Third National HIV/AIDS Conference

My work with the Pasteur Institute provided an unexpected opportunity to attend the Third National HIV/AIDS conference in Sai Gon. Organized by the Ministry of Health and Ho Chi Minh City People’s Committee, the conference attracted 1,500 registrations, including 200 international participants. Booths like PEPFAR, WHO, and local HIV/AIDS organizations lined the parking lot to provide fantastic pamphlets, cds, and condoms to the eager attendees.

In three days, the health professionals and people with HIV shared their awesome knowledge and goals for Viet Nam. Now armed with pertinent knowledge, I learned:

1. First case of HIV in Viet Nam was recorded in 1990.
2. There are 100,000 reported cases of HIV cases, but likely upwards to 300,000 infections out of a population of 82 million people.
3. Typical HIV cases are young males in their 20s. Numbers range from 70-85 percent of all HIV cases are males.
4. Majority of the HIV/AIDS are Injecting Drug Users (IDUs) and Commercial Sex Workers (CSW) and their clients.
5. Before 1995 the drug of choice was opium. However after 1995 the rise of heroin usage caused a correlating increase of HIV infections, making IDUs the biggest at-risk group.
6. Although methadone substitution is used to wean IDUs off of heroin, there is no subsequent counseling to minimize relapse.
7. There are two types of CSWs. The direct sex workers which are the traditional workers from the streets and the indirect sex workers from high-end establishments like hotels, massage parlors, and karaoke entertainment centers. Numbers show that up to 10-25% of young males have had sex with CSWs. Also many CSWs are IDUs.
8. ARVs costs nearly $60-$90 a month while the average monthly income for a person is $45.
9. 21 locations provide VCT and testing for HIV/AIDS in Sai Gon and of those 21 locations, 12 locations provide ARVs for free
10. Only 3000 people are receiving ARVs
11. The adherence rates in some places are below 50% due to lack of adequate counseling and lack of education for the health professionals.
12. After years of excellent TB care, TB is back on the rise because of co-infections with HIV. Co-infections with Hep B and C is also concerning.
13. Stigma and discrimination is still a huge factor with as high as 50-60% of the public blaming the individual for their infection.
14. There is a misconception that mosquitoes can transfer HIV.
15. Traditional medicine is widely accepted within the medical community and many would like to see traditional medicine used in tandem with ARVs.
16. Condoms are becoming more accepted. However some females are not empowered to ask their partners to use one or view the use of condoms as evidence of promiscuity.
17. The younger generation is more open about sex and talking about sex. There is a greater prevalence of sex before marriage and decrease of age of first sexual intercourse. However 19-20 years old is the average age of first sexual intercourse.
18. Harm reduction programs have focused on the dispersal of new needles and condoms. Also there are peer educator programs showing excellent results in education.
    

The political and social context of HIV/AIDS is incredibly different from nation to nation and culture to culture. I am impressed that the Vietnamese government has embraced harm reduction in their fight against HIV and organized a huge public awareness event in the city center of Sai Gon to reduce the stigma of HIV and hand out millions of free condoms. Also, there is a vast influx of money from the Global AIDS fund, PEPFAR, and World Bank. Most importantly Viet Nam still has a window of opportunity to decrease the effects of the HIV epidemic in the risk groups within the next 5 years before it spreads into the general public.