HIV infections have now been reported in all of Viet Nam's 61 provinces. The Government estimates that between 135,000 and 160,000 people had been infected (up to the end of 2000). All forecasts point to a rapid and consistent increase in people infected and affected.

The largest HIV/AIDS epidemic in Viet Nam is among injecting drug users (IDUs) who share injecting equipment. Unsafe injection (which also includes the frequent re-use of unsterilized disposable syringes in health settings) still accounts for two-thirds of reported infections. HIV/AIDS is predominantly associated with men: some 85.9% of reported cases have been male. However, sexual transmission is expected to overtake infections through unsafe injections in the next five years, accelerating the spread of HIV/AIDS into the general population and putting women and children at greater risk.

Reported levels of STIs among sex workers are high while STI levels among women in the general population are lower but still significant. This indicates that safe sex is not widely practised and that a sexually-led epidemic has the potential to accelerate quickly. Hepatitis B, transmitted in the same ways as HIV/AIDS, now affects an estimated 15-20% of the population.

Identified risk factors in Viet Nam include:

• Rapid economic liberalization has widened the disparities between rich and poor, creating ideal conditions for exploitation, abuse and HIV/AIDS infection.
• Adolescents and young people have scant opportunity to learn about or discuss sex, substance abuse and HIV/AIDS/STIs. Almost half of Viet Nam's population is under 20 years old.
• Women and girls are in a very weak position to negotiate safe sex because of traditional gender norms.