Communist Vietnam commonly locks up rather than treats HIV-positive intravenous drug users and commercial sex workers, while a third high-risk group, men who have sex with men, are a taboo subject, the CSIS study found.

Some of the detention centres for tens of thousands of heroin addicts and prostitutes had served as "incubators" of HIV/AIDS, said Phillip Nieburg, a chief author of the Center for Strategic and International Studies report.

"People living with HIV/AIDS are highly stigmatised in Vietnam, regardless of how they became infected, leading to reluctance to seek prevention, testing and treatment services," said the report.

The Washington-based think-tank in January conducted a study tour of Vietnam led by former US health secretary Tommy Thompson, and it officially presented the report in Hanoi on Friday.

It praised Vietnam's health care system and its efforts to fight bird flu and SARS and said its centralised political system, which extends from Hanoi to nationwide youth and women's groups, could do much to tackle HIV/AIDS.

UN, US and other donor support had risen tenfold in the past five years to over 50 million dollars annually, and future political leaders were now being taught about the problem in the elite Ho Chi Minh Political Academy, it said.

UNAIDS Vietnam chief Nancy Fee also praised a law due to take effect in coming months that will legalise anti-HIV measures such as syringe exchanges and methadone programmes and strengthen the confidentiality of HIV tests.

But the CSIS report cautioned that the true extent of the disease remained unknown, as crucial data such as the number of HIV-positive people and AIDS patients in hospitals and rehabilitation centres remained unavailable.

According to the best available estimates, Vietnam's epidemic is still concentrated in high-risk groups and is "of manageable proportions," with about 300,000 out of 83 million people believed to be carrying the virus, it said.

National HIV prevalence was below 0.5 percent, but the rate has risen to 1.2 percent in the southern metropolis of Ho Chi Minh City, 1.1 percent in the major port city of Haiphong and 0.7 percent in Hanoi.

In a worrying report earlier this week, Vietnam's Labour daily quoted health ministry officials as saying that the percentage of HIV infections among pregnant women had risen from 0.02 percent in 1994 to 0.37 percent in 2005.

CSIS also said more than half of Vietnam's reported HIV carriers were intravenous drug users (IDUs), mostly heroin addicts.

"Like Thailand and China, HIV prevalence among IDUs began rising sharply in Vietnam in the late 1990s and now exceeds 70 percent in some cases," it said.

Vietnam -- which classifies illegal drug use, prostitution and general crime as "the three social evils" -- incarcerates 40,000 to 80,000 drug users and prostitutes in some 80 rehabilitation centres, it said.

Of Vietnam's incarcerated heroin users, 50 to 70 percent were believed to be HIV-positive, often without knowing it, said the report, warning that over 15,000 inmates were due to be released this year.

"How they will be cared for is currently unknown," said the report. "A high proportion (30 percent or more) of these persons live with HIV, and many are likely to have already progressed to AIDS."

To stem the spread of the disease, Vietnam needs to "resolve the clash between public health and public security objectives," said the report.

"Reducing the tension between these two national policy interests is the single greatest challenge before Vietnam in its evolving efforts to control HIV/AIDS."

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