Gay Star News, March 21, 2017
Men who have sex men (MSM) are at risk of being left behind in Vietnam’s efforts to reach ambitious HIV targets.
Vietnam became the first Asian country to adopt the targets for 90-90-90 targets in 2014. The targets are for 90% of people living with HIV to be diagnosed, 90% of people diagnosed with HIV to be on antiretroviral treatment, and 90% of people on treatment to have an undetectable viral load.
But a new study has revealed Vietnamese health services need to do a better job when it comes to MSM.
HIV rates have risen among MSM in Vietnam. About 16% of MSM in Hanoi and Ho Chi Minh City are living with HIV.
MSM, female sex workers and injecting drug users are the groups in Vietnam where HIV is most concentrated.
HIV testing and uptake of treatment happened at a lower rate for MSM than the other two at risk groups.
Hanoi Medical University and the University of New South Wales joined forces to run the study into the experiences of MSM around the topic of HIV. The results will be published in the Culture, Health and Sexuality journal.
The shock of a positive diagnosis
Many of the participants had limited knowledge of HIV before their diagnosis and had not perceived themselves to be at risk.
The men said health services were reluctant to discuss same-sex relationships or HIV risks associated with specific sexual practices.
‘When I was informed of the HIV-positive result, I did not believe [it],’ one participant said.
‘I went to Hanoi to test again but the result stayed the same. So I was very confused about how I could be infected with HIV.’
The lack of knowledge and shock reaction to a diagnosis delayed the start of treatment.
‘The result was a tremendous shock,’ one man said.
‘I couldn’t think of anything and just wanted to go somewhere and do something for fun before ending my life… I did all kinds of things such as using marijuana, ecstasy and ice [crystal methamphetamine].’
Stigma and discrimination made men wary of disclosing their HIV status. Some participants had their confidentiality breached at HIV clinics and others were nervous about the identity documents they had to provide to register with a clinic.
‘After my ART (anti-retroviral treatment) initiation, the HIV clinic sent my identity information to the health station in my home town and the health station informed my mother of my HIV status,’ one participant said.
‘The clinic didn’t inform me that it will send my information back to my home town when asking me my identity information for registration.’
Vietnam and WHO
In 2015 Vietnam adopted World Health Organization guidelines recommending immediate HIV treatment for MSM and other key populations.
Researchers said there was little evidence the policy was actually being used.
Healthcare providers did not ask men about their sexual identity, which meant they were considered ineligible for immediate treatment. Some men were forced to visit several clinics or bribe clinicians in order to try to access ART.
The researchers called for better pre-test counselling, peer support and respect for confidentiality to help men accept an HIV-positive diagnosis and engage with treatment services.
The results also reinforce arguments that the 90-90-90 targets will be hard to achieve if ‘key populations’ are marginalised and discriminated against in healthcare settings.
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March 22, 2017
Gay men being left behind in Vietnam’s HIV fight
by Nhan Quyen • [Human Rights]
Gay Star News, March 21, 2017
Men who have sex men (MSM) are at risk of being left behind in Vietnam’s efforts to reach ambitious HIV targets.
Vietnam became the first Asian country to adopt the targets for 90-90-90 targets in 2014. The targets are for 90% of people living with HIV to be diagnosed, 90% of people diagnosed with HIV to be on antiretroviral treatment, and 90% of people on treatment to have an undetectable viral load.
But a new study has revealed Vietnamese health services need to do a better job when it comes to MSM.
HIV rates have risen among MSM in Vietnam. About 16% of MSM in Hanoi and Ho Chi Minh City are living with HIV.
MSM, female sex workers and injecting drug users are the groups in Vietnam where HIV is most concentrated.
HIV testing and uptake of treatment happened at a lower rate for MSM than the other two at risk groups.
Hanoi Medical University and the University of New South Wales joined forces to run the study into the experiences of MSM around the topic of HIV. The results will be published in the Culture, Health and Sexuality journal.
The shock of a positive diagnosis
Many of the participants had limited knowledge of HIV before their diagnosis and had not perceived themselves to be at risk.
The men said health services were reluctant to discuss same-sex relationships or HIV risks associated with specific sexual practices.
‘When I was informed of the HIV-positive result, I did not believe [it],’ one participant said.
‘I went to Hanoi to test again but the result stayed the same. So I was very confused about how I could be infected with HIV.’
The lack of knowledge and shock reaction to a diagnosis delayed the start of treatment.
‘The result was a tremendous shock,’ one man said.
‘I couldn’t think of anything and just wanted to go somewhere and do something for fun before ending my life… I did all kinds of things such as using marijuana, ecstasy and ice [crystal methamphetamine].’
Stigma and discrimination made men wary of disclosing their HIV status. Some participants had their confidentiality breached at HIV clinics and others were nervous about the identity documents they had to provide to register with a clinic.
‘After my ART (anti-retroviral treatment) initiation, the HIV clinic sent my identity information to the health station in my home town and the health station informed my mother of my HIV status,’ one participant said.
‘The clinic didn’t inform me that it will send my information back to my home town when asking me my identity information for registration.’
Vietnam and WHO
In 2015 Vietnam adopted World Health Organization guidelines recommending immediate HIV treatment for MSM and other key populations.
Researchers said there was little evidence the policy was actually being used.
Healthcare providers did not ask men about their sexual identity, which meant they were considered ineligible for immediate treatment. Some men were forced to visit several clinics or bribe clinicians in order to try to access ART.
The researchers called for better pre-test counselling, peer support and respect for confidentiality to help men accept an HIV-positive diagnosis and engage with treatment services.
The results also reinforce arguments that the 90-90-90 targets will be hard to achieve if ‘key populations’ are marginalised and discriminated against in healthcare settings.