News from Vietnam

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REPRODUCTIVE HEALTH and HIV/AIDS from VIETNAM will be presented in this section

30 November 2018

Vietnam launches national program for pre-exposure prophylaxis for HIV

PATH, USAID, and Vietnam’s Ministry of Health launch PrEP program to substantially reduce new HIV infections as total PrEP service enrollment passes 2,000.

On the eve of the 30th World AIDS Day, Vietnam’s Ministry of Health (MOH), the United States Agency for International Development (USAID), and global health non-profit organization PATH, announced the nationwide launch of pre-exposure prophylaxis (PrEP) services for HIV prevention in Vietnam.

PrEP allows people who do not have HIV but are at substantial risk of infection to prevent HIV by taking a pill every day, as part of a combination HIV prevention strategy.

If a HIV-negative person uses PrEP, their chance of contracting HIV through unsafe sex or injection drug use decreases, as the medication will work to prevent the virus from establishing a permanent infection. PrEP is extremely effective when taken correctly, and is proven to reduce the risk of HIV infection by 92 percent or more.

Since 2015, the World Health Organization has strongly recommended PrEP as an additional prevention choice for people at substantial risk of HIV.

“International guidance, plus the in-country evidence generated from pilot programs led by the MOH and implemented by the USAID/PATH Healthy Markets project and UNAIDS, shows that PrEP is an effective method for HIV prevention for those most at risk of HIV. This is why Vietnam has established and will implement the national plan for PrEP for 2018-2020, making PrEP available for at least 7,300 people in at least 11 provinces by 2020,” stated Associate Professor Phan Thi Thu Huong, the vice director of Vietnam Administration for HIV/AIDS Control (VAAC). This important step makes Vietnam the second country in Asia, after Thailand, to roll out PrEP nationwide. “We will take good care of PrEP users by providing them with sufficient information about the prevention of sexually transmitted infections including HIV, and will also aim to negotiate with PrEP providers to reduce the treatment cost so people who are in need can more easily access PrEP.”
VAAC, USAID, and PATH launched pilot PrEP services (Prepped for PrEP—P4P) in 2017 through the USAID/PATH Healthy Markets project.

The USAID/PATH Healthy Markets project has worked with community groups led by people at risk of HIV, provincial MOH leaders, commercial sector partners, and private and public outpatient clinics to provide PrEP for 1,967 people at high risk of contracting HIV—men who have sex with men (MSM), transgender women (TGW), and the HIV-negative partners of people living with HIV who are not viral load suppressed—in Ho Chi Minh City and Hanoi.

PrEP was also made available through a pilot project run by UNAIDS.

“The launch of PrEP through P4P in June 2017 made a critically important HIV prevention tool available to those most at risk in Ho Chi Minh City and Hanoi,” said Dr. Kimberly Green, chief of party for Healthy Markets. “This pilot was only possible due to a strong partnership between civil society organizations, social enterprises, and private clinics led by MSM, TGW and people living with HIV, along with local health leaders, public outpatient clinics, and commercial partners including Gilead Sciences, Reliv/Mylan, and Abbott.

The national scale-up of PrEP is essential to dramatically bending down the curve of new HIV infections in Vietnam.”

Guests at the launch also heard from community leaders, PrEP providers and users, and private sector partners who participated in a symbolic commitment to the future of PrEP in Vietnam, along with leaders of the VAAC, provincial Centers for Disease Control, USAID, and PATH.

“Since 2017, we’ve enrolled 635 people on PrEP at our clinic,” shared Dr Tran Le Viet Thanh, from G-link Clinic. “The retention rate—people that continue to take PrEP over time—is high, as we support people to integrate the medication regimen into their daily lives.

I have no doubt that PrEP is already saving a lot of lives in Vietnam and so I am very happy to see it will be available to many more people who need it, very soon.”

“I’ve been on PrEP for nearly a year. I feel very happy and secure with this wonderful choice,” said Tuan, an office worker in Ho Chi Minh City. “Many of my friends are jealous because PrEP isn’t available yet where they live—they will be very happy to hear about the national expansion of the service! I hope a lot more people will now consider and try PrEP to protect themselves and their loved ones.”

The USAID/PATH Healthy Markets project has also worked with the World Health Organization, UNAIDS and PEPFAR partners to support the VAAC to develop a comprehensive package of national policies, guidelines, and training materials that will support the scale up of PrEP. Roll-out will begin in nine provinces in 2019 before expanding to eleven provinces in 2020.

“The nationwide launch of PrEP in Vietnam has been a long-standing goal of PEPFAR and USAID,” said Mary Tarnowka, U.S. Consul General.

“We are extremely appreciative of the Ministry of Health’s commitment to this truly catalytic approach to HIV prevention, and its ability to lead the way in HIV innovation. By working together with USAID to introduce and now roll-out PrEP nationwide, the 2030 HIV elimination goals are one step closer.”

The national launch of PrEP services in Vietnam was hosted by VAAC, in coordination with USAID, and PATH. Through PEPFAR, the U.S. Government works closely with the MOH; the Global Fund to Fight AIDS, Tuberculosis and Malaria; and others to develop a long-term, sustainable program to support the Vietnamese government to scale up activities for HIV prevention, treatment, and eradication.

 

16 May 2018

Vietnam and LGBT rights: Making strides

Vietnam has seen a radical change in lesbian, gay, bi-sexual and transgender (LGBT) rights over the last decade as the State has made significant steps to protect rights and equality.
Just more than a decade ago, homosexuality wasn’t accepted widely. There was stigma and discrimination against LGBT people because of their sexual orientation or gender identity.

Things have changed.

Lawmakers slam anti-LGBT discrimination

Public attention turned to homosexuality and the LGBT community in 2012 when Minister of Justice Ha Hung Cuong became the first senior Vietnamese government official to publicly call for the end of prejudice against homosexual people and mentioned the once-taboo subject of same-sex marriage.

“Personally, I think that the recognition or non-recognition of same-sex marriage should be based on very basic studies, credible assessment of impacts on many social and legal aspects, such as personal freedom, compatibility with cultural practices of Vietnamese families and society, and sensitivity and social consequences of the regulations,” stated Cuong in an online public dialogue in July that year.

He further emphasised the need to protect the rights of gay couples. “The country should adopt a legal mechanism to protect their rights in terms of legal personality, property or children of cohabiting couples.”

For many LGBT people, the minister’s words were a bold step forwards, paving the way for their search for marriage equality, given that the previous Law on Marriage and Family specifically outlawed gay marriage.

The LGBT community did not have to wait long for the next supporter to step up.

“In the angle of human rights, gay people also have the right to live, eat, wear, love, and pursue happiness,” Vice Minister of Health Nguyen Viet Tien said publicly a few months later.

“In terms of citizenship, they have the right to work, study, receive medical check-ups and treatment, and register birth, death and marriage… in line with rights and obligations with the State and society.”

The ban made many homosexuals afraid to come out due to fear of discrimination from families, friends and colleagues and being abandoned, he stressed, calling for the legal recognition of same-sex marriage as it is a human right.

New rules spark hope and motivation

Also in 2012, the Ministry of Justice (MoJ) activated a review of the Marriage and Family Law which, for the first time in Vietnamese history, brought up legal consideration of same-sex marriage.

The ministry asked all government agencies for opinions about revising the law again in an official letter sent in May, 2012, concerned that the community of gays and lesbians was expanding in the country but many lived together without registering a marriage.

“From the perspective of individual rights, marriage between people of the same sex should be recognised,” the letter said.

“The cohabitation of same-sex couples is a real social phenomenon, which results in binding relations and issues concerning property ownership and child custody.”

“The current law may not legalise their marriage but there must be a legal framework to address these issues.”

The MoJ launched a number of policy dialogues with LGBT groups during the formation of the bill.

It also engaged several organisations, including the Institute for Studies and Society, Economy and Environment (iSEE) and the Women’s Union, in civil society consultation to get insight and relevant expertise in the LGBT community and related issues, and to assess impacts of the bill on the society.

“We worked with the Ministry of Justice in many consultation workshops on this bill… We really appreciated the effort of the government in protecting the rights of LGBT people… and to show its acceptance of alternative lifestyle,” Le Phan Anh Thu, iSEE’s Acting Coordinator of LGBT Rights Programme told Vietnam News Agency.

The draft bill was submitted to the Vietnamese National Assembly for debate in 2013, making Vietnam the first country in Asia where the topic was discussed at parliamentary level.

June 19, 2014 was a special day for LGBT people.

After two years of discussion, the NA passed the revised law, with no clause prohibiting marriage between people of the same sex. The new law allowed same-sex couples to co-habit and have wedding ceremonies, but they are not considered a legal family.

Though the act does not recognise gay marriage, an activist called it “quite amazing change in such a short span of time,” given that the LGBT social movement was said to have only started a decade ago.
Despite some disappointments about the outcome, many others felt optimistic. “It may be not completely there yet… but it is good to know it’s moving forward,” said H.H.T, an LGBT activist.

“The new law has positive effects on advocacy to change public awareness as it sends a message that same-sex marriage is not a bad thing.”

“Some were upset, but in return, many others have become more deeply engaged into the community’s activities because they understand if they do not advocate for their own rights, then nobody can,” he added.

“This might be a baby step towards equal marriage, but was an important one that brought us hope and motivation,” Anh Thu added.

“Practically, same-sex couples still are not protected by law but on the other hand, lifting the ban on same-sex marriage reflected a huge change in the mindset of policy makers.”

“LGBT people now can be more confident to not only present their visibility but also to talk about their rights to access services, such as education, legal and medical services”.

Vietnam well ahead in Asia

Vietnam grabbed big attention again in November 2015 when lawmakers took a major step by voting to pass the amended Civil Code that legalises sex reassignment surgery.

Previously, sex reassignment in Vietnam was limited to only those without complete sex organs and those with both male and female sex organs. Now anyone can have sex change surgery and can legally register under a new name and new gender.

The LGBT community is excited for more big changes in the next few years as the new Law on Gender Change is being crafted by the Ministry of Health (MoH) to protect the rights of transgender people.

The law is set to be submitted to parliament for review in 2019 at the latest.

“The bill stipulates how to identify a person whose gender identity is different from his/her assigned sex at birth through psychological evaluations… After that, doctors are allowed to perform medical interventions, such as hormone therapy or breast and genital surgeries,” said Nguyen Huy Quang, director of the MoH’s department of legal affairs.

“If passed, the bill will provide a basic and humane legal framework… for transgender people to live true to themselves and set their bodies free,” he said.

“It’s a work in progress and I am pleased to see the efforts that are going in to considering the different aspects of the bill on protecting the rights of transgender people in healthcare,” Ambassador of Canada to Vietnam Ping Kitnikone told Vietnam News Agency.
“The support of the MoH as well as iSEE clearly shows that the LGBT issue is becoming more and more salient in Vietnam, and that more and more officials and individuals are beginning to see the importance of empowering this community.”

According to H.H.T, his activist peers in the region are impressed with what Vietnam has achieved so far, referring to those from the Asian countries where gay marriage remains outlawed.

“This makes Vietnam one of the leaders in the region”, H.H.T said.

“During our interactions with fellow activists, Vietnam is always being referred to as a beacon of hope with regards LGBT rights in ASEAN,” said Ryan V. Silverio, Regional Coordinator of ASEAN Sexual Orientation and Gender Identity/Expression Caucus (ASC), a regional organisation of LGBT human rights activists in Southeast Asia.

“The revision of the civil code and the Vietnamese government’s openness to LGBT organisations in crafting a new law on gender recognition was positively welcomed by activists.”

If Vietnam adopts the bill, the country will become the sixth in Asia and the second in Southeast Asia to have specific legislation on gender reassignment.

Anh Thu was convinced that it (the adoption of bill) reflects the government’s consistent view – LGBT rights are basic human rights.

“So protecting them is the right thing to do.”

 

20 June 2017
Vietnam has built an LGBT friendly medical centre

Vietnam has built an LGBT-friendly medical centre so the community can have safe access to health care, sexual health information and counselling.
The centre is working towards improving access to health care to trans people especially, as it is currently illegal for people to access hormone of surgery in the country.
Although the country has put laws in place to decriminalise this, they will not take full force until 2019 at the earliest.

As well as decriminalising hormone and surgery treatment, the legislation has introduced more protections for trans people.
The centre will be providing free STI testing as well as providing this extra level of care to trans people,

It will also provide care for those diagnosed with HIV by working with other facilities who may be better equipped.

Based in Ho Chi Minh City, it has been set up by the Men’s Health Centre and G -Link, who promote health care within the LGBT community.
Doctors at the clinic have said that it will greatly improve the care of LGBT people, especially trans people who may be self-prescribing hormones.
Dr Trà Anh Duy is a doctor at Bình Dân Hospital in the same region as the new clinic explained that the clinic was crucial as some trans people “can overdose or use substandard hormones”, he also fears that these hormones might not be administered “in a hygienic way.”
One 24-year-old trans woman said that the community was often scared of seeking medical help in the country because they feared being judged.
She explained that she and friends she knew had bought hormones from Thailand but had bad side effects.

She said: “I could easily buy hormones from people who had visited Thailand for sex-change surgery. Hormones and that kind of surgery are still not available in Việt Nam.
“My friends, who had gone through gender transition, had problems from overdoses because they did not go to a doctor, but just listened to advice from friends.
“They had vomiting and spinal pain, and at times felt dizzy. Others even had bleeding after returning to Vietnam from Thailand where they had sex-change surgery.”

1 March 2017
Viet Nam embraces zero HIV-related discrimination in health car

A demonstration project aiming at reducing HIV related discrimination in healthcare settings is underway in Ho Chi Minh City, as part of the broader effort of the Viet Nam Administration for AIDS Control (VAAC) to intensify anti- discrimination efforts toward ending AIDS by 2030, with support from UNAIDS.

Removing unnecessary fear of HIV among health workers

Inspired by the global movement, Viet Nam embarked on a new initiative in late 2016 to further reduce HIV-related discrimination in healthcare settings. Under the overall guidance of the Viet Nam Administration for AIDS Control (VAAC) and with support from UNAIDS, Ho Chi Minh City spearheaded the adaptation of a HIV-related discrimination survey tool and piloted a survey among health workers and service users in three health facilities in the city.
“We chose both general hospitals and HIV specialized health facilities for conducting this survey,” said Dr. Tieu Thi Thu Van, Director of Ho Chi Minh City Provincial AIDS Centre. “It provides us with scientific evidence of the level of HIV-related stigma and discrimination in health facilities that will inform interventions to create change among health workers. This demonstration project is therefore rather important.”
It is clear from the survey that discrimination related to HIV still exists in healthcare settings. 40% of the respondents who are HIV positive reported having experienced discrimination in health facilities. On the other hand, many health workers (about 70% of all respondents) applied over self- protection measures when taking care of people living with HIV due to their worry of getting HIV infection.
Informed by the results of this survey in late 2016, Ho Chi Minh AIDS Centre is working with the three health facilities to build staff HIV related stigma and discrimination knowledge and enhance their professional skills. A training toolkit has been adapted for Viet Nam based on the findings of this survey, and the training of trainers is underway from 28 February to 3 March 2017 for selected staff of the three health facilities and representatives of people living with and people at higher risk of HIV. Participants at the training of trainer workshop will also discuss plans for rolling out the training and development of a code of conducts related to zero HIV discrimination for their health facilities, as well as the role of community in the project implementation.

Discrimination-free health care for ending AIDS

“HIV-related discrimination in healthcare settings is a major barrier for Viet Nam to maximize HIV service uptake and achieve the 90-90-90 treatment target, so the country can firmly move toward ending AIDS by 2030,” said Mr. Ali Safarnejad, UNAIDS Viet Nam Acting Country Director.
“This is particularly important as Viet Nam is transitioning HIV services from donor financing to social health insurance funds whereby HIV services will be provided mostly at general hospitals and not specialized HIV clinics,” added Mr. Safarnejad.
The agenda on zero discrimination in health care, jointly initiated by UNAIDS and the World Health Organization’s Global Health Workforce Alliance nurtures respect for equality and aims to ensure healthy lives for all.
According to the global agenda, a national action plan on zero discrimination in healthcare settings should embrace seven priorities. Some of these priorities are very relevant for the response to HIV-related stigma and discrimination in Viet Nam, such as providing timely and quality healthcare regardless of HIV or other health status, or because of selling sex and using drugs; respecting patient’s privacy and confidentiality; prohibiting mandatory testing or coercive practices; and, ensuring participation of the affected communities.

Partnership for success

The initiative has been developed and implemented in close consultation with representatives of the Viet Nam Network of People Living with HIV (VNP+) while also engaging members of other HIV key affected populations.
“Reducing HIV-related discrimination is not only the task of health workers. We the people living with HIV also have to take part,” said Nguyen Anh Phong, VNP+ Steering Committee representative in southern Viet Nam. “We will work closely with the three health facilities to find appropriate solutions to address the existing discrimination that suits both health workers and community, so as to mobilize community participation in this effort.”
Participation of people living with HIV and key populations from conceptualization of the initiative, adaptation of the tool kit, conducting the survey, the training of trainers and training sessions at health facilities, as well as monitoring progress at health facilities is key to ensuring the project delivers expected results.
“We will conduct an assessment at the end of this pilot project. I hope lessons learned from this pilot will help further improve the methodology of measuring HIV-related discrimination in healthcare settings and intervention approaches, so we can expand the practice nation-wide,” said Dr. Hoang Dinh Canh, VAAC Vice Director.

22 november 2016
PrEP in HCMC

UNAIDS in collaboration with the Center for Applied Research on Men and Health (CARMAH) and with an agreement of the Viet Nam Administration for AIDS Control (VAAC) and the HCMC Provincial AIDS Center (PAC), plans to implement a PrEP demonstration project among MSM community in HCMC. Linked to the community-based testing pilot that UNAIDS is also conducting in the city, the PrEP project will see 200 high-risk,HIV-negative MSM enrolled on PrEP, and maintained for a duration of 18 months. During the project, those enrolled will be monitored for adherence, tolerance for the medication, and tested for HIV. The evidence generated will demonstrate the feasibility of implementing PrEP in community settings in Viet Nam, and form the foundation of advocacy for adoption of PrEP as an additional measure of HIV prevention for MSM. It will also demonstrate the willingness of MSM to self-pay for PrEP after 12 months.

25 November 2015
Vietnam passes landmark law recognizing transgender people

Ban on gender reassignment surgery has also been lifted

Vietnam has passed a landmark law legally recognizing transgender people and lifting a ban on gender reassignment surgery.

More than 80% of lawmakers Tuesday (24 November) voted in favor of the law change, which will come into effect on 17 January 2017.

Under the new legislation, those who have undergone gender reassignment surgery can change their gender marker and will be given the ‘personal rights in accordance with their new sex,’ the state-controlled VnExpress website reported.

The National Assembly said the law was an attempt to ‘meet the demands of a part of society… in accordance with international practice, without countering the nation’s traditions.’
There are an estimated 270,000 transgender people in the communist country, many of whom travel to nearby Thailand for operations.

‘According to a survey in 2014, four in every five transgender people in Vietnam desire to have [sex reassignment surgery]. Of these 11% had undergone the surgery, mostly made outside of Vietnam,’ said Luong Minh Ngoc, director of Institute for Studies on Society, Economy and Environment.
‘Transgender person can now perform sex change with affordability and safety in Vietnam. It is also an important step forward in recognizing the existence and equality of transgender people to live as themselves.’

Homosexuality and gender dysphoria are still taboo in the Vietnam but in recent years the country has become leader in LGBTI rights in the region.
A ban on gay marriage was lifted earlier this year but same-sex unions remain unrecognized by the law.

26 November 2015
58% of Married Women in Vietnam Have Been the Victims of Domestic Violence: Report

Though the scourge of sexual harassment is well documented in Vietnam (to the point where Hanoi has considered launching gender-specific busses), its ugly cousin, domestic violence, is an even more serious problem, according to a joint United Nations and Vietnamese government report.

At a meeting in Hanoi on November 21 organized by White Ribbon, an Australian campaign to end men’s violence against women, officials learned that 58% of married women “are victims of either or both kind of violence, which causes them heavy physical and mental damage,” reports Voice of Vietnam.

According to Pratibha Mehta, UN Resident Coordinator and UN Development Program (UNDP) Resident Representative in Vietnam, most victims kept quite in the wake of abuse. “87 percent of victims did not seek help due to the lack of available services. Many were also too afraid to speak up due to the fear of stigma, discrimination and further harassment,” she said at the meeting.

To help reduce domestic violence, White Ribbon is working with Vietnamese authorities to raise awareness about domestic abuse. The program focuses on garnering men’s support in stopping and speaking out about violence.

At the conference, Nguyen Thuy Hien, deputy director of the Hanoi-based Women and Development Center, said that having men speak out against the issue is a linchpin for turning the tide.

“The ending of violence against women and girls cannot succeed without the participation of men and boys.”

Nguyen Bao Thanh Nghi, a sociology professor at Ho Chi Minh City Open University, said that while there have been domestic campaigns to address the issue in the past, “they often die prematurely and fail to create systematic and widespread changes,” since they are unable to get male support.

Hopefully, the Vietnamese government will begin to take action on this important issue as it has recently done with sexual harassment.

 

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