ObjectiveWe evaluated the patient satisfaction with HIV/AIDS care and treatment and its determinants across levels of health service administration in Vietnam.MethodsWe interviewed 1016 patients at 7 hospitals and health centers in three epicenters, including Hanoi, Hai Phong, and Ho Chi Minh City. The Satisfaction with HIV/AIDS Treatment Interview Scale (SATIS) was developed, and 3 dimensions were constructed using factor analysis, namely “Quality and Convenience”; “Availability and Responsiveness”; and “Competence of health care workers”.ResultsIn a band score of (0; 10), the mean scores of all domains were large; it was the highest in “Competence of health workers” (9.34±0.84), and the lowest in “Quality and Convenience” (9.03±1.04). The percentages of respondents completely satisfied with overall service quality and treatment outcomes were 42.4% and 18.8%, respectively. In multivariate analysis, factors related to higher satisfaction included female sex, older age, and living with spouses or partners. Meanwhile, lower satisfaction was found among patients who were attending provincial and district clinics; in the richest group; had higher CD4 count; and drug users.ConclusionThis study highlights the importance of improving the quality of HIV/AIDS services at the provincial and district clinics. Potential strategies include capacity building for health workers, integrative service delivery, engagements of family members in treatment supports, and additional attention and comprehensive care for drug users with HIV/AIDS.

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IntroductionHIV voluntary counseling and testing (VCT) comprise an effective preventive measure and an entry point to care and support services. We sought to assess VCT uptake and HIV-related knowledge and perceived risk among female sex workers (FSWs) in five provinces of the Mekong Delta region.MethodsA cross-sectional survey was carried out in 1998 FSWs, including both street-based sex workers (SSWs) and entertainment-based sex workers (ESWs).ResultsHigh proportions of FSWs were aware that using condoms (94.6%), and clean needles (34.1%) are preventive measures that reduce the risk of HIV transmission. Some FSWs reported avoiding public toilet use (8.6%), physical contacts (16.1%), or sharing meals (10.9%) with people living with HIV/AIDS, and preventing mosquito bites (20.8%). Twenty-nine percent (29.0%) of FSWs perceived themselves as being at risk of HIV infection. Only 32.7% had ever tested for HIV, of whom 54% were voluntary for testing. FSWs who ever injected drugs (OR = 0.03, p=0.05), had drug-injecting clients (OR = 0.07, p<0.01), and had inconsistent condom use with husbands or lovers (OR = 0.10, p=0.01) were less likely to have a voluntary test. Inconsistent condom use with clients (OR = 13.86, p<0.01), and receiving HIV information from radio (OR = 13.28, p<0.05) and communication campaigns (OR = 6.69, p<0.05), increased the likelihood of VCT uptake.ConclusionInadequate knowledge and some misconceptions about HIV transmission routes and preventive measures, low perceived risk of HIV infection, and low VCT uptake were observed among FSWs in the Mekong Delta region. Interventions to improve their knowledge and self-efficacy, reduce risky behaviors, and encourage VCT uptake and early access to health care services are necessary to prevent HIV transmission in this region.

A multi-site survey was conducted on a sample of 365 clients to assess their willingness to pay for HIV voluntary counseling and testing (VCT) services in Ha Noi and Nam Dinh province, two epicenters of Vietnam. By using contingent valuation technique, the results showed that most of respondents (95.1 %) were willing to pay averagely 155 (95 % CI 132-177) thousands Vietnam Dong (~US $7.75, 2013) for a VCT service. Clients who were female, had middle income level, and current opioid users were willing to pay less; meanwhile clients who had university level of education were willing to pay more for a VCT service. The results highlighted the high rate of willingness to pay for the service at a high amount by VCT clients. These findings contribute to the implementation of co-payment scheme for VCT services toward the financial sustainability of HIV/AIDS programs in Vietnam.

ObjectivesSmoking is associated with adverse health outcomes among drug users, including those in treatment. To date, however, there has been little evidence about smoking patterns among people receiving opioid-dependence treatment in developing countries. We examined self-reported nicotine dependence and associated factors in a large sample of opioid-dependent patients receiving methadone maintenance treatment (MMT) in northern Vietnam.SettingFive clinics in Hanoi (urban area) and Nam Dinh (rural area).ParticipantsPatients receiving MMT in the settings during the study period.Primary and secondary outcome measuresWe collected data about smoking patterns, levels of nicotine dependence and other covariates such as socioeconomic status, health status, alcohol use and drug use. The Fagerström test was used to measure nicotine dependence (FTND). Logistic regression and Tobit regression were employed to examine relationships between the smoking rate, nicotine dependence and potentially associated variables.ResultsAmong 1016 drug users undergoing MMT (98.7% male), 87.2% were current smokers. The mean FTND score was 4.5 (SD 2.4). Longer duration of MMT (OR 0.98, 95% CI 0.96 to 0.99) and being HIV-positive (OR 0.46, 95% CI 0.24 to 0.88) were associated with lower likelihood of smoking. Being employed, older age at first drug injection and having long duration of MMT were inversely related with FTND scores. Higher age and continuing drug and alcohol use were significantly associated with higher FTND scores.ConclusionSmoking prevalence is high among methadone maintenance drug users. Enhanced smoking cessation support should be integrated into MMT programmes in order to reduce risk factors for cigarette smoking and improve the health and well-being of people recovering from opiate dependence.