AEGiS-WSJ: Vietnam Battles HIV Epidemic With U.S. Aid

Important note: Information in this article was accurate in 2008. The state of the art may have changed since the publication date.

Vietnam Battles HIV Epidemic With U.S. Aid

Wall Street Journal - December 26, 2008
Lam Thuy Vo, lam.vo@wsj.com

HO CHI MINH CITY -- Sixty-eight-year-old Dang Thi Nhu sits on her living room floor surrounded by plastic drug containers. Each month she receives hundreds of pills from the Vietnamese government for her son Dang Ngoc Than, who was infected with HIV while sharing a heroin syringe with other drug users.

The 40-year-old Mr. Dang is so weakened from his battle with AIDS that he can barely move or digest solid food. In recent months he became one of more than 11,000 beneficiaries of a Vietnamese drive to distribute free antiretroviral drugs. The program draws support and funding from the U.S. government.

Though much of the Bush Administration's foreign policy has proved polarizing, the President's Emergency Plan for AIDS Relief, which is supporting the Vietnamese effort, has drawn widespread praise.

In 2007, Vietnam became the prime focus of PEPFAR in Asia. There, PEPFAR officials hope to develop approaches to curb the spread of HIV that could be applied in other places where injecting drug users are the main drivers of the AIDS epidemic.

In Vietnam, the government is beefing up public education and help for people at high risk for the disease. One initiative involves the opening of outpatient methadone treatment for drug addicts. Previously, drug users first underwent community-based rehabilitation, which often consisted of family members trying to detoxify the drug user themselves. Patients who didn't succeed that way were moved into residential rehabilitation centers. Mr. Dang spent four years in one of these centers.

The government opened six methadone clinics in April, each capable of treating about approximately 250 people a year. Encouraged by their initial success, the government has plans to add six more clinics.

There are challenges to changing the way drug addicts are treated. Under Vietnamese law, injecting drug users are subject to prosecution, and government employees are required to alert authorities to active drug users. The requirements reinforce negative attitudes among health workers toward drug users and also keep addicts, afraid of incarceration, from taking advantage of treatment services, says Jean-Marc Olive, the World Health Organization representative in Vietnam.

While it is too early to fully gauge the effectiveness of Vietnam's new HIV/AIDS prevention program, observers are encouraged by the changes.

"It is really a breakthrough step on drug treatment in Vietnam, aiming to reduce HIV transmission among heroin-injecting users," says Nguyen To Nhu from Family Health International, a group active in the fight against HIV/AIDS in Vietnam.

For HIV/AIDS patients in Vietnam, the changes have eased medical worries and lifted some of the stigma surrounding the disease.

Before he came home from the rehabilitation center "our neighbors thought we were useless," Mrs. Dang. "But ever since the government started taking care of him people also started having more sympathy for him."

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