Drug use and HIVAIDS in Viet Nam

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Drug use and HIV/AIDS in Viet Nam
Do Thanh Nam, Peter Higgs Gary Reid
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Drug use

• A long history of opium cultivation in Vietnam.
• In the early 19th century, British opium began
  flooding into southern China and then into
  Vietnam.
• Term Drug appeared in the end of 1980s and drug
  use took off from 1993.

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Trend of drug use
Source National conference on drug addiction and
prostitution.
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Issues

• Nearly 28,000 new users officially recorded in
  2002
• 140,000 registered users (Lao Dong newspaper)
• Opium and heroin most commonly used drugs
• 60 of users are injecting
• high rates of needle sharing
• HIV rapidly transmitted into this population

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History of HIV/AIDS Vietnam

• 1993 defined the 1st HIV outbreak with
  estimation of 1,100 infected cases
• mostly among IDUs (Southern provinces)
• 1993 - 1997 HIV epidemic continues among IDU
• at least 65 detections among IDU
• 1997 - 1999 2nd outbreak occurred widely in
  northern provinces increase amongst young people
• Mainly 18-29 years
• Recent evidence of HIV in drug using sex workers
• Possible sexual transmission to community

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HIV/AIDS situation Viet Nam (As of 31/12/2002)

• 59,200
• 8,793
• 4,889

• HIV cumulative detections
• AIDS cumulative cases
• AIDS deaths

Source National conference on 2002 HIV/AIDS
works report
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HIV cumulative reported detections by year
Source National conference on 2002 HIV/AIDS
works report
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Trend of HIV transmission among selected groups
Source NASB
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HIV infected cases distributed by ages
Source National conference on 2002 HIV/AIDS
works report
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New policies

• Relapse rates are up to 99
• Compulsory placement in rehabilitation
• 17,000 IDUs from HCMC have been placed since
  December 2001
• Terms 2 5 years

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Situation inside rehab centres

• Majority of inmates presumed HIV positive
• No antiretroviral treatment
• Burden of AIDS/TB significant
• Forced Labor
• Discharged when too ill
• Economic burden of current policy significant
• - Up to 1.9 of HCMC GDP

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Street impact of this policy

• Reduced supply and demand of heroin
• IDUs go underground
• Reduced needle exchange activity
• HIV other blood borne viruses in detention
  facilities

MDM outreach district 5 HCMC, June 2002
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Orientation and Directions for fighting HIV
epidemic

• Strengthen the leadership across all levels of
  govt.
• Multi-sectorial approach
• co-operation between National AIDS Program and
  the National Programs for Drug Prostitution
  Control and other socio-economic programs
• Treatment care for PLWHA
• Strengthen role of AIDS workers at all levels
• Promote international co-operation

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Conclusions

• HIV/AIDS epidemic in Viet Nam closely associated
  with drug use
• Promote investment in and development of HR
  policies programs for IDUs
• Preventive interventions for sexual HIV
  transmission
• ? ART for AIDS treatment
• Health facilities require development for AIDS
  patients

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Acknowledgements

• Prof. Chung A - the Director of NASB
• Nick Walsh AusAID Youth Ambassador Ho Chi Minh
  City (May October 2002)
• Vu Doan Trang, Victorian Public Health Training
  Scheme (October 2000 February 2001)
• Le Truong Giang Le Thuy Lan Thao (HCMC AIDS
  Standing Bureau)
• Jamie Uhrig
• Serge Doussantousse