Circular No. 09/2012/TT-BYT guiding epidemiological surveillance of HIV/AIDS and sexually transmitted infections.

CIRCULAR

Guidelines for HIV/AIDS epidemiological surveillance and sexually transmitted infection surveillance

sexually transmitted infections surveillance

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Article 24, 25, and 34 of the Law on Prevention and Control of Infection with Human Immunodeficiency Virus (HIV/AIDS) dated June 29, 2006;

Decree No. 188/2007/ND-CP dated December 27, 2007 of the Government stipulating the functions, tasks, powers, and organizational structure of the Ministry of Health;

1. Positive HIV test results may only be notified when such results have been confirmed by a laboratory that has been authorized by the competent authority to conduct confirmatory testing for HIV-positive cases as stipulated in Decree No. 75/2016/NĐ-CP dated July 1, 2016 of the Government on conditions for conducting HIV tests and Decree No. 155/2018/NĐ-CP dated November 12, 2018 of the Government amending and supplementing certain provisions related to investment and business conditions under the management of the Ministry of Health.

The Minister of Health promulgates guidelines for HIV/AIDS epidemiological surveillance and sexually transmitted infections surveillance as follows:

Section 1

GENERAL PROVISIONS

Article 1. Scope of Regulation

These guidelines specify measures for HIV/AIDS epidemiological surveillance and sexually transmitted infections surveillance, including: HIV/AIDS detection surveillance, sexually transmitted infections detection surveillance, focused HIV surveillance, focused sexually transmitted infections surveillance, and behaviorally integrated focused HIV surveillance.

Article 2. Interpretation of Terms

In this Circular, the following terms are understood as follows:

1. HIV/AIDS detection surveillance involves collecting information related to individuals tested for HIV with positive results, AIDS patients, and deceased HIV-infected persons to provide data for planning, prevention, care, and treatment of HIV-infected individuals.

2. Behaviorally integrated focused HIV surveillance involves continuously and systematically collecting behavioral risk questions related to HIV transmission among selected groups within focused HIV surveillance.

3. Sexually transmitted infections are infections caused by bacteria, viruses, fungi, parasites, protozoa, or other agents transmitted through sexual contact.

4. Sexually transmitted infections detection surveillance involves collecting information related to individuals diagnosed with sexually transmitted infections.

5. Focused sexually transmitted infections surveillance involves continuously and systematically collecting information through testing for sexually transmitted infections among selected groups at chosen locations.

6. Etiologic sexually transmitted infections surveillance involves periodically and systematically collecting information based on testing for causative agents of sexually transmitted infections.

7. Symptomatic sexually transmitted infections surveillance involves periodically and systematically collecting information based on clinical symptoms and signs to classify sexually transmitted infections according to syndromes.

8. Urban area refers to administrative units named wards or towns.

9. Rural areas refers to administrative units named communes.

Article 3. General principles for implementation of surveillance

1. All cases of HIV testing, AIDS diagnosis, and sexually transmitted infections must be reported to competent state authorities as prescribed in these guidelines.

2. A surveillance case can only be classified and reported under one surveillance group. If an individual has multiple risk behaviors, all risk behaviors of the individual must be recorded and the individual classified under the highest-risk behavior group.

3. Confidentiality must be maintained regarding the name, address, image, and test results of individuals tested for HIV and AIDS patients.

Section 2

HIV DETECTION SURVEILLANCE

Article 4. Subjects for HIV Detection Surveillance

1. Persons tested for HIV.

2. AIDS patients.

3. Deceased persons infected with HIV.

Article 5. Contents of HIV Detection Surveillance

1. Collecting information on persons tested for HIV as follows:

a) Full name or code number of the person tested for HIV; year of birth; gender; ethnicity; occupation; place of residence (if applicable);

b) Groups of subjects:

- High-risk groups for HIV transmission: drug users; sex workers; individuals with sexually transmitted infections; men who have sex with men;

- Low-risk groups for HIV transmission: pregnant women; blood donors; young people undergoing health examinations for military service (hereinafter referred to as young people undergoing military service recruitment medical examination);

- Tuberculosis patients;

- Other groups of subjects.

c) Risk factors for HIV transmission: transmission through blood, sexual transmission, mother-to-child transmission;

d) Date confirming positive HIV test results;

đ) Location where blood samples were taken;

e) HIV testing laboratory that confirmed the positive HIV blood sample;

g) Verification status of the HIV-infected person's current residence in the locality (after implementing the process of providing a list of HIV-infected individuals): currently residing in the locality, moved to another location, lost contact, or the address collected does not exist in the locality;

h) History of antiretroviral therapy: start date of treatment, treatment regimen, CD4 cell count, treatment facility.

2. Collecting information on AIDS patients as follows:

In addition to collecting the information as prescribed in Clause 1 of this Article, additional information must be collected as follows:

a) Date of AIDS diagnosis;

b) Diagnosing unit;

c) Clinical symptoms as stipulated in Decision No. 3003/QD-BYT dated August 19, 2009 of the Minister of Health on issuing "Guidelines for Diagnosis and Treatment of HIV/AIDS" (hereinafter referred to as Decision No. 3003/QD-BYT).

3. Collecting information on deceased HIV-infected individuals:

In addition to collecting the information as prescribed in Clauses 1 and 2 of this Article, additional information must be collected as follows:

a) Date of death;

b) Cause of death: death due to AIDS, other diseases, overdose of drugs, suicide, accidents, or other causes.

Article 6. Statistics of Information in HIV Detection Surveillance

1. Value of data in the reporting period:

a) The value of monthly reported data is calculated from the first day to the last day of the month;

b) The value of quarterly reported data is defined as follows:

- Data for Quarter I is calculated from January 1 to March 31 of each year;

- Data for Quarter II is calculated from April 1 to June 30 of each year;

- Data for Quarter III is calculated from July 1 to September 30 of each year;

- Data for Quarter IV is calculated from October 1 to December 31 of each year.

2. Statistics of information on persons tested for HIV in the locality according to the form prescribed in Appendix 1 issued together with this Circular.

3. Collecting and managing information on persons with positive HIV test results discovered in the locality, AIDS patients, and deceased HIV-infected individuals shall be carried out according to the form prescribed in Appendix 2 issued together with this Circular.

Article 7. Procedures for Implementing HIV Detection Surveillance

1. Pre-test counseling, blood sample collection for testing, and post-test counseling for individuals undergoing HIV testing at facilities in accordance with laws on HIV/AIDS prevention and control.

2. Collection and processing of data on individuals undergoing HIV testing at facilities.

3. Management of lists of HIV-infected persons, AIDS patients, and deceased HIV-infected individuals.

4. Implementation of reporting procedures as stipulated in Section 5 of this Circular.

Section 3

SURVEILLANCE OF SEXUALLY TRANSMITTED INFECTIONS

Article 8. Principles of Surveillance for Sexually Transmitted Infections

In addition to adhering to the general principles set forth in Article 3 of this Circular, surveillance of sexually transmitted infections shall be conducted based on the principle that a case of sexually transmitted infection may only be reported either by etiology or by syndrome. If the etiology has been determined, it must be reported by etiology and not by syndrome.

Article 9. Subjects of Surveillance for Sexually Transmitted Infections

Individuals diagnosed with sexually transmitted infections.

Article 10. Content of Surveillance for Sexually Transmitted Infections

1. Personal information: age, gender, occupation.

2. Sexually transmitted infections:

a) By etiology: syphilis, gonorrhea, Chlamydia infection, trichomoniasis vaginitis, granuloma inguinale, bacterial vaginosis, genital herpes, genital warts, candidal vulvovaginitis, and other sexually transmitted infections;

b) By syndrome: urethral discharge in males, vaginal discharge, genital ulcer syndrome, lower abdominal pain syndrome in females, and other sexually transmitted infection syndromes.

3. HIV status of cases infected with sexually transmitted infections.

Article 11. Collection and Statistics of Information on Subjects of Surveillance for Sexually Transmitted Infections

1. Collection and statistics of information on subjects under surveillance in the area by etiology: Implemented in accordance with Appendix 3 attached to this Circular.

2. Collection and statistics of information on subjects under surveillance in the area by syndrome: Implemented in accordance with Appendix 4 attached to this Circular.

3. Collection and statistics of information on subjects under surveillance in the area based on the results of sexually transmitted infection tests: Implemented in accordance with Appendix 5 attached to this Circular.

Article 12. Procedures for Implementing Surveillance for Sexually Transmitted Infections

1. Collection of personal information as stipulated in Clause 1 of Article 10 of this Circular, review of medical history, examination, and counseling for all individuals seeking medical care at facilities providing diagnosis and treatment of sexually transmitted infections.

2. Diagnosis of sexually transmitted infections: collect samples for testing and conclude the diagnosis based on test results. In cases where testing conditions are not available, diagnose based on the patient's symptoms according to the syndrome.

3. Collection and statistics of data on sexually transmitted infections by syndrome or by etiology and HIV status as stipulated in Clauses 2 and 3 of Article 10 of this Circular.

4. Implementation of reporting procedures as stipulated in Section 5 of this Circular.

Section 4

TARGETED SURVEILLANCE OF HIV, TARGETED SURVEILLANCE OF SEXUALLY TRANSMITTED INFECTIONS AND TARGETED SURVEILLANCE OF HIV BEHAVIORAL INTERVENTIONS

 TARGETED SURVEILLANCE OF SEXUALLY TRANSMITTED INFECTIONS AND INTEGRATED HIV BEHAVIORAL INTERVENTION SURVEILLANCE

Article 13. Principles for Implementing Targeted Surveillance

1. Ensure compliance with the provisions set forth in Article 25 of the Law on Prevention and Control of Viral Infections Causing Acquired Immunodeficiency Syndrome (HIV/AIDS) (hereinafter referred to as the Law on Prevention and Control of HIV/AIDS).

2. Sampling for targeted surveillance must be conducted independently from other forms of surveillance and research.

3. Data from HIV/AIDS detection surveillance, data from voluntary counseling and testing facilities, and results from other studies shall not be used to report targeted surveillance data.

4. The selection of subjects for targeted HIV surveillance shall not be based on their current HIV status.

5. Ensure the continuity of the targeted surveillance area over the years.

6. Sampling for targeted surveillance shall not be conducted in hospitals, educational institutions, social welfare centers, prisons, detention centers, educational facilities, and juvenile correctional schools.

7. Blood sampling, body fluid sampling, and urine sampling must be carried out in private and discreet locations.

8. HIV testing and sexually transmitted infection testing shall not be repeated on the same individual within the same year of targeted surveillance.

9. Test results from targeted surveillance shall not be used for definitive diagnosis of HIV infection.

10. HIV tests and sexually transmitted infection tests must be conducted using anonymous testing methods.

11. Services provided by the HIV/AIDS prevention and control program must be offered to individuals participating in targeted surveillance.

Article 14. Subjects for Targeted HIV Surveillance and Sexually Transmitted Infection Surveillance

1. Subjects for Targeted HIV Surveillance:

Depending on the actual situation in each province, select the following groups for targeted surveillance:

a) Male drug users;

b) Female sex workers;

c) Men infected with sexually transmitted infections;

d) Pregnant women;

đ) Young men undergoing preliminary military service examinations;

e) Men engaging in homosexual relationships;

g) Other groups: Based on the risk of HIV transmission in each province, select groups that play a role in increasing HIV transmission locally, with an estimated HIV prevalence rate of at least 1%, and ensure continuous surveillance over the years.

2. Subjects for Targeted Sexually Transmitted Infection Surveillance:

a) Syphilis: targeted surveillance for subjects specified in points a, b, c, d, and đ of Clause 1 of this Article;

b) Gonorrhea: targeted surveillance for subjects specified in points b and c of Clause 1 of this Article;

c) Chlamydia: targeted surveillance for subjects specified in points b and c of Clause 1 of this Article;

d) Trichomoniasis: targeted surveillance for subjects specified in point b of Clause 1 of this Article.

Article 15. Timeframe for Conducting Targeted HIV and Sexually Transmitted Infection Surveillance

1. The timeframe for conducting targeted surveillance begins on June 1st and ends on September 30th each year.

2. For young men undergoing preliminary military service examinations, targeted surveillance shall be conducted according to the local military service health examination schedule but shall not be later than December 31st each year.

Article 16. Method for Selecting Sites for Intensive Monitoring of HIV and Sexually Transmitted Infections

1. Group of Male Drug Users: Based on mapping results, select up to five districts, counties, towns, or cities within a province (hereinafter referred to as county) with the highest number of drug users in the community. Annually, the selected counties will conduct mapping activities to serve as the basis for allocating and sampling each commune, ward, or town.

2. Group of Female Sex Workers: Based on mapping results, select up to five districts, counties, towns, or cities within a province (hereinafter referred to as county) with the highest number of female sex workers in the community. On the basis of the selected counties, conduct mapping to identify hotspots and the number of female sex workers operating at these hotspots before implementing annual intensive monitoring.

3. Group of Males Infected with Sexually Transmitted Infections: Select all healthcare facilities that provide diagnosis and treatment for sexually transmitted infections within the province.

4. Group of Pregnant Women:

a) Select general hospitals or obstetric hospitals or reproductive health centers in the province to implement intensive monitoring for pregnant women residing in urban areas;

b) Select up to five district hospitals with the largest population to implement intensive monitoring for pregnant women residing in rural areas.

5. Group of Young Men Undergoing Initial Military Service Examination:

a) Select up to five districts, towns, or cities within the province to implement intensive monitoring for young men undergoing initial military service examination residing in urban areas;

b) Select up to five counties to implement intensive monitoring for young men undergoing initial military service examination residing in rural areas.

6. Group of Males Engaging in Homosexual Relations: Select up to five counties estimated to have the highest number of males engaging in homosexual relations. On the basis of the selected counties, conduct mapping to identify hotspots and the number of males engaging in homosexual relations at these locations before implementing annual intensive monitoring.

7. Other Groups: Select sites where the monitored subjects currently reside.

Article 17. Criteria for Selecting Target Groups in Intensive Monitoring of HIV and Sexually Transmitted Infections

1. General Criteria: Select individuals aged 16 years or older who have full civil capacity.

2. Specific Criteria for Each Intensive Monitoring Group:

a) Group of Male Drug Users: Have injected drugs at least once in the month prior to sample collection;

b) Group of Female Sex Workers: Have engaged in vaginal or anal sex work at least once in the month prior to sample collection within the provincial area;

c) Group of Males Infected with Sexually Transmitted Infections:

- Diagnosed with sexually transmitted infections based on etiology or syndrome;

- Currently residing in the province.

d) Group of Pregnant Women:

- Currently pregnant (regardless of whether they come for abortion, prenatal checkup, or delivery);

- Currently residing in the province.

đ) Group of Young Men Undergoing Initial Military Service Examination: Male youths participating in initial military service examination at the local level;

e) Group of Males Engaging in Homosexual Relations: Males who have had anal sex with other males in the past twelve months;

g) Other Groups:

- Engage in behaviors increasing the risk of HIV transmission in the provincial area;

- Currently residing in the province.

Article 18. Sample size, sampling method, and specimens for key surveillance of HIV and sexually transmitted infections

1. Group of male drug injectors:

a) Sample size: 150-300 samples;

b) Sampling method:

- On the basis of selected districts, allocate the sample size specified for each district proportionally to the estimated number of drug injectors in each district;

- In each selected district, list communes, wards, towns (hereinafter referred to as communes) with drug injectors and estimate the number of drug injectors in each commune;

- Calculate the number of communes that need to be monitored by dividing the allocated sample size by the average number of drug injectors in each commune;

- Randomly select communes for key monitoring;

- In the first selected commune, mobilize all drug injectors residing in the commune to participate in key monitoring through community outreach workers or through drug injectors themselves;

- Continue implementing in the remaining listed communes until the allocated sample size for the district is reached.

c) Specimens to be collected: blood samples.

2. Group of female sex workers:

a) Sample size: 150-300 samples;

b) Sampling method:

- Allocate the sample size specified for each district proportionally to the estimated number of female sex workers in each district on the basis of selected districts;

- In each selected district, list venues with female sex workers and estimate the number of female sex workers at each venue;

- Calculate the number of venues that need to be monitored by dividing the allocated sample size by the average number of female sex workers at each venue;

- Randomly select the required number of venues for key monitoring;

- In the first selected venue, mobilize all female sex workers at the venue to participate in key monitoring through community outreach workers or through the heads or managers of the venues;

- Continue implementing in the remaining listed venues until the allocated sample size for the district is reached.

c) Specimens to be collected: blood, cervical secretions, and vaginal secretions. For provinces not conducting key monitoring of sexually transmitted infections, cervical and vaginal secretions from the subjects under monitoring are not required.

3. Group of males infected with sexually transmitted infections:

a) Sample size: 150-300 samples;

b) Sampling method: collect consecutive samples from all males infected with sexually transmitted infections at selected surveillance sites from the start of key monitoring until the required sample size is reached or until the end of the key monitoring period;

c) Specimens to be collected: blood, urethral secretions. For provinces not conducting key monitoring of sexually transmitted infections, urethral secretions from the subjects under monitoring are not required.

a) Sample size:

4. Group of Pregnant Women:

- Pregnant women residing in urban areas: 400 samples;

- Pregnant women residing in rural areas: 400 samples.

- Urban pregnant women: collect consecutive samples from all pregnant women residing in urban areas who come for prenatal checkups at selected healthcare facilities according to point a, Clause 4, Article 16 of this Circular from the start of key monitoring until the required sample size is reached or until the end of the key monitoring period;

b) Sampling method:

- Rural pregnant women: collect consecutive samples from all pregnant women residing in rural areas who come for prenatal checkups at selected healthcare facilities according to point b, Clause 4, Article 16 of this Circular from the start of key monitoring until the required sample size is reached or until the end of the key monitoring period.

- Urban young men participating in preliminary military service examinations residing in urban areas: 400 samples;

c) Specimens to be collected: blood samples.

5. Group of Young Men Undergoing Initial Military Service Examination:

- Pregnant women residing in urban areas: 400 samples;

- Urban young men participating in preliminary military service examinations residing in rural areas: 400 samples.

- Young men participating in preliminary military service examinations residing in urban areas: based on the selected urban districts, towns, and cities within provinces according to point a, Clause 5, Article 16 of this Circular, select wards and towns where preliminary military service examinations are conducted, estimate the average number of young men participating in preliminary military service examinations in each ward and town. Determine the number of wards and towns needed for key monitoring of young men participating in preliminary military service examinations by dividing the specified sample size by the average number of young men participating in preliminary military service examinations in each ward and town. Randomly select wards and towns until the required number is reached. In each selected ward and town, select all young men participating in preliminary military service examinations in the ward and town until the required sample size is reached;

b) Sampling method:

- Young men participating in preliminary military service examinations residing in rural areas: based on the selected rural districts according to point b, Clause 5, Article 16 of this Circular, select villages where preliminary military service examinations are conducted, estimate the average number of young men participating in preliminary military service examinations in each village.

Determine the number of villages needed for key monitoring of young men participating in preliminary military service examinations by dividing the specified sample size by the estimated average number of young men participating in preliminary military service examinations in each village. Randomly select villages until the required number is reached. In each selected village, select all young men participating in preliminary military service examinations in the village until the required sample size is reached.

6. Group of males engaging in homosexual relationships:

c) Specimens to be collected: blood samples.

- Allocate the sample size specified for each district proportionally to the estimated number of males engaging in homosexual relationships in each district on the basis of selected districts;

a) Sample size: 150-300 samples;

b) Sampling method:

- In each selected district, list venues with males engaging in homosexual relationships and estimate the number of males engaging in homosexual relationships at each venue;

- Calculate the number of venues that need to be monitored by dividing the allocated sample size by the average number of males engaging in homosexual relationships at each venue;

- In the first selected venue, invite all males engaging in homosexual relationships present at the venue to participate in key monitoring through community outreach workers.

- Randomly select the required number of venues for key monitoring;

7. Other groups:

- Continue implementing in the remaining listed venues until the allocated sample size for the district is reached.

c) Specimens to be collected: blood samples.

7. Other group:

a) Sample size: 400 samples;

b) Sampling method: based on the sampling methods stipulated in point b of Clauses 1, 2, 3, 4, 5, and 6 of this Article to select a sampling method suitable for the actual conditions at the locality;

c) Specimens to be collected: blood samples.

Article 19. Procedure for implementing surveillance for provinces conducting both HIV focal surveillance and sexually transmitted infection surveillance

1. Develop plans to organize annual implementation of HIV focal surveillance and sexually transmitted infection surveillance.

2. Organize meetings to implement surveillance plans; train healthcare workers, community outreach workers, and other participants involved in the process of implementing focal surveillance.

3. Implement focal surveillance at selected locations:

a) Agree with individuals who consent to participate in focal surveillance;

b) Collect and transport specimens. The sample separation for testing will be conducted as follows:

- Blood samples: collected and transported by the provincial lead unit for HIV/AIDS prevention and control to its own facility. Each serum sample obtained is then separated into two equal parts: one part used for HIV testing at the provincial lead unit for HIV/AIDS prevention and control; the other part used for syphilis detection testing at the provincial lead unit for dermatology.

- Specimens of cervical, vaginal, and urethral secretions: collected and transported by the provincial lead unit for dermatology to its own facility for gonorrhea and Chlamydia detection testing.

4. Conduct testing:

a) HIV testing carried out according to the guidelines of the Ministry of Health;

b) Testing for sexually transmitted infections conducted in accordance with the provisions set forth in Appendix 6 attached to this Circular. Syphilis testing must be performed immediately after collecting vaginal secretion samples using direct microscopy at the surveillance site.

5. Compile data after testing:

a) The provincial lead unit for dermatology prepares a list of test results according to the forms specified in Appendices 8, 9, 10, 11, 12, and 13 attached to this Circular and sends it to the provincial lead unit for HIV/AIDS prevention and control;

b) The provincial lead unit for HIV/AIDS prevention and control prepares a list of test results according to the forms specified in Appendices 7, 9, 10, 11, 12, 13, 14, and 15 attached to this Circular and compiles the results of sexually transmitted infection focal surveillance sent by the provincial lead unit for dermatology.

6. Implement reporting procedures as prescribed in Section 5 of this Circular.

Article 20. Procedure for implementing HIV focal surveillance for provinces only conducting HIV focal surveillance

1. Develop plans to organize annual implementation of HIV focal surveillance.

2. Organize meetings to implement surveillance plans; train healthcare workers, community outreach workers, and other participants involved in the process of implementing focal surveillance.

3. Implement focal surveillance at selected locations:

a) Agree with individuals who consent to participate in focal surveillance;

b) Collect and transport specimens and conduct testing according to the guidelines of the Ministry of Health.

4. Compile data on individuals subject to HIV focal surveillance according to the forms specified in Appendices 7, 9, 10, 11, 12, 13, 14, and 15 attached to this Circular.

5. Implement reporting procedures as prescribed in Section 5 of this Circular.

Article 21. Integrated behavior-focused HIV surveillance

1. The subjects of integrated behavior-focused HIV surveillance are those defined in Clause 1 of Article 14 of this Circular. Select groups of subjects for annual integrated behavior-focused HIV surveillance based on the actual conditions of each province and the guidance of the Ministry of Health.

2. Individuals selected for HIV focal surveillance in accordance with the guidelines stipulated in Articles 14, 15, 16, 17, and 18 of this Circular will be asked to answer questions on the behavioral survey form.

3. The provincial lead unit for HIV/AIDS prevention and control is responsible for organizing, compiling, analyzing, writing reports on the results of integrated behavior-focused HIV surveillance according to the guidance of the Ministry of Health and implementing reporting procedures as prescribed in Section 5 of this Circular.

Section 5

REPORTING SYSTEM

Article 22. Provisions on the principle of reporting and confidentiality regime for information in surveillance reports

1. For cases of HIV testing, AIDS diagnosis, and diagnosis of sexually transmitted infections, the facilities directly responsible for sample collection shall be responsible for reporting the list. For provinces implementing focused HIV surveillance and focused surveillance of sexually transmitted infections, the provincial focal units for HIV/AIDS prevention and control shall be responsible for compiling the results and reporting them.

2. During transportation, the list of HIV-infected individuals must be placed in sealed envelopes with tamper-evident seals and clearly marked with the name and address of the recipient.

3. Only those persons assigned the responsibility to manage the list of HIV-infected individuals from the following agencies shall have the right to access information related to the identity of HIV-infected individuals in the epidemiological surveillance database:

a) The National Center for HIV/AIDS Prevention and Control under the Ministry of Health;

b) The Central Institute of Hygiene and Epidemiology and regional institutes;

c) Provincial focal units for HIV/AIDS prevention and control;

d) District Health Centers or District Preventive Health Centers for districts without district health centers (hereinafter referred to as district preventive health focal units);

đ) Commune Health Stations.

Article 23. Provisions on reporting HIV detection surveillance

1. Commune Level:

a) Reporting unit: Commune Health Stations, private healthcare facilities within the locality;

b) Reporting period: From the 1st to the 5th day of each month;

c) Content of report: In accordance with the form prescribed in Appendix 2 attached hereto;

d) Receiving unit: District preventive health focal units.

2. District Level:

a) Reporting unit:

- Hospitals (for districts with independent district hospitals);

- Outpatient HIV/AIDS Clinics;

- Voluntary Counseling and Testing Centers for HIV.

b) Reporting period: From the 1st to the 5th day of each month;

c) Content of report: In accordance with the forms prescribed in Appendices 1 and 2 attached hereto;

d) Receiving unit: District preventive health focal units.

3. Provincial Level:

a) Reporting unit:

- District preventive health focal units;

- State-owned healthcare facilities at the provincial level;

- Institutes and hospitals under the Ministry of Health located within the province;

- Healthcare units of various sectors located within the province.

b) Reporting period: From the 6th to the 10th day of each month;

c) Content of report: In accordance with the forms prescribed in Appendices 1 and 2 attached hereto;

d) Receiving unit: Provincial focal units for HIV/AIDS prevention and control.

4. Provincial focal units for HIV/AIDS prevention and control shall submit reports through the online reporting system as directed by the Ministry of Health from the 10th to the 15th day of each month. These units shall be responsible for storing and preserving reports received from other units.

5. The Central Institute of Hygiene and Epidemiology, Pasteur Institute Nha Trang, Ho Chi Minh City Pasteur Institute, and West Central Institute of Hygiene and Epidemiology shall submit reports through the online reporting system as directed by the Ministry of Health from the 10th to the 15th day of each month. These institutes shall be responsible for storing and preserving reports received from other units.

Article 24. Procedure for Feedback of Lists of HIV-Infected Individuals

1. Provincial focal units for HIV/AIDS prevention and control shall implement feedback of HIV/AIDS data as follows:

a) Based on the list of newly detected HIV-infected individuals compiled through the online reporting system, they shall prepare lists for each district and send them to the heads of district preventive health focal units;

- Lists of newly detected HIV-infected individuals not residing in the province and send them to the heads of focal units for HIV/AIDS prevention and control at the provincial level where the HIV-infected individuals reside.

b) Time limit for feedback: Not later than the 15th day of the month following the reporting month.

2. District preventive health focal units shall implement feedback of HIV/AIDS data as follows:

a) Based on the list of HIV-infected individuals provided by the provincial focal units for HIV/AIDS prevention and control, they shall classify and compile lists of newly detected HIV-infected individuals for each commune and send them to the heads of Commune Health Stations;

b) Time limit for feedback: Five days after receiving notification from the provincial focal units for HIV/AIDS prevention and control requesting a review.

3. Heads of Commune Health Stations shall carry out:

a) Cross-checking the names, years of birth, and places of residence of HIV-infected individuals listed against actual population records in their locality;

b) Correcting the list for cases where there are errors in the year of birth, place of residence, or if the HIV-infected individual does not exist in the locality, and sending this corrected list to the district preventive health focal units;

c) Time limit for feedback: Ten days from the date of receipt of the notification from the provincial focal units for HIV/AIDS prevention and control requesting a review.

4. Feedback of data after review at the commune level to higher-level focal units:

a) After receiving the corrected list from the commune health stations, within ten working days, the district preventive health focal units shall submit a consolidated report to the provincial focal units for HIV/AIDS prevention and control;

b) The provincial focal units for HIV/AIDS prevention and control shall consolidate the corrected lists and update them on the online reporting system.

b) The lead unit for HIV/AIDS prevention and control in the province shall compile the lists of corrections and update them on the online reporting system.

Article 25. Provisions on reporting for monitoring the detection of sexually transmitted infections

1. Commune Level:

a) Reporting unit: Commune Health Stations, private healthcare facilities within the locality;

b) Time of submission of report: from the 1st to the 5th day of July and January each year;

c) Content of the report: report on the number of patients examined and treated for sexually transmitted infections in the previous six months according to the forms prescribed in Appendices 3, 4, and 5 issued together with this Circular;

d) Receiving unit: District preventive health focal units.

2. District Level:

a) Reporting unit:

- Hospitals (for districts having independent district hospitals).

b) Time of submission of report: from the 6th to the 10th day of July and January each year;

c) Content of the report: report on the number of patients examined and treated for sexually transmitted infections in the previous six months according to the forms prescribed in Appendices 3, 4, and 5 issued together with this Circular;

d) Receiving unit: District preventive health focal units.

3. Provincial Level:

a) Reporting unit:

- District preventive health focal units;

- State-owned healthcare facilities at the provincial level;

- Healthcare units of various sectors located within the province.

b) Time of submission of report: from the 11th to the 15th day of July and January each year;

c) Content of the report: report on the number of patients examined and treated for sexually transmitted infections in the previous six months according to the forms prescribed in Appendices 3, 4, and 5 issued together with this Circular;

d) Receiving unit of the report: provincial dermatology focal point unit.

4. The provincial dermatology focal point unit shall aggregate and submit the report on the number of patients examined and treated for sexually transmitted infections in the previous six months (including cases handled by the unit itself) to the Central Dermatology Hospital within the period from the 16th to the 20th day of July and January each year according to the forms prescribed in Appendices 3, 4, and 5 issued together with this Circular.

5. Institutes and hospitals under the Ministry of Health shall aggregate and submit the report on the number of patients examined and treated for sexually transmitted infections in the previous six months to the Central Dermatology Hospital within the period from the 1st to the 5th day of July and January each year according to the forms prescribed in Appendices 3, 4, and 5 issued together with this Circular.

6. The Central Dermatology Hospital shall aggregate the number of patients examined and treated for sexually transmitted infections in all provinces nationwide, and the list of cases tested for HIV conducted at the Hospital, and submit them to the AIDS Prevention and Control Department - Ministry of Health within the period from the 20th to the 25th day of July and January each year.

Article 26. Provisions on reporting in key surveillance of HIV, key surveillance of sexually transmitted infections, and key surveillance of HIV integrated behavior

1. By the latest on October 15th each year, the provincial dermatology focal point unit must submit the report on key surveillance of sexually transmitted infections to the provincial AIDS Prevention and Control focal point unit and the Central Dermatology Hospital according to the forms prescribed in Appendices 8, 9, 10, 11, 12, and 13 issued together with this Circular.

2. By the latest on October 31st each year, the provincial AIDS Prevention and Control focal point unit must submit the report on the results of key surveillance of HIV and key surveillance of sexually transmitted infections to the AIDS Prevention and Control Department, the Central Institute of Hygiene and Epidemiology, and the Regional Institute through the online reporting system as guided by the Ministry of Health. Specifically, the report on key surveillance of HIV for the group of young people undergoing preliminary military service examination must be submitted by the latest on December 31st each year. The provincial AIDS Prevention and Control focal point unit is responsible for storing and preserving reports received from other units.

3. By the latest on October 31st each year, the provincial AIDS Prevention and Control focal point unit must submit the raw data already entered into the key surveillance of HIV integrated behavior data entry software to the AIDS Prevention and Control Department, the Central Institute of Hygiene and Epidemiology, and the Regional Institute.

4. By the latest on November 15th each year, the Central Institute of Hygiene and Epidemiology shall submit the comprehensive report on the results of key surveillance of HIV, the comprehensive report on the results of key surveillance of HIV integrated behavior, and the Central Dermatology Hospital shall submit the comprehensive report on the results of key surveillance of sexually transmitted infections to the AIDS Prevention and Control Department.

Section 6. IMPLEMENTATION ORGANIZATION

Article 27. Responsibilities of the National AIDS Control Center - Ministry of Health

1. Direct, inspect, supervise, evaluate activities, and compile epidemiological surveillance data on HIV/AIDS and sexually transmitted infections nationwide.

2. Propose provinces to implement key surveillance for HIV and provinces to conduct key surveillance for sexually transmitted infections, and key integrated behavior surveillance for HIV for approval by the Ministry of Health leadership.

3. Annually, take the lead and coordinate with the Central Institute of Hygiene and Epidemiology, the Central Dermatology Hospital, and regional institutes to review key surveillance plans for provinces.

4. Direct the Central Institute of Hygiene and Epidemiology, the Central Dermatology Hospital, and regional institutes to develop materials and organize training on epidemiological surveillance of HIV/AIDS and sexually transmitted infections for units and localities.

5. Update, complete, and gradually expand the scope of use of software for epidemiological surveillance of HIV/AIDS and sexually transmitted infections; establish regulations on access permissions to information in the national database for HIV/AIDS and sexually transmitted infection surveillance.

6. Annually, take the lead and coordinate to organize meetings to assess and deploy key surveillance work for HIV and sexually transmitted infections, and integrated behavior surveillance for HIV.

Article 28. Responsibilities of the Central Institute of Hygiene and Epidemiology

1. Advise the National AIDS Control Center to approve annual plans for epidemiological surveillance of HIV/AIDS and sexually transmitted infections.

Coordinate with regional institutes to guide provinces in developing annual implementation plans.

2. Advise the National AIDS Control Center on technical guidance related to epidemiological surveillance of HIV/AIDS nationwide.

3. Inspect, supervise, and evaluate epidemiological surveillance activities of HIV/AIDS in provinces under its jurisdiction.

4. Compile, analyze, and report nationwide results of epidemiological surveillance of HIV/AIDS to the National AIDS Control Center.

5. Compile and recommend amendments to address issues arising during the implementation of this Circular's provisions related to epidemiological surveillance of HIV/AIDS.

6. Coordinate with the National AIDS Control Center and regional institutes:

a) Develop materials and organize training on epidemiological surveillance of HIV/AIDS;

b) Conduct studies and evaluations on the quality of reagents used for HIV testing;

c) Conduct trials of new methods for HIV/AIDS surveillance.

7. Guide and urge provinces assigned to develop annual key surveillance plans for HIV according to Appendix 16 issued together with this Circular.

8. Annually, coordinate with the National AIDS Control Center and relevant units to organize meetings to assess and deploy epidemiological surveillance work for HIV/AIDS and sexually transmitted infections.

Article 29. Responsibilities of the Central Dermatology Hospital

1. Advise the National AIDS Control Center to approve annual key surveillance plans for sexually transmitted infections in provinces.

Advise the National AIDS Control Center on technical guidance related to surveillance of sexually transmitted infections. Inspect, supervise, and evaluate activities related to surveillance of sexually transmitted infections nationwide.

2. Compile, analyze, and report results of surveillance of sexually transmitted infections to the National AIDS Control Center.

3. Compile and recommend amendments to address issues arising during the implementation of this Circular's provisions related to surveillance of sexually transmitted infections nationwide.

4. Coordinate with the National AIDS Control Center and relevant units:

a) Develop materials and organize training on surveillance of sexually transmitted infections;

b) Develop and update software for surveillance of sexually transmitted infections;

c) Develop plans to expand the scope of key surveillance for sexually transmitted infections.

5. Provide technical support for surveillance of sexually transmitted infections for provinces nationwide.

6. Guide and urge provinces to develop annual key surveillance plans for sexually transmitted infections according to Appendix 16 issued together with this Circular.

Article 30. Responsibilities of the Ho Chi Minh City Pasteur Institute, Nha Trang Pasteur Institute, and West Central Sanitary and Epidemiological Institute

1. Coordinate with the Central Sanitary and Epidemiological Institute to advise the HIV/AIDS Prevention and Control Department on approving the key surveillance plans for provinces within their assigned regions.

2. Inspect, monitor, and evaluate HIV/AIDS epidemiological surveillance activities and coordinate with relevant units to inspect, monitor, and evaluate sexually transmitted infection surveillance activities in provinces within their assigned regions.

3. Aggregate, analyze, and report epidemiological surveillance data results of HIV/AIDS from provinces within their assigned regions to the HIV/AIDS Prevention and Control Department - Ministry of Health.

4. Aggregate and propose amendments and supplements to address issues arising during the implementation of this Circular's provisions related to HIV/AIDS epidemiological surveillance.

5. Participate in organizing and training for provinces regarding HIV/AIDS epidemiological surveillance work.

6. Guide and urge provinces within their assigned regions to develop annual key surveillance plans according to the plan development guidelines stipulated in Appendix 16 issued together with this Circular.

Article 31. Responsibilities of Provincial Departments of Health under central cities

1. Direct the organization of implementation, inspection, and supervision of HIV/AIDS epidemiological surveillance and sexually transmitted infection surveillance within the province.

2. Propose amendments and supplements to address issues arising during the implementation of this Circular's provisions and HIV/AIDS epidemiological surveillance software within the province.

3. Assign the provincial focal point for HIV/AIDS prevention and control to be responsible for implementing HIV/AIDS detection surveillance work within the province.

4. Assign the provincial dermatology focal point to be responsible for implementing sexually transmitted infection detection surveillance work within the province.

5. Direct the provincial HIV/AIDS prevention and control focal point to lead and coordinate with the provincial dermatology focal point (for provinces implementing key sexually transmitted infection surveillance) to develop plans according to the guidelines set out in Appendix 16 issued together with this Circular, submit them to the competent authority for approval, and implement surveillance procedures as prescribed in Articles 19 and 20 of this Circular.

6. Coordinate with relevant provincial departments to support and organize the monitoring of HIV/AIDS and sexually transmitted infection surveillance implementation (for provinces implementing key HIV and sexually transmitted infection surveillance).

7. Direct state and private healthcare facilities within the province that provide HIV counseling, testing, and AIDS treatment to comply with reporting requirements stipulated in Section 5 of this Circular.

8. Organize annual evaluations of the HIV/AIDS epidemic situation in the province and determine the epidemic stage within the province.

Section 7

IMPLEMENTING PROVISIONS

Article 32. Reference Provisions

In cases where the referenced documents in this document are replaced or amended, implementation shall be in accordance with the replacement or amended document.

Article 33. Effective Date

This Circular takes effect from July 15, 2012.

Repeal Decision No. 1418/2000/QĐ-BYT dated May 4, 2000 of the Minister of Health on issuing the "Regulations on HIV/AIDS Surveillance in Vietnam" and Decision No. 2691/2002/QĐ-BYT dated July 19, 2002 of the Minister of Health on issuing the "Regulations on Sexually Transmitted Infection Surveillance in Vietnam"

Article 34. Responsibility for Implementation

The Director of the Ministry’s Office, the Director of the HIV/AIDS Prevention and Control Department, the Heads of Departments, Directors of Cuc, General Directors under the Ministry of Health, Heads of agencies and units directly under the Ministry, Directors of Provincial Health Departments under central cities, and Heads of health agencies under Ministries and sectors are responsible for enforcing this Circular.

During implementation, if difficulties arise, units and localities should report to the Ministry of Health for research and resolution./.