On World AIDS Day, a WHO, Viet Nam Authority of HIV/AIDS Control (VAAC), and partners review reveals Viet Nam has made significant progress in enhancing the benefits of HIV treatment.
Antiretroviral therapy (ART) or HIV treatment helps people living with HIV to have healthier lives and to extend their lives for many years. In addition, in recent years, strong evidence was established showing that ART will also prevent HIV transmission.
In Viet Nam an estimated 259,000 people live with HIV, concentrated mainly in a few key populations. In 2013, the estimated HIV prevalence in the general population (aged 15-49 years) was 0.39%, while HIV prevalence in people who inject drugs (PWID) is 10.3%, followed by men having sex with men (MSM) at 3.7% and female sex workers (FSWs) at 2.6%. However, the review estimates approximately 12,000 new infections occur in 2014 and will continue at the same rate unless the current response changes.
The review concludes that actively supporting key populations to access HIV testing early and if HIV positive to provide ART as early as possible would significantly reduce new HIV infection and AIDS deaths. In addition, combining prevention interventions will further accelerate the impact of the interventions.
In 2013, over forty million condoms and approximately 27 million needles and syringes were distributed. At the end of 2013, 15,542 people were receiving methadone maintenance therapy (MMT) and 82,687 adults and children were receiving ART.
The distribution of clean needles and syringes; access to methadone maintenance therapy among PWID; the promotion of consistent condom use among MSM and FSW, and the provision of ART among PLHIV are key interventions.
Pilot studies are being conducted in selected provinces in Viet Nam (Dien Bien, Can Tho, Thai Nguyen, Thanh Hoa) to assess how early HIV testing and early HIV treatment initiation can be promoted among key populations, and whether it can be offered in acceptable ways respecting the rights of key populations. The findings from the pilot studies will feed into future policies to optimize investments to minimize HIV transmission and AIDS deaths in Viet Nam.
“These studies and pilots are very important for us to plan future HIV response in Viet Nam. We still face various challenges, but based on the lessons from the pilot, we will further strengthen our response to HIV, and will move towards ending AIDS in Viet Nam” says Associated Professor Bui Duc Duong, Deputy Director General of VAAC.
The review led by WHO and VAAC also highlights the need of funding for the HIV response in the years to come. Currently 70% of the budget for the HIV response is funded by external donors. The Government and international partners will need to secure domestic funds to sustain and enhance the HIV response in the future.
Another challenge is delayed access to HIV testing and treatment of key populations due to discrimination and stigma. Putting a halt to discrimination and creating a supportive environment for key populations to test for HIV frequently, and start treatment early is important to minimize HIV transmission, the reviewers suggest.
In November, Viet Nam committed itself to the global 90-90-90 HIV treatment targets:
• By 2020, 90% of all people living with HIV will know their HIV status
• By 2020, 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy.
• By 2020, 90% of all people receiving antiretroviral therapy will have viral suppression.
“We have seen impressive progress in HIV prevention and treatment in Viet Nam. Viet Nam’s HIV response faces critical challenges. Creating supportive communities for key populations and helping them access early HIV testing, treatment and retain care will be key to minimize new HIV infections and AIDS deaths” says Acting WHO representative to Viet Nam Mr Jeffery Kobza.
Reference documents
Masaya Kato, Nguyen Hoang Long, Bui Duc Duong et al. Enhancing benefits of antiretroviral therapy in Vietnam: Towards ending AIDS. Current HIV. Current HIV/AIDS Reports, 2014
Masaya Kato M, Reuben Granich, Bui Duc Duong et al. The potential impact of expanding antiretroviral therapy and combination prevention in Vietnam: Towards elimination of HIV transmission. J Acquir Immune Defic Syndr. 2013 Aug 15;63(5):e142-9.
Viet Nam AIDS Response Progress Report, 2014. National Committee for AIDS, Drugs and Prostitution Prevention and Control. (2014)