National Technical Workshop on People Who Inject Drugs (PWID) and HIV

On July 29-30 in Hanoi, CDC and the Vietnam Administration on AIDS Control (VAAC) hosted the first national technical workshop to share information and identify strategies to address the HIV/AIDS service needs, gaps, and challenges for people who inject drugs (PWID).  The workshop focused on service coverage, accessibility, and quality of 4 key areas: 1) population estimations and risk factors, 2) harm reduction interventions, 3) HIV testing and counseling, and 4) care and treatment.

Over 100 participants from the Vietnam Ministry of Health, international organizations (PEPFAR, CDC, FHI360, SAMHSA, USAID), and 10 provinces with the highest number of PWID in Vietnam attended the workshop.

Summarized below are a few of the key issues and lessons learned:

• PWID and partners make up > 70% of new HIV infections.
• PWID are indeed reducing their risk behaviors. Half of the PWID we spoke with did not believe they were personally at risk for HIV because they “did not share needles”, “knew how to safely inject” and/or “did not care about sex”.
• PWID are late to care and late initiation of antiretroviral therapy (ART)
• However, less than 30% of PWID were tested and knew about their HIV status over the past 12 months in the majority of provinces and late diagnosed. Coverage of NSP and MMT still very low.
• What works: correct and consistent condom use, needle and syringe programming (NSP); methadone maintenance therapy (MMT); HIV testing and counseling (HTC); ART.
• Innovative outreach models (peer driven intervention, post-test care and support, incentive-based intervention, etc. ) showed improved outcomes in reaching, linking PWID with HIV testing, care and treatment.
• Offering HTC annually and initiating immediate ART in prioritized key populations, including PWID, effectively reduces new HIV infections and leads to future cost-savings.

Recommendations:

• Expand innovative outreach model to reach and link PWID with HTC and care and treatment services more effectively.
• Low perception of risk suggests needs to expand coverage of NSP and condom accessibility.
• Promote early testing and re-testing through various VCT models at different settings.
• Advocate and support for full scale-up and wider implementation of HIV rapid testing, rapid results and finger prick testing.
• Develop an effective referral  & tracking system.
• Promote clear benefits of early access to and retention in MMT and care and treatment.

Integrate HIV servicesinto primary healthcare structure.