HIV Prevention and Stigma Among High-Risk Populations in Vietnam
Summary
Vietnam’s HIV epidemic remains concentrated among men who have sex with men (MSM), persons who inject drugs (PWID) and sex workers. Despite rapid scale-up of antiretroviral treatment (ART), persistent stigma rooted in social norms and structural inequalities undermines both prevention and care. Socioeconomic disparities, legal constraints and fear of discrimination deter individuals from seeking testing, counselling and harm-reduction services. Recent programme innovations include community-led outreach, peer navigation and confidential eHealth platforms designed to circumvent barriers of cost, anonymity and provider bias. Multifaceted interventions that integrate stigma reduction with tailored biomedical and behavioural strategies have begun to demonstrate reductions in high-risk behaviours and improvements in linkage to care. Vietnam’s experience offers insight into aligning policy reforms, community engagement and service provision to meet global 90-90-90 targets, informing interventions in other settings with concentrated epidemics.
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Technical terms
Stigma: A social process of devaluation or discrimination against people living with HIV based on moral or cultural beliefs.
Key populations: Groups at elevated risk of HIV infection, including MSM, PWID and sex workers, who often face legal and social marginalisation.
Men who have sex with men (MSM): Individuals assigned male at birth who engage in sexual activity with other men, irrespective of sexual identity.
Persons who inject drugs (PWID): Individuals who administer psychoactive substances via injection, facing heightened HIV risk through needle sharing and social exclusion.
Antiretroviral treatment (ART): Combination drug regimens that suppress HIV replication, improve immune function and reduce onward transmission.
HIV care cascade: The sequence of steps from HIV diagnosis and linkage to care through sustained treatment adherence and viral suppression.
References
- Individual‐level socioeconomic status and community‐level inequality as determinants of stigma towards persons living with HIV who inject drugs in Thai Nguyen, Vietnam. Journal of the International AIDS Society (2013).
- Stigma against patients with HIV/AIDS in the rapid expansion of antiretroviral treatment in large drug injection-driven HIV epidemics of Vietnam. Harm Reduction Journal (2019).
- An exploratory assessment of the preference for eHealth interventions to prevent HIV and sexually transmitted infections among men who have sex with men in Hanoi, Vietnam. BMC Public Health (2020).
- Structural barriers to HIV prevention among men who have sex with men (MSM) in Vietnam: Diversity, stigma, and healthcare access. PLOS ONE (2018).
- Persisting stigma reduces the utilisation of HIV-related care and support services in Viet Nam. BMC Health Services Research (2012).
- Effectiveness of community outreach HIV prevention programs in Vietnam: a mixed methods evaluation. BMC Public Health (2019).
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