Sexually transmitted infections among clients seeking both pre-exposure prophylaxis (PrEP) and non-PrEP services at key population-led and -friendly private clinics in Vietnam

Title

Sexually transmitted infections among clients seeking both pre-exposure prophylaxis (PrEP) and non-PrEP services at key population-led and -friendly private clinics in Vietnam

Presenter

Hong Anh Doan

Authors

H.A. Doan * (1), L.K. Tran (1), T.M. Le (2), K.Q. Do (3), B.H. Nguyen (4), P.A. Nguyen (5), B.N. Vu (1), K.E. Green (1)

Institutions

(1) PATH, Hanoi, Viet Nam, (2) Glink Vietnam, Ho Chi Minh City, Viet Nam, (3) Galant Clinic, Ho Chi Minh City, Viet Nam, (4) Bien Viet Clinic, Hanoi, Viet Nam, (5) My Home Clinic, Ho Chi Minh City, Viet Nam

BACKGROUND: Sexually transmitted infection (STI) testing and treatment is an essential component of key population (KP) healthcare in Vietnam. HIV pre-exposure prophylaxis (PrEP) further routinizes STI screening among KP. The USAID/PATH Healthy Markets project has supported KP-led and KP-friendly private clinics to integrate STI screening, diagnosis and treatment as part of routine care and PrEP services.
DESCRIPTION: PrEP users in five KP-led and KP-friendly private clinics are screened for syphilis using a rapid diagnostic test (RDT) every three months. If the RDT result is positive, a blood sample is sent to a specialized lab for confirmatory testing using a Treponema pallidum hemagglutination (TPHA) test. Nucleic acid amplification testing (NAAT) is used as gold standard for chlamydia and gonorrhea testing. Due to high costs, this is offered to PrEP users every six months. Samples collected from oropharyngeal, anal and urethral or vaginal swaps, together with a urine sample, are pooled by specialized labs offering NAAT. Confirmatory results are sent back to PrEP providers for client counseling and treatment.
LESSONS LEARNED: From October 2020 to November 2021, 6,380 clients at KP-led and KP-friendly private clinics sought testing for STIs: 14.4% were diagnosed with either syphilis, gonorrhea or chlamydia (8.3% syphilis, 7.6% gonorrhea and 4.9% chlamydia). 90.0% of clients diagnosed with one or more STI were men who have sex with men. Among PrEP users, syphilis and gonorrhea infection were significantly higher (12.0% and 25.5%, respectively) than among non-PrEP users (8.0% and 6.6%, respectively).
CONCLUSIONS: We found STI rates to be high overall but higher among PrEP users, indicating that access to routine STI screening and testing services is essential among KP in Vietnam. Programs should prioritize financing STI testing and treatment among KP including as part of PrEP services.

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