The Role of Community-based Organizations in HIV/AIDS Prevention and Control

Significant achievements in HIV/AIDS prevention and control

Vietnam has spent more than 30 years responding to the HIV/AIDS epidemic and achieved many important achievements. The most important is the continuous expansion and improvement of the quality of HIV/AIDS prevention and control services.

• In terms of enhancing public awareness of HIV/AIDS prevention and control through communication: Vietnam has done very well, mobilizing the participation not only of the health sector and various authorities at all levels but also of community organizations in communication efforts. The forms of communication are also diverse and rich, not only through mass media such as radio, television, and print media but also through direct communication activities.

Recently, Vietnam has focused on using electronic platforms such as websites, Facebook, and TikTok for communication. This method is favored by the majority of communities and is highly effective. As a result, most people now have a basic understanding of HIV/AIDS prevention and control. Discrimination related to HIV/AIDS has also significantly reduced.

• Vietnam also effectively implemented harm reduction interventions such as distributing and instructing the use of clean needles, condoms, and lubricants for groups with high-risk behaviors. Recently, they have especially focused on interventions for the MSM group. Every year, tens of millions of clean needles and condoms are distributed for free. The treatment of opioid addiction with methadone has also been expanded to all cities and provinces.

Nowadays, more than 50,000 people addicted to opioids are treated with methadone. Vietnam is also promoting HIV pre-exposure prophylaxis treatment with PrEP for more than 40,000 people. This significantly reduced HIV transmission in groups with high-risk behavior. At the peak of the epidemic in the 2000s, the HIV transmission rate of injection drug users was approximately 30%, but now it is only a little over 10%.

• In terms of HIV screening testing: it has covered 100% of district levels with over 1,300 facilities. HIV confirmatory testing has covered 100% of provinces/cities with 204 confirmatory labs. New infection testing has been implemented in 28 provinces/cities. Each year, more than 1 million HIV tests are deployed not only in the health system but also in the community and by the community organizations themselves.
• In terms of HIV/AIDS treatment: there are currently over 167,022 people being treated with ARV and it is very effective. With the proportion of patients on ARV treatment with a viral load below the suppression threshold of 96%, Vietnam is one of the few countries that could reach this figure.

With this effectiveness, it not only helps patients stay healthy but also reduces HIV transmission to the community, and even prevents transmission to their partners. In addition, Vietnam is also implementing hepatitis C treatment for HIV patients and patients undergoing Methadone treatment, with a cure rate of up to 97.4%.

With the continuous expansion of coverage and improvement of the quality of preventive and treatment services for HIV/AIDS, Vietnam has successfully controlled the HIV/AIDS epidemic. For many years, the HIV infection rate in the general population has remained below 0.3%. Along with this, the HIV/AIDS prevention and control program has prevented around 950,000 people from being infected with HIV and has prevented over 300,000 deaths related to HIV/AIDS.

Community organizations greatly contributed to HIV/AIDS prevention and control in Vietnam

• In the above results of HIV/AIDS prevention and control, in addition to the participation of the entire political system and health sector, there is also a significant contribution of social organizations.

Social organizations have been actively involved in most HIV/AIDS prevention and control activities, from giving opinions during the development of laws and legal documents to contributing to the national strategy for HIV/AIDS prevention and control. They have also been instrumental in developing plans, organizing service provision, monitoring and evaluating program implementation. National reports show that community organizations can contribute from 25-50% of service delivery targets, especially services in which community organizations have advantages such as community outreach, providing harm reduction intervention services, HIV testing, and referral for ARV or PrEP treatment consultation.

Randolph Augustin, Chief of the Health Population and Nutrition Office of USAID presents the role of community organizations at the seminar on sustainable finance for HIV/AIDS prevention and control, held by the NA Committee for Social Affairs.

• In terms of HIV testing in the community: Due to the characteristics of Vietnam, the HIV epidemic is still a concentrated epidemic, which means that most HIV-positive individuals belong to vulnerable groups that are often discriminated against, such as injection drug users, sex workers, or MSM. Therefore, the state healthcare system has a harder time reaching these groups compared to community organizations. The latter tend to be more empathetic and understanding toward their own community, making it easier for them to communicate, counsel, and provide services.

Community organizations have contributed to discovering 50% of HIV-positive cases in cities and provinces. In some areas, this figure is 60-70%.

Early testing and treatment of HIV is one of the important solutions to end the AIDS epidemic by 2030. People with high-risk behaviors, when advised to test for HIV early and receive a negative result (not infected with HIV), will be counseled to use preventive measures to avoid HIV infection. If the HIV test is reactive (suspected of HIV infection), they will be advised and referred to a recognized healthcare facility for confirmatory testing, and if confirmed to be HIV-positive, they will receive early HIV treatment.

Early HIV treatment will help keep the patient's immune system strong and lead to a healthy long life. When treated early, ARV can suppress the HIV from replicating, thereby reducing the amount of virus in the blood to undetectable levels, and they will no longer transmit HIV to others through sexual contact (Undetectable = Untransmittable).

• Another advantage of community organizations is that they are very proactive and have an edge in reaching and raising awareness for their target audience. Community organizations conduct outreach and communication through social networking sites such as Facebook, and TikTok, and through livestreams, which are very responsive, innovative, and engaging. Due to this, they easily draw the attention of people with high-risk behaviors.

The role of community organizations in HIV/AIDS prevention and control in Vietnam in recent years has made a significant contribution to controlling the HIV epidemic. Therefore, mobilizing the participation of community organizations in HIV/AIDS prevention and control in the future, as well as establishing a policy mechanism to sustain the involvement of community organizations through state budget funding, is extremely important.