Stigma Raises HIV Threat in Vietnam, Says U.S. Study Group

In a report recently presented in Hanoi, the Washington-based Center for Strategic and International Studies said HIV/AIDS stigma could cause Vietnam's epidemic to expand beyond high-risk groups. According to CSIS, which conducted a January study tour of the country led by former US Health and Human Services Secretary Tommy Thompson, "People living with HIV/AIDS are highly stigmatized in Vietnam, regardless of how they became infected, leading to reluctance to seek prevention, testing, and treatment services."

Communist Vietnam routinely incarcerates, rather than treats, HIV-positive commercial sex workers and intravenous drug users (IDUs), the study found. Phillip Nieburg, a chief author of the report, said some of these 80 or so detention centers for 40,000 to 80,000 IDUs and prostitutes have served as HIV "incubators." Meanwhile, another high-risk group, men who have sex with men (MSM), remains a taboo subject, the study noted.

The think-tank praised Vietnam's health care system and its efforts to combat bird flu and SARS. A law set to take effect in coming months that will strengthen the confidentiality of HIV tests and legalize syringe exchanges and methadone programs also received praise.

But the true extent of Vietnam's epidemic is unknown, since key data such as the number of HIV/AIDS patients in hospitals and detention centers remain unavailable, CSIS warned.

More than half of Vietnam's HIV cases are IDUs, the report said. "Like Thailand and China, HIV prevalence among IDUs began rising sharply in Vietnam in the late 1990s and now exceeds 70 percent in some cases," it said.

To stem the spread of HIV/AIDS in Vietnam, the country must "resolve the clash between public health and public security objectives," the report noted. "Reducing the tension between these two national policy interests is the single greatest challenge before Vietnam in its evolving efforts to control HIV/AIDS."

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