HIV and Injecting Drug Users in Vietnam: An Overview of Policies and Responses

Abstract

The HIV epidemic in Vietnam is fueled by injecting drug use. Since HIV emerged, because of a lawenforcement-focused drug policy and response, injecting drug users (IDUs) frequently experience drug detention and compulsory treatment. It has taken more than a decade to shift the focus from punitive to liberal policies. This overview presents a brief discussion on policies, responses, and experiences to identify implications. Related literature including government policies, peer-reviewed articles, and reports has been reviewed. The HIV epidemic in IDUs accelerated rapidly in an environment characterized by a lack in understanding and recognition of significance. There was limited leadership and weak direction to implement a countrywide response. Policies and responses gradually shifted to a harm reduction approach and recognized the need for harmonization, relating common features of drug and HIV. The review identifies that government leadership is crucial for supportive policies and long-term strategies. A multi-sectoral collaboration and continuous resource allocation with national priorities is essential to impact on the epidemic. In this review the context of these issues in policies and responses are highlighted and discussed, which gradually can lead towards the development of a substantial response for the drug use-driven HIV epidemic in Vietnam.

Tuberculosis and HIV co-infection in Vietnam

“…Interestingly HIV/AIDS prevalence rates were high in the remote Northern provinces, although TB/HIV co-infection rates were relatively low. High HIV infection rates may be a legacy of poverty among remote tribal groups, commercial sexual exploitation and movement across the Chinese border, 7,14,15 while relatively low rates of TB/HIV co-infection rates may reflect lower rates of HIV testing among TB patients and reduced access to TB and HIV services. 16 The Northeastern coastal province of Quang Ninh reported high TB, HIV and TB/HIV co-infection rates, which may be linked to its position as a special economic zone with lots of cross-border people movement, access through its multiple seaports and tourism related to the World Heritage status of Halong Bay.…”

“…3 The first case of HIV in Vietnam was detected in 1990. 7 After an initial delay in acknowledging and recognizing the full extent of the problem, Vietnam has made significant efforts to address the HIV/ AIDS epidemic. Worryingly the HIV prevalence among high-risk populations remains high in several cities and provinces, with increasing rates of HIV infection among men who have sex with men.…”

A critical exploration of professional perceptions of harm reduction policy and practice in Vietnam

“…The inconsistencies in law and policy have resulted in significant confusion between practitioners, especially among police (Ahmed et al, 2014). Importantly, these inconsistencies in law and policy mean that people who use drugs distrust service providers, because of the high risk of being arrested and being sent to compulsory treatment centres.…”

A critical exploration of professional perceptions of harm reduction policy and practice in Vietnam

“…However, in reality, many countries, Vietnam included, have been strongly influenced by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and WHO, which view addiction as a brain disease. Therefore, Vietnamese government documents and legislation endorse the view that addiction is a brain disease (Ahmed, Long, Huong, & Stewart, 2014;Ha et al, 2010;Khuat et al, 2012;Nguyen & Scannapieco, 2008;Peele, 2012a; The National Committee on AIDS Drugs and Prostitution Prevention and Control, 2011;Thien, 2002). For example, according to the 2006 HIV Prevention Law, addiction is a brain disease that is naturally chronic and relapsing, which is characterised by compulsive drug seeking and use, despite harmful consequences (VAAC, 2011).…”

“…In 2006, the HIV Prevention Law officially acknowledged that drug use and drug addiction are public health issues. However, in practice, drug use has been seen as an administrative violation in the 2012 Administrative Violation Law -which means that people who use drugs are still cast as a high risk group that potentially cause social disorder or crimes (Ahmed et al, 2014). Therefore, drug use and users are largely seen as social evils rather than a health issue and patients.…”