Though HIV prevalence in Vietnam is currently estimated to be less than 1%, public health officials fear that an increasing number of men are having sex before marriage and that this trend may lead to a rise in the epidemic. A new study reveals that many men who have sex before they marry do so only with the woman who eventually becomes their wife. Overall, 22% of men in the South and 17% of those in the North report having had premarital sex with a girlfriend they did not marry, thus increasing their risk of contracting and spreading HIV.

The study, "Continuity and Change in Premarital Sex in Vietnam," by Sharon Ghuman of the Population Council, et al., appears in the December issue of International Family Planning Perspectives. The authors analyze surveys conducted in 2003 and 2004 in the Red River Delta region in northern Vietnam and in Ho Chi Minh City and surrounding provinces in southern Vietnam. Although premarital sex has become increasingly common over the last 40 years, only one in three men and one in 10 women married in the 1990s had had sex before marriage.

Regional differences in rates of sex before marriage reveal the lasting influence of foreign occupation. In contrast to the Democratic Republic of Vietnam in the North, South Vietnam was exposed to Western ideas—including greater sexual openness—by French colonialism and the American presence. In addition, the war in Vietnam and the presence of many American soldiers supported a thriving industry of sex workers. Though numbers are rough, there were an estimated 50,000–70,000 sex workers in Ho Chi Minh City in the mid-1990s. Seventy-five percent of the increase of premarital sex in the South is due to sex with someone other than a future spouse. A clearer understanding of the patterns of sexual networks among men and high-risk groups would help policymakers design more effective HIV prevention policies and programs.

Also in this issue:

“Unwanted Pregnancy and Associated Factors Among Nigerian Women,” by Gilda Sedgh of the Guttmacher Institute, et al.

“Using Strength of Fertility Motivations to Identify Family Planning Program Strategies,” by Ilene S. Speizer of the University of North Carolina School of Public Health

“Relationship Between HIV Risk Perception and Condom Use: Evidence from a Population-Based Survey in Mozambique,” by Ndola Prata of the University of California, Berkeley, et al.

“Domestic Violence and Symptoms of Gynecologic Morbidity Among Women in North India,” by Rob Stephenson of Emory University

“Choice Is Empowering: Getting Strategic About Preventing HIV Infection in Women,” a viewpoint by Erica L. Gollub of the University of Bordeaux, France.