SEATTLE — The rate of new HIV/AIDS infections in Vietnam peaked in 2002, when an estimated 28,000 individuals contracted the disease each year. That number has dropped dramatically; in 2016, an estimated 11,000 individuals contracted HIV/AIDS. Likewise, HIV/AIDS-related deaths have declined. Death rates peaked in 2005-2006. with an estimated 11,000 people dying from the disease annually. By 2016, that number had been reduced to 8,000. Despite considerable success in lowering HIV/AIDS contraction and death rates in Vietnam, there is still considerable room for improvement. What efforts has worked and are working? And what challenges does the Southeast Asian nation still face?
Successful Initiatives and Efforts
G-Link, an HIV/AIDS-fighting organization, was launched by an initiative from the PATH-led Healthy Markets in November 2015. It aims to help people in key population groups find, access and utilize HIV/AIDS testing and treatment. The key populations targeted are those considered most vulnerable to HIV/AIDS. In 2013, only about one in three members of the most vulnerable population groups sought testing or treatment for HIV/AIDS. G-Link wanted to change that.
The organization, which is funded by the President’s Emergency Plan for AIDS Relief and backed by both the U.S. Agency for International Developments (USAID) and the World Health Organization (WHO), saw tremendous success right away. A report published by PATH in 2016 states that in its first nine months of operation, G-Link offered testing to almost 18,000 individuals belonging to these key population groups.
Implemented through local organizations already working with these target populations, G-Link offers accessible and affordable testing and treatment to populations that because of lack of access, stigmatization and discrimination would otherwise not receive the medical care they need.
Run in conjunction with the Vietnam Youth Union and the Health and Education Volunteers, and funded by USAID, the Hanoi HIV/AIDS Awareness Project aims to stop the spread of HIV/AIDS in Vietnam’s capital city of Hanoi. The project specifically works with youths in Hanoi and has adopted a highly successful peer mentorship program in which teens and youths educate one another about the risk of HIV/AIDS as well as about opportunities for testing and treatment.
The Joint United Nations Programme on HIV and AIDS (UNAIDS) and the WHO developed Treatment 2.0, a treatment approach designed to get key populations groups in Vietnam faster and better access to testing for and treatment of HIV/AIDS. Treatment 2.0 works to educate local and communities leaders about HIV/AIDS so that they can then encourage people at high risk of contracting the disease to seek testing and treatment. The program tries to empower people to speak more openly about HIV/AIDS in order to combat the stigma surrounding it and end the taboo around seeking medical aid for the disease.
Continued Challenges in the Fight Against HIV/AIDS in Vietnam
Despite efforts that specifically target the key population groups most at risk for contracting HIV/AIDS, rates of the disease still remain higher in these groups than in the population as a whole. Educating and treating the most vulnerable groups continues to be a challenge. These populations tend to face such high levels of stigmatization and discrimination that they are often reluctant, or completely unable, to seek medical care.
Furthermore, many rural, mountainous communities (especially ones dominated by ethnic minorities) have limited information about and access to HIV/AIDS treatment and care. Even mobile medical groups find traveling into such remote regions challenging. For this reason, in 2015, the Inter-Parliamentary Union reported that some such communities have HIV/AIDS prevalence rates up to 10 times higher than the national average.
The future of funding for prevention programs for HIV/AIDS in Vietnam is uncertain. Nearly 80 percent of funding currently comes from the international community. However, as the crisis has abated since the early 2000s, that funding has steadily dwindled. As such, Vietnam faces the challenge of how it will finance HIV/AIDS treatment facilities and educational initiatives as international financial support declines.
Vietnam was the first nation in Asia to adopt UNAIDS’s 90-90-90 goals and to pledge a commitment to ending the HIV/AIDS epidemic by 2030. The 90-90-90 targets, which UNAIDS created in 2016, aim to have 90 percent of all people with HIV know they are HIV positive, 90 percent of those who known their status receiving antiretroviral therapy (ART) consistently and 90 percent of those receiving treatment showing viral suppression (having no symptoms of HIV/AIDS) by 2020. These ambitious targets put nations on track to ending the epidemic fully by 2030.
In 2016, UNAIDS estimated that 70 percent of HIV positive individuals in Vietnam knew their status. Of those, only 47 percent were regularly receiving ART. Increasing this number to 90 percent by 2020 will be a challenge. That being said, ART coverage has improved tremendously. In 2010, only 21 percent of HIV positive individuals who knew their status were receiving the treatment. That in just six years that number more than doubled is a good sign that Vietnam can achieve the 90-90-90 targets by 2020.
Further, as of 2016, 73 percent of those receiving ART show suppressed viral loads, only 17 percentage points away from the goal. At the same time, however, this 72 percent showing suppressed viral loads is equivalent to only 34 percent of the total population living with HIV/AIDS.
Vietnam has made tremendous strides towards curbing the epidemic of HIV/AIDS in Vietnam, especially since the early 2000s when both the infection rate and the death rate from HIV/AIDS peaked. The nation still faces challenges: how it will continue to support the often stigmatized and discriminated against populations most at risk for HIV/AIDS, how it will reach rural, mountainous communities and how it will continue to fund its HIV/AIDS programs. Nevertheless, its commitment to the 90-90-90 targets and to ending the epidemic in full by 2030 demonstrate Vietnam’s commitment to eradicating this devastating disease.
– Abigail Dunn