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MINISTRY OF
HEALTH OF VIETNAM
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SOCIALIST
REPUBLIC OF VIETNAM
Independence - Freedom – Happiness
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No. 07/2023/TT-BYT
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Hanoi, April 04,
2023
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CIRCULAR
Providing procedures and methods for
EPIDEMIOLOGical surveillance of HIV/AIDS and sexually transmitted diseases (STDs)
Pursuant to the Law on Prevention and Control of
HIV/AIDS dated June 29, 2006; Law on amendments to the Law on Prevention and
Control of HIV/AIDS dated November 16, 2020;
Pursuant to Decree No. 95/2022/ND-CP dated
November 15, 2022 of the Government on functions, tasks, powers and
organizational structure of the Ministry of Health of Vietnam;
At the request of the Director of Vietnam
Administration of HIV/AIDS Control (VAAC);
The Minister of Health promulgates a Circular
providing procedures and methods for surveillance of hiv/aids epidemiology and sexually transmitted diseases
(STDs).
Chapter I
GENERAL PROVISIONS
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This Circular providing guidance on procedures and
methods for HIV/AIDS epidemiology and STD surveillance.
Article 2. Definitions
For the purposes of this Circular, the terms below
shall be construed as follows:
1. “HIV surveillance“ means collection of
data on HIV/AIDS epidemiological indicators of groups of people who are
at different risks of getting HIV/AIDS to detect cases of confirmed HIV
infection.
2. “HIV/AIDS case surveillance" means
ongoing collection and monitoring of data on epidemiological indicators of
people having HIV after they have confirmed HIV-positive test results, during
the process of HIV/AIDS treatment, until they are dead to have knowledge about
directions and results day by day in order to provide such data to serve
preparation of plans, suppression and assessment of efficiency of anti-HIV/AIDS
measures.
3. “HIV behavioral surveillance survey
(BSS)" means collection of information on HIV risk behaviors by
putting interview questions to groups of the selected people of targeted HIV
surveillance.
4. “Sexually transmitted infections (STD)” means
infections caused by bacteria, viruses, fungi, parasites, protozoa or other
agents that are transmitted through sexual contact.
5. “STD surveillance“ means collection of
information on epidemiological indicators of people who are at different risks
of getting STDs after diagnosis.
6. "etiological surveillance of STDs" means
periodic and systematic collection of information relating to epidemiological
indicators of people who are at different risks of getting STDs on the basis of
testing to find out infectious agents that are transmitted through sexual
contact.
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8. “Syphilis targeted surveillance” means
collection of data on epidemiology and syphilis tests from groups of selected
people of HIV surveillance.
Chapter II
METHODS AND PROCEDURES FOR
SURVEILLANCE OF HIV/AIDS EPIDEMIOLOGY
Section 1. HIV surveillance
Article 3. Methods for HIV surveillance
1. Methods for HIV surveillance include:
a) Counselling before and after HIV testing;
b) HIV testing;
c) Collection, consolidation of and report on
epidemiological indicators of HIV/AIDS.
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a) Drug users;
b) Prostitutes;
c) Homosexual active people;
d) Transgender people;
dd) Spouses and other family members living
together with HIV-positve people; spouses of the persons prescribed in Points
a, b, c and d of this Clause;
c) Sex partners of HIV-positive people;
g) People infected with STDs;
h) Frequent travelers;
k) Tuberculosis patients;
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m) Prisoners, persons held in detention, and
persons held in custody at reform schools, compulsory education institutions or
rehabilitation centers;
n) Other subjects.
Article 4. HIV testing and counselling process
1. Counselling before and after HIV testing:
a) Counselling before and after HIV testing at
healthcare facilities, compulsory education institutions, reform schools,
rehabilitation centers, social protection centers, prisons, detention centers
and other custody facilities shall be done according to regulations in Circular
No. 01/2015/TT-BYT dated February 27, 2015 of the Minister of Health on
guidelines on counseling for HIV/AIDS prevention and control at healthcare
facilities;
b) Counselling before and after HIV testing in
community shall be done according to Decision No. 2673/QD-BYT dated April 27,
2018 of the Minister of Health on promulgation of HIV testing and counseling
guidelines in community.
2. HIV testing shall be done according to
professional guidelines in Decision No. 2674/QD-BYT dated April 27, 2018 of the
Minister of Health on promulgation of the national guidelines for HIV testing.
Article 5. Procedures for collection,
consolidation of and report on epidemiological indicators of HIV/AIDS.
1. Epidemiological indicators of HIV/AIDS of the
person subject to HIV testing shall be collected, consolidated and reported as
follows:
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b) The confirmatory HIV testing facility shall
receive the electronic document via the HIV-INFO system or printed document
from the HIV screening and testing center. In case the person subject to HIV
testing directly have test at the confirmatory HIV testing facility, this
facility shall collect information as prescribed in Point a Clause 1 of this
Article.
2. The update of information, transfer and return
of the confirmed positive result shall be done as follows:
a) After the confirmed HIV result is presented, the
confirmatory HIV testing facility is responsible for updating the testing
result on the HIV-INFO system and transfering an electronic document or
physical document on the confirmed positive result to the screening facility or
returning the confirmed positive result to the person subject to HIV testing;
b) The HIV screening facility shall receive the
confirmed positive result from the confirmatory HIV testing facility and update
the confirmed HIV-positive test results (if any) as prescribed in Appendix 1
enclosed herewith and send the updated information to the confirmatory HIV
testing facility.
3. The confirmatory HIV testing facility shall
prepare a HIV surveillance report prescribed in Appendix 1 enclosed herewith
and send the report to the HIV/AIDS surveillance agency prescribed in Article 6
of this Circular.
4. The HIV screening facility and the confirmatory
HIV testing facility shall transfer information of the HIV-positive person to
the HIV/AIDS treatment facility registered by the HIV-positive person.
Article 6. Procedures for notifying positive HIV
test results to agencies and units tasked with HIV/AIDS epidemiological
surveillance
1. After the confirmed HIV-positive test result is
presented, the confirmatory HIV testing facility shall notify to an agency or
unit tasked with HIV/AIDS epidemiological surveillance of a province or
district, the National Institute of Hygiene and Epidemiology, the Pasteur
Institute in Ho Chi Minh City, the Central Highlands Institute of Hygiene and
Epidemiology and Pasteur Institute in Nha Trang (hereinafter referred to as
“Institute”) and VAAC (hereinafter referred to as “HIV/AIDS surveillance
agencies”) through the HIV-INFO system.
The confirmatory HIV testing facility affiliated to
the Ministry or Central authority shall notify the positive HIV test result to
the HIV/AIDS surveillance agency of the province where the testing facilty is
located.
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Section 2. HIV/AIDS
case surveillance
Article 7. Methods for HIV/AIDS case
surveillance
1. Methods for HIV/AIDS case surveillance include:
a) Surveillance of HIV-positive person;
b) Surveillance of treatment status of HIV-positive
person;
c) Surveillance of HIV-related deaths.
2. Subjects under HIV/AIDS case surveillance are
HIV-positive people.
Article 8. Procedures for managing information
of people getting tested for HIV confirmation
1. After receiving information on the HIV-positive
person, VAAC shall assign an official to be in charge of HIV/AIDS surveillance
(hereinafter referred to as “surveillance official” to:
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b) Review, compare and certify information on the
HIV-positive person on the HIV-INFO system if there is a request;
c) Cooperate with Institutes in organizing HIV
surveillance and assess HIV transmission risks when the number of HIV-positive
people increases according to the professional guidelines.
2. After receiving information on the HIV-positive
person, the Institutes shall assign a surveillance official to:
a) Update, review, compare and certify information
of the HIV-positive person according to Point a and Point b Clause 1 of this
Article;
b) Cooperate with VAAC and the provincial HIV/AIDS
surveillance agency in organizing HIV surveillance and assess HIV transmission
risks when the number of HIV-positive people increases according to the
professional guidelines.
3. After receiving information on the HIV-positive
person, the provincial HIV/AIDS surveillance agency shall assign a surveillance
official to:
a) Update, review, compare and certify information
of the HIV-positive person according to Point a and Point b Clause 1 of this
Article;
b) Send a notification of information on the
HIV-positive person to the HIV/AIDS surveillance agency of the district where
the HIV-positive person is residing or has permanent residence via the HIV-INFO
system;
c) Organize HIV surveillance in the district and
assess HIV transmission risks when the number of HIV-positive people increases
according to the professional guidelines.
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a) Update information of the HIV-positive person according
to Point a Clause 1 of this Article;
b) Take charge and cooperate with the Commune-level
medical station in reviewing, comparing, certifying and updating information on
the HIV-positive person receiving from the provincial HIV/AIDS surveillance
agency on the HIV-INFO system;
c) Send a notification of information on the
HIV-positive person to medical station of the commune where the HIV-positive
person is residing or has permanent residence via the HIV-INFO system;
d) Organize HIV surveillance in the district and
assess HIV transmission risks when the number of HIV-positive people increases
according to the professional guidelines.
5. After receiving information on the HIV-positive
person, the commune-level medical station shall assign a surveillance official
to:
a) Review and calibrate information on the
HIV-positive person on the HIV-INFO system;
b) Cooperate with the district-level HIV/AIDS
surveillance agency in assessing HIV transmission risks when the number of
HIV-positive people increases according to the professional guidelines.
Article 9. Procedures for managing information
on the HIV-positive person who are undergoing HIV/AIDS treatment
1. After the HIV-positive person sent to a HIV/AIDS
treatment facility or in the process of HIV/AIDS treatment, the HIV/AIDS
treatment facility shall send information on the HIV/AIDS treatment of the
HIV-positive person as prescribed in Appendix 2 enclosed herewith to the
HIV/AIDS surveillance agency.
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2. After receiving information on the HIV-positive
person who is undergoing HIV/AIDS treatment, the provincial HIV/AIDS
surveillance agency shall assign a surveillance official to:
a) Update information on the HIV/AIDS treatment of
the HIV-positive person prescribed in Appendix 2 enclosed herewith on the
HIV-INFO system;
b) Review and compare information on HIV-positive
people who are undergoing HIV/AIDS treatment for the first time with HIV/AIDS
treatment data on the HIV-INFO system;
c) Send a notification of list of HIV-positive
people who are undergoing HIV/AIDS treatment to the HIV/AIDS surveillance
agency of the district where such HIV-positive people are residing or have
permanent residence via the HIV-INFO system;
d) Submit a report on the HIV/AIDS treatment of the
HIV-positive people to VAAC and local institutes.
3. After receiving information on the HIV/AIDS
treatment of the HIV-positive person, the district-level HIV/AIDS surveillance
agency shall assign a surveillance official to:
a) Update information on the HIV/AIDS treatment of
the HIV-positive person prescribed in Point a Clause 2 of this Article and send
a report on the HIV/AIDS treatment of the HIV-positive person to the provincial
HIV/AIDS surveillance agency;
b) Notify the list of HIV-positive people who are
undergoing HIV/AIDS treatment to the commune-level medical station;
c) Review and compare information on HIV-positive
people who are undergoing HIV/AIDS treatment for the first time with HIV/AIDS
treatment data on the HIV-INFO system;
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5. After receiving information on the HIV-positive
person who is undergoing HIV/AIDS treatment, the local institute shall assign a
surveillance official to:
a) Update information on the HIV/AIDS treatment of
the HIV-positive person prescribed in Point a Clause 2 of this Article and send
a report on the HIV/AIDS treatment of the HIV-positive person to VAAC;
b) Review information on the HIV-positive people
who are undergoing HIV/AIDS treatment in the assigned area on the HIV-INFO
system;
6. After receiving information on the HIV-positive
person who is undergoing HIV/AIDS treatment, VAAC shall assign a surveillance
official to:
a) Update information of the HIV/AIDS treatment of
the HIV-positive person prescribed in Point a Clause 2 of this Article;
b) Review and respond information on HIV-positive
people who are undergoing HIV/AIDS treatment nationwide on the HIV-INFO system
to HIV/AIDS surveillance agencies (if any).
Article 10. Procedures for managing information
on HIV-related deaths
1. After receiving information on a dead
HIV-positive person in a commune, the commune-level medical station shall
cooperate with a judicial official of the commune where the dead HIV-positive
person had resided or had permanent residence in collecting and updating
information prescribed in Appendix 3 enclosed herewith on the HIV-INFO system
or sending them in writing to the district-level HIV/AIDS surveillance agency.
2. After receiving information on a HIV-related
death, the district-level medical station shall update information of the
HIV-positive person prescribed in Appendix 3 enclosed herewith on the HIV-INFO
system.
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Article 11. Consolidated reports on HIV/AIDS
case surveillance data
1. Reporting frequency: quarterly reports and
annual reports;
2. Reporting periods:
a) The reporting period of a quarterly report shall
be the period from the first day of the quarter to the end of the last day of
the same quarter;
b) The reporting period of an annual report shall
be the period from the first day of the year to the end of the last day of the
same year;
3. Reports shall be sent in person or by email or
via the HIV-INFO system. Reports must be signed, sealed and saved according to
regulations of law on archives.
4. Contents of a consolidated report on HIV/AIDS
case surveillance data include the number of new HIV-positive people and the
number of HIV-related deaths using the form prescribed in Appendix 4 enclosed
hererwith.
5. Reporting entities and procedures:
a) Commune-level medical stations shall submit their
reports as prescribed in Clause 4 of this Article to district-level HIV/AIDS
surveillance agencies no later than the 5th of the next month of the
reporting period;
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c) The provincial HIV/AIDS surveillance agencies
shall consolidate the reports sent from the district-level medical stations as
prescribed in Clause 4 to VAAC and Institutes no later than the 15th
of the next month of the reporting period;
d) The Institutes shall consolidate the reports sent
from the provincial HIV/AIDS surveillance agencies as prescribed in Clause 4 to
VAAC no later than the 20th of the next month of the reporting
period;
Section 3. TARGETED SURVEILLANCE
Article 12. Methods for targeted surveillance
1. Methods for targeted surveillance include:
a) HIV/AIDS targeted surveillance;
b) Syphilis targeted surveillance;
c) HIV behavioral surveillance survey (BSS).
2. Subjects under targeted surveillance include:
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b) Female prostitutes;
c) Men who have sex with men (MSM);
d) Another group: Based on the risk of HIV
transmission of each province to select a group that play a role in increasing
HIV transmission in their provinces, the estimated HIV infection rate in this
group must be over 1% and continuous surveillance must be ensured according to
the frequency specified in Clause 1 Article 14 of this Circular.
Article 13. Procedures for organizing targeted
surveillance
1. Provincial HIV/AIDS surveillance agencies shall
take charge and cooperate with district-level HIV/AIDS surveillance agencies,
commune-level medical stations and organizations and individuals tasked with
targeted surveillance in:
a) Conducting surveys, making model frames for
targeted surveillance;
b) Accessing, inviting entities under targeted
surveillance;
c) Sampling, transporting and testing;
d) Interviewing participants in targeted
surveillance according to survey forms;
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e) Summarizing and reporting targeted surveillance
results.
2. VAAC shall take charge and cooperate with
Institutes and National Hospital of Dermatology and Venereology in developing
and updating guidelines on the process of organizing and carrying out targeted
surveillance.
Article 14. Frequency and period of targeted
surveillance
1. Targeted surveillance is carried out
simultaneously or sequentially according to target groups every two years and
not overlapping with each other in the same year.
2. Surveillance period: Starting from June 1 and
ending on September 30 of the year in which the surveillance is carried out.
Article 15. Criteria for selecting targeted
surveillance sites
1. Targeted surveillance sites shall be
selected as follows:
a) District-level authorities may select to carry
out targeted surveillance when there are the largest number of entities
specified in Clause 2 Article 12 of this Circular according to the managed or
estimated data on entities under targeted surveillance;
b) In a province, no more than 5 districts shall be
selected to carry out targeted surveillance.
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Article 16. Selection criteria, sample size and
targeted surveillance sample selection methods
1. Criteria for selection of entities under
targeted surveillance: people who are full 16 years of age or older, have civil
act capacity and meet the following criteria:
a) Drug users who are men having at least one
injection of drug within a month before sample collection;
b) Female prostitutes having vaginal or anal sex at
least one time within a month prior to sample collection;
c) Men having had anal sex with other men within 12
months prior to sample collection;
d) Other subjects having HIV risk behaviors in the
province and currently reside in the province.
2. Targeted surveillance sample size:
a) Men addicted to drug injection: 150-300 samples;
b) Female prostitutes: 150-300 samples;
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d) Other subjects who have HIV risk behaviors: 300
samples.
3. The sample selection methods shall follow the
professional and technical guidelines of the Ministry of Health (via VAAC).
Article 17. Consolidated reports on targeted
surveillance data
1. Reporting frequency shall comply with the
regulations in Clause 1 Article 14 hereof.
2. Reporting periods shall comply with the
regulations in Clause 2 Article 14 hereof.
3. Reports shall be sent and received in accordance
with the regulations in Clause 3 Article 11 hereof.
4. A consolidated report on targeted surveillance
data includes areas and entities under targeted surveillance, sample size and
results of HIV and syphilis tests, assessment of HIV infection trend and
syphilis infection rate, analysis of indicator groups, assessment of
implementation and submit petitions using the form specified in Appendix 8
enclosed herewith.
5. Reporting entities and procedures:
a) Provincial HIV/AIDS surveillance agencies shall
report targeted surveillance specified in Appendices 5, 6, 7 and 8 enclosed
herewith to VAAC, the National Institute of Hygiene and Epidemiology and local
institutes where they take charge before October 31 of the year in which the
targeted surveillance is carried out;
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Chapter III
STD SURVEILLANCE
Article 18. Methods for STD surveillance
1. Methods for STD surveillance include:
a) Etiological and syndromic diagnosis and
treatment of STDs;
b) Collection, consolidation of and report on epidemiological
indicators of STDs.
2. Entities under STD surveillance are patients
diagnosed with STDs.
Article 19. Procedures for collection of
information on STD surveillance
1. Healthcare facilities shall diagnose and manage
STDs according to regulations of law on medical examination and treatment and
collect epidemiological information of people who have STDs as prescribed in
Article 20 hereof.
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Article 20. Information on epidemiology of
people having STDs to be collected
1. Age, sex, occupation.
2. Information on etiological and syndromic
diagnosis of STDs prescribed in Appendices 9 and 10 enclosed herewith.
3. HIV infection status of people infected with
STDs;
Article 21. Frequency, ending date of the
reporting period and reporting methods
1. Reporting frequency shall be every 6 months.
2. Reporting periods:
a) The first 6-month report shall cover the period
from January 01 to the end of June 30;
b) The last 6-month report shall cover the period
from July 01 to the end of December 31;
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Article 22. Procedures for STD surveillance
reports
1. Reports of commune-level medical stations:
a) Content of reports: the number of patients who
have STDs and have been examined and managed in the last 6 months using the
forms prescribed in Appendices 9, 10 and 11 enclosed herewith;
b) Submitting period: The first 6-month report
shall be submitted within the period from July 01 to 05 of the reporting year;
The last 6-month report shall be submitted within the period from January 01 to
05 of the succeeding year;
c) Units receiving reports: district-level HIV/AIDS
surveilance agencies.
2. Reports submitted to district-level authorities
include:
a) Contents of reports as prescribed in Point a
Clause 1 of this Article;
b) Units submitting reports: commune-level medical
stations, district-level healthcare facilities providing STD examination and
treatment services and private healthcare facilities in the districts;
c) Submitting period: The first 6-month report
shall be submitted within the period from July 01 to 05 of the reporting year;
The last 6-month report shall be submitted within the period from January 01 to
05 of the succeeding year;
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3. Reports submitted to provincial authorities
include:
a) Contents of reports as prescribed in Point a
Clause 1 of this Article;
b) Units submitting reports: district-level
HIV/AIDS surveillance agencies, provincial healthcare facilities providing STD
examination and treatment services, healthcare units affiliated to the Ministry
and central authorities located in provinces and other healthcare facilities
providing STD examination and treatment services.
c) Submitting period: The first 6-month report
shall be submitted within the period from July 06 to 10 of the reporting year;
The last 6-month report shall be submitted within the period from January 06 to
10 of the succeeding year;
d) Units receiving and consolidating reports:
provincial dermatology and venereology facilities.
4. Reports submitted to central authorities
include:
a) Contents of reports as prescribed in Point a
Clause 1 of this Article;
b) Unit submitting reports: provincial dermatology
and venereology facilities;
c) Submitting period: The first 6-month report
shall be submitted within the period from July 11 to 15 of the reporting year;
The last 6-month report shall be submitted within the period from January 11 to
15 of the succeeding year;
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Chapter IV
IMPLEMENTATION CLAUSES
Article 23. Organizing implementation
1. VAAC shall:
a) Take charge and cooperate with relevant agencies
and organizations in guiding, inspecting and summarizing the implementation of
this Circular nationwide;
b) Take charge and cooperate with specialized
agencies in formulating and updating technical professional guidelines;
selecting entities and cities/central-affiliated cities under targeted
surveillance; organizing trainings, providing technical supports to units and
local authorities; doing researches, assessing HIV/AIDS epidemiological
surveillance and STD surveillance methods;
c) Preside over implementation of the HIV-INFO
system.
2. Relevant Institutes affiliated to the Ministry
of Health and the National Hospital of Dermatology and Venereology shall:
a) Implement this Circular within their scope of
professional operation;
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3. Department of Health of provinces and
central-affiliated cities shall guide, implement, inspect, assess and summarize
the implementation of regulations of this Circular in their provinces.
Article 24. Effect
1. This Circular comes into force from June 01,
2023.
2. Circular No. 09/2012/TT-BYT dated May 24, 2012
of the Minister of Health on issuance of guidelines on HIV/AIDS epidemiological
surveillance and STD surveillance shall be invalid from the day on which
this Circular comes into force.
Article 25. Responsibility for implementation
The Director General of VAAC, Chief of the Ministry
Office, Chief Inspector of the Ministry, Director Generals Departments and
Sub-Departments affiliated to the Ministry of Health, Directors of the
Departments of Health of provinces and central-affiliated cities, relevant
organizations and individuals are responsible for the implementation of this
Circular.
Agencies, organizations and individuals should
report difficulties that arise during the period of implementation of this
Circular to the Ministry of Health (via VAAC) for consideration and
settlement./.
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