30 November 2009
Ha is a 34-year-old drug user from Lang Son province who started using heroin when he was 18 or 19 years old, “simply out curiosity”. He stayed in a detoxification centre for two years but relapsed soon after returning home. Six years ago he began injecting and in 2005, after a test at a local health clinic, found he was HIV positive.
The head of the clinic persuaded Ha to become a peer educator to prevent other injecting drug users from making the same mistakes. Ha says: “I’ve got HIV and there’s nothing I can do about it. But by joining the peer educator group I can help other users who I can approach easily, and tell them to stay away from HIV by using a clean syringe. I feel good about it.”
Once a week, he comes to the local health centre to collect 100 syringes, a box of 144 condoms and 50 health coupons that can be exchanged for a condom or a syringe at a local pharmacy. He usually distributes them all and sometimes needs even more. Ha also goes to injecting ‘hot spots’, where he collects used needles and syringes to take back to the health clinic for safe disposal. “Since joining the project, I no longer share needles and advise others do the same,” he says.
Face to face action
Since the start of the programme, peer educators like Ha have been covering more and more injecting hot spots, from 300 sites in 2005 to over 6,000 sites in 2008, offering face to face support to drug users. Syringe distribution has been phenomenally successful, from 200,000 in 2005 to more than 14 million in 2008. As a result, HIV prevalence in new injectors in the province has fallen dramatically, from over 30% in 2004 to 6% in 2007.
At the end of 2007, it was estimated that there were about 300,000 people living with HIV in Vietnam. The national HIV infection levels are the highest in South-East Asia and the epidemic has grown rapidly - the estimated number of people living with HIV doubled between 2000 and 2005.
According to UNAIDs, injecting drug use and unprotected commercial sex are two of the major factors that explain the growth in the epidemics across of several Asian countries, including Vietnam.
Other efforts are underway alongside the peer education programme, including methadone treatment and sexually transmitted disease diagnosis and treatment, to support people who are vulnerable to HIV in Vietnam.
Facts and stats
- DFID started the £17.5 million ‘Preventing HIV Programme’ (PHP) in 2003, with technical assistance from WHO Vietnam.
- The programme has focused on harm reduction strategies for high risk groups, including providing condoms and clean syringes.
- DFID is providing £18 million to form a joint harm reduction programme with the World Bank in Vietnam that will run until 2012, with WHO's continuous technical assistance.