub of the Mekong Delta and a stopping point for truckers going from Ho Chi Minh City to Cambodia, the area has long been a thriving market for sex.

At a busy highway intersection just outside the city -- a place known as ``The Condom Tunnel'' -- health workers have lined the road with billboards urging people to practice safe sex.

Throughout Vietnam, prostitutes are driven into the trade by harsh economic realities. Poorly educated, with few job prospects, they can earn less than a dollar a day doing menial labor, or up to $20 an hour selling sex.

Before she became a health worker, Thu worked in a setting where many young women are lured into prostitution, although she never entered the trade. She was a waitress in one of several Can Tho restaurants where the patrons come for lunch -- and sex.

The customers, mostly local businessmen and government officials, would berate any woman who turned them down.

`` `If you come to work here, you have to do everything,' '' Thu recalled one man saying.

Among those at the Women's Health Club infected with the AIDS virus is Nhieu, who is trying to leave prostitution after six years.

With a sixth-grade education, her prospects are bleak. She sells lottery tickets on the streets for about 60 cents a day. She also works to keep her secrets from her mother, who doesn't know that she has sold her body and has HIV.

Nhieu is taking reading lessons at the center but her progress is slow. ``I'm trying my best, but I always forget what the teacher tells me,'' said Nhieu, who is missing two of her front teeth.

Each night, health workers from the center join forces with a team of motorcycle taxi drivers, cruising to Can Tho's prostitution hot spots -- cheap hotels, public parks, vacant lots. They sell condoms for a few cents apiece to anyone who needs them.

``We tell the men that the prostitutes won't have sex with them if they don't wear a condom,'' said Ta Quang An, 35, a motorcycle taxi driver who shuttles customers to their trysts.

It is normal for men in the region to hire prostitutes, An said. ``It's very unusual to find a man who wouldn't see one.''

Can Tho's first HIV case, in a visiting Thai sailor, was reported in 1992. The next year, six more cases were discovered, all in Vietnamese women who had worked as prostitutes in Cambodia.

With help from several foreign health organizations, Can Tho launched the first AIDS public education campaign in Vietnam nine years ago. Though the overall number of HIV cases continues to grow, the campaign has had some important achievements, said Dr. Lai Kim Anh, director of the Can Tho Center for Preventive Medicine.

More than 600 of the area's estimated 3,000 prostitutes have become members of the Women's Health Center, and the staff has consulted with many of those who haven't joined.

``We are proud that we have been successful in containing HIV cases among sex workers, who are the main source of AIDS transmission here,'' said Anh.

In the beginning, the campaign's outreach workers were nervous. One of their first missions: to knock on every door in Can Tho, hand out condoms and warn about the dangers of unprotected sex.

This wasn't easy in a traditional southern Vietnamese city, where sex wasn't a topic for everyday conversation.

``I could not say the word `condom,' '' Anh said. ``Everyone thought that condoms were bad.''

At first they wrapped the condoms in paper so nobody would see them. Still, they had many doors slammed in their faces by people aghast that a stranger would try to talk to them about sex.

``Gradually, people have come to understand and support our project,'' Anh said.

http://www.mercurynews.com/ Posted by Editor at July 7, 2004 01:47 AM