News from Vietnam

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

Below is the news from June 2017

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.

10 September 2015
Juvenile abortion rate remains high in Vietnam

A range of obstetrics and gynecology clinics sit along Giai Phong Street, across from Bach Mai Hospital.
Staff members wearing white blouses wait at the front doors of those private facilities, ready to approach anyone who passes by slowly or appears to be seeking an abortion.

It is a tacit understanding that those who come to the clinics want to end their pregnancies rather than receive prenatal check-ups. Most of them are teenagers.

Three young couples between the ages of 17 and 20 who were waiting for an abortion at one of the clinics said they had “made a mistake” and had come to “solve the problem”. One young woman said it was her third procedure.

“You made mistakes, then you end it – no big problem,” a 20-year-old woman calmly told an undercover reporter of Kinh Te Do Thi (Urban Economy) newspaper. “Many clinics offer this service. This is very easy.”
Viet Nam now ranks first in Southeast Asia and fifth in the world in abortions, according to statistics from the Viet Nam National Committee for Population and Family Planning. In fact, the number of abortions among the country’s unmarried teenagers – 300,000 – was significantly higher than other countries near the top of the list for total abortions.

It was reported that Viet Nam sees between 1.2 and 1.6 million abortions each year, and juveniles had 40 per cent of the total abortions last year.

The actual number of juvenile abortions may be higher because many teenagers come to private clinics in order to keep their pregnancies a secret.

Immeasurable

Adolescent abortions could cause serious physical and psychological harm to young women’s health, said Doan Thi Lan Phuong, a senior midwife at the National Hospital of Obstetrics and Gynecology.
“After becoming aware of their pregnancies, teenagers are afraid of being scolded by parents and gossiped about by friends,” Phuong told the Radio Voice of Viet Nam’s Traffic Channel. “Therefore, they tend to seek private health facilities for termination in order to hide their unwanted pregnancy.”

“Having an abortion creates an increased risk of internal bleeding, uterine perforation and many other serious post-abortion complications, which can have long-term effects on women’s health,” Phuong added.
Phuong said the potential risk of secondary infertility among women who had had at least one abortion was three to four times higher than other women.

“Abortion seems just like a simple trick, but its complications are truly immeasurable,” Phuong said.

Heavy on theory, insufficient in practical skills

Sexual and reproductive health education for young people in Viet Nam has been incorporated into other subjects such as biology, or delivered to students through extracurricular activities.

That style of education may make it difficult for youth to practically apply the information to their lives, Nguyen Thu Giang, vice president of the Institute for Development and Community Health, told the Kinh Te Do Thi newspaper.

“Viet Nam does have education programmes on sexual relations and reproductive health for students, but they are mainly theoretical and lack practical knowledge in conformity with the adolescent development age,” Giang said. “Those programmes remain generic. Few of them mention the sensitive elements of culture, gender and sex safety.”

Facts also have shown that reproductive health care programmes in Viet Nam focus on sexuality, conception, contraception, pregnancy symptoms and sexually transmitted diseases, but do not provide students with the necessary practical skills, behaviour and ways to solve problems in each particular situation.

“I have attended many training courses on reproductive health, but I still do not know how to respond to the ‘requirements’ of my boyfriend,” said a student of the Social Labour University, Dam Phuong Nhung.
According to Le Thi Quy, director of the Institute for Gender and Development, the cause of adolescent pregnancy stems from cultural acceptance of premarital sex among youth.

“They ignored everything rather than weighing the pros and cons of having sex before marriage,” Quy said.

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