Social media can potentially serve as a platform to coordinate medical care among fragmented health sectors. This paper describes procedures of using social media to enhance antiretroviral therapy (ART) and methadone maintenance treatment (MMT) providers' virtual network for integrated service for HIV-positive people who inject drugs (PWID) in Vietnam. A total of 88 ART and MMT treatment providers participated in person group sessions followed by online virtual support to improve service integration. In-person reunions were held to reinforce Facebook participation and network activities. Content analysis was used to identify keywords and topic categories of the online information exchange. Both MMT and ART providers were actively engaged in online communications. Referral and treatment adherence were the two most frequently discussed topic areas by both the MMT and ART providers. Frequent cross-agency connections were observed. Online provider networks and communities could be built and useful to support treatment providers to improve service integration. Keywords Social media • Treatment providers • Service integration • Network • Vietnam Resumen Los medios sociales pueden potencialmente servir una plataforma para coordinar atencion medica entre los sectores de salud fragmentados. Este documento describe los procedimentos de uso de las redes sociales para mejorar proveedores red virtual de proveedores de terapia antiretoriviral (TARV) y la tratamiento de mantenimiento con metadona (TMM) para el servicio integrado para personas VIH positivas que se inyectan drogas en Vietnam. Un total de 88 proveedores de tratamiento de TARV y TMM participación en sesiones grupales en persona siguiendo un ayuda virtual web para mejorar integracions de servicio. Se llevaron reuniones en persona para reforzar la participación en Facebook y en las actividades de la red. El método de análisis se utiliza para identificar palabras y categorías de intercambio de información en línea. Los proveedores de TMM y TARV participaron activamente en las comunicaciones en línea. La referencia y la adherencia al tratamiento fueron las dos áreas temáticas más discutidas por los proveedores de TMM y TARV. Observaron conexiones frecuentes entre agencias. Las redes y comunidades de proveedores en línea podrían ser construidas y útiles para apoyar a los proveedores de tratamiento para mejorar la integración del servicio. Palabra claves Medios sociales • Proveedores de tratamiento • Integración del servicio • La red • Vietnam
The association between concurrent heroin use among MMT patients and lack of family emotional/financial support, highlights the critical importance of these types of support for successful treatment. Association with shorter heroin use history suggests motivational enhancement may reduce concurrent heroin use. Living with HIV, whether on ART or not, is associated with increased concurrent heroin use and suggests safe injection commodities and education, and drug-drug interaction management, are needed for this subgroup. Though few MMT clients reported baseline methamphetamine use, its association with later heroin use suggests the need for effective methamphetamine use interventions.
Stigma poses considerable challenges to the mental health of people living with HIV who use drugs (PLHWUD). In this study, we explored factors related to different types of stigma (perceived and internalized) attached to layered stigmatizing characters (HIV and drug use) and their mental health influences on PLHWUD. The study used baseline data of an ongoing randomized controlled trial among 241 PLHWUD recruited between March and December 2018 in Vietnam. A structural equation model was used to assess the relationships among different types and layers of stigma and mental health status. Both perceived and internalized drug-related stigma measures were significantly higher than their corresponding HIV-related stigma. HIV-related stigma was negatively associated with mental health status; however, we did not find a significant relationship between drug-related stigma and mental health. Tailored intervention strategies in consideration of types and layers of stigma are needed to address stigma-related challenges faced by PLHWUD.
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