Stigma hurts HIV diagnosis, treatment

HIV patients receive treatment at Phạm Ngọc Thạch Hospital in HCM City (Photo VNA)

“Stigma and discrimination related to HIV remain among the biggest barriers to universal access to HIV health services, and this leads to a high number of AIDS-related deaths,” said Marie-Odile Emond, country director of UNAIDS (United Nations Programme on HIV/AIDS) Vietnam.

Despite great efforts from the Government and affected communities over the years, discrimination still exists in schools, workplace, family, community and healthcare facilities, she said at a conference held in HCM City on December 1.

This has hindered Vietnam’s progress towards achieving testing and treatment 90-90-90 targets (90 percent of all people living with HIV will know their HIV status; 90 percent of all people with diagnosed HIV infection will receive sustained antiretroviral therapy; and 90 percent of all people receiving antiretroviral therapy will have viral suppression) and the goal of ending AIDS by 2030, she said.

Vietnam has a clear supportive legal framework that addresses HIV stigma and discrimination, including the Law on HIV/AIDS Prevention and Control and many sub-law instruments.

“The challenge often lies in inconsistent enforcement of these across all sectors and at all levels, and as the law cannot cover all situations,” she added.
In 2015, UNAIDS launched a fast-track approach, focusing on innovative interventions to reduce discrimination in healthcare settings in large cities, including HCM City.

The pilot project was implemented between September 2016 and December 2017 in three health facilities in HCM City: Pham Ngoc Thach Hospital in HCM City, District 6 Hospital, and District 4 Preventive Medical Centre.

The project includes two major components: assessment of sigma and discrimination in healthcare settings and interventions to reduce HIV related sigma and discrimination.

After more than a year of implementation, the results and useful lessons learned from the project will inform the national policy to reduce discrimination in healthcare settings and expand this effort in other high-burden provinces, with support from development partners.

Findings from the project show that it was necessary to measure stigma and discrimination in healthcare settings to develop evidence-based interventions that would improve the quality of health care services.

A participatory training approach with healthcare workers to share views and agree on action, as well as dialogue between patients and health care providers to better understand stigma and discrimination issues and health facilities’ procedures, are critical factors to reduce HIV-related stigma and discrimination.

Discrimination comes from limited awareness and knowledge of HIV, HIV transmission, and lack of universal precautions among healthcare workers, said Le Tien Dung, deputy director of Pham Ngoc Thach Hospital.

The programme’s participatory training with healthcare workers proved useful and led to initial changes, according to Dung.-VNA