Vietnam adjusts approach to fighting HIV/AIDS
HO CHI MINH CITY - Returning here after three years of absence, Nguyen Viet Quang, a U.S. citizen of Vietnamese origin, remarked that he no longer saw posters with skulls and bones or bloody syringes warning of the danger of HIV/AIDS displayed in large cities.
The change is welcome, Quang said, not only because the old anti-HIV/AIDS posters were ''much too stressful''. Now, the new billboards promote safe sex using images of smiling or dancing condoms, and the use of clean needles and syringes.
The shift has a deeper rationale to it - it reflects Vietnam's new approach to HIV/AIDS, one that focuses more on public awareness about the illness, on protection measures, and on a more humane attitude towards those living with the pandemic.
This change has not been lost on those like U.N. Development Programme (UNDP) Vietnam Representative Jordan Ryan, who recently said at a conference organised by the World Health Organisation (WHO) in Hanoi that ''the mindset of the government is beginning to change''.
The Ministry of Health has submitted to the government a National HIV/AIDS Prevention and Combat Strategy whose goal is to keep the incidence of HIV/AIDS below 0.3 percent through 2010.
''We hope to fight the disease with educational programmes and anti-discrimination policies,'' said Dr Trinh Quoc Huan, head of the ministry's department for preventive medicine and HIV/AIDS combat.
Huan said his department has issued policies on combating HIV and AIDS before, but that these measures were not very effective. ''Only drastic measures could contain the epidemic,'' Huan said. These include using more effective prevention and support messages in place of the old focus on instilling fear in people about HIV/AIDS.
In Vietnam, HIV infection has been closely linked to drug abuse and prostitution, and ignorance about the illness.
Health ministry figures show that the proportion of drug users with HIV increased from 9.4 percent in 1996 to 29.34 percent in 2002, while that proportion among sex workers was 0.6 percent in 1994 and 6 percent in 2002.
More than 73,600 people were reported HIV-positive of Nov. 22 this year, equal to 0.1 percent of the population. Of this number, 10,840 cases have developed full-blown AIDS while 6,067 died from the disease. ''Each day passes and Vietnam finds out there are some 50 more people infected with HIV. The speed has not slowed down since 2000,'' reported Chung A, Huan's assistant.
Amid this backdrop, officials are now widening the HIV/AIDS campaign to go beyond groups with high-risk behaviour. Huan was referring to criticism by international health experts that Vietnam had been focusing on HIV/AIDS as something affecting drug users and sex workers, rather than raising awareness among the wider population.
''Everybody could be at risk unless adequate protection measures are taken,'' Huan said, adding that ''we need to change our mindset in dealing with the killer virus.''
Of particular concern in reviewing the anti-HIV/AIDS campaign is the HIV rates among young people, given figures that HIV rates among the 20 to 29 age bracket leapt to 61 percent last year from 29 percent in 1997.
''Those with HIV have become younger; worse, they are from all walks of life,'' Huan said, including office employees, high school students and young farmers as well, reflecting concern about trends of the illness.
Health ministry figures show that 95 percent of those with HIV are between 15 to 45 year old, and that HIV is found at more than 90 percent of communes and 50 percent of villages in Vietnam.
Cases of husbands transmitting the virus to their wives are increasing. If in 1999, the Hung Vuong Obstetric Hospital in this southern Vietnamese city counted only 46 pregnant women with HIV, the number rose to 139 in 2001.
The new programme proposed by Huan's department includes information campaigns to help people become familiar with HIV/AIDS, and needle and syringe exchanges to help stabilise the HIV infection rates.
Already, some innovative information campaigns are underway. Hairdresser Nguyen Tuan is one of the volunteers for the 'Harm Reduction' and 'Living with AIDS' programmes. While he takes care of customers, Tuan would talk about HIV/AIDS, protection measures and a more human approach to the illness.
Tuan's team of volunteers includes ex-sex workers and former drug addicts, some HIV-positive. ''Their presence is very helpful. They send a concrete, conclusive message to people who still have little understanding of the virus,'' Tuan said.
''Those with HIV fear they would be denied by the society, while families' members fear that the HIV-positive would infect them with the disease,'' Tuan said. ''Our task is trying to bring up changes to people's attitude about HIV/AIDS.''
It is a hard task indeed, since many look at those living with HIV/AIDS with suspicious and fearful eyes. Many hospitals and clinics have refused to receive such patients, including pregnant women who had tested positive.
Vietnamese authorities recently issued a regulation banning discrimination of those with HIV/AIDS in accessing healthcare services. It also bans HIV/AIDS discrimination in the workplace, and asks employers to provide all of employees with information on the disease.
''Those with HIV, including detainees, prisoners, and students who have begun to develop AIDS have the right to treatment in clinics at the jails, re-education camps and schools,'' Huan said. ''In case their disease develops more seriously, they will be brought to state-run hospitals or health care centres.''
Huan added that health ministry has set a goal of providing 70 percent of those with HIV/AIDS with medical treatment by 2010.
But there are difficulties. Its programme of 'Living with AIDS' has not gained much result to date. ''HIV/AIDS patients still feel they are either a burden to their families or a menace to society,'' Huan said. ''Only 30 percent of those infected felt accepted by their community and families, while a mere 2 percent joined peer education and friendship groups.''
By Tran Dinh Thanh Lam - Inter Press Service - December 10, 2003.
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