AEGiS-15IAC: Harm creation: assessing and addressing the HIV risk environments among highland ethnic minorities in northern Vietnam.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

Harm creation: assessing and addressing the HIV risk environments among highland ethnic minorities in northern Vietnam.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. D10026)

Eligh J
United Nations Office on Drugs and Crime, Hanoi, Vietnam

ISSUE: The drug-related harm and risk environments emerging in highland ethnic minority border areas of Northwest Viet Nam are a direct result of on-going and planned socio-economic development initiatives and projects.

DESCRIPTION: Using a comparative analysis of both qualitative and quantitative data derived from situation assessments in sixteen remote ethnic minority communes from four highland districts in Northwest Vietnam, in combination with historical data of the same nature derived from other complimentary research initiatives, this paper describes with illustrative examples the fundamental characteristics of the drug use and harm creation environments in these remote and highland areas.

LESSONS LEARNED: Inhabitants of these areas are marginalised physically, culturally, and economically. Ethnic minority drug users, and those who are HIV+, continue to face discrimination. Most rural minority inhabitants are non-literate, have little formal education and have lived in their village their entire life. Infrastructure development and improvement initiatives aimed at connecting these remote areas to domestic and transnational transport and communication networks have caused drastic transformations in the surrounding landscapes. Local drug use and risk behaviour reflects these environmental changes. Opium is giving way to heroin, smoking to injecting. New drug users are younger and their behaviours are being influenced and modified as much by their surrounding traditional cultural environment as by the emerging and globalising socioeconomic one which is rapidly encroaching.

RECOMMENDATIONS: Development initiatives must acknowledge and account for their risk environment enabling consequences. A more effective approach against the spread of HIV/AIDS and other BBVs in these remote communities is the identification and mitigation of risk-enabling and harm creation factors before they germinate rather than the post-enablement implementation of interventions.

Keywords: AEGIS, Acquired Immunodeficiency Syndrome, Risk-Taking, Ethnic Groups, HIV Seropositivity, Substance-Related Disorders, Vietnam, Behavior, Research, Rural Population

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