On World AIDS Day, WHO encourages Viet Nam to address critical gaps that remain in the prevention, testing, and treatment of HIV and to move towards the global target to end AIDS epidemic by 2030. Viet Nam has demonstrated a high-level of commitment
and innovative approaches in the fight against HIV/AIDS.
In November 2016, Nguyễn Xuân Phúc, Prime Minister of Viet Nam, paved the way for health insurance funds to be used for the national procurement of antiretroviral (ARV) medicines. This important decision provides sustainable financing sources for antiretroviral therapy (ART) for people living with HIV/AIDS. Furthermore, the Prime Minister’s decision directed local authorities to support co-payment for ART and to purchase social health insurance cards for people living with HIV.
“This decision is a critical step for Viet Nam in increasing domestic financing of HIV treatment and care, and constitutes an important advancement towards a sustainable health sector response to HIV/AIDS in the country”, stated Dr. Lokky Wai, WHO representative to Viet Nam. “I would like to congratulate Viet Nam for its timely action and acknowledge the great efforts made so far in improving the access of people living with HIV to appropriate treatment. At the same time, it is essential that Viet Nam’s response ensures no one is left behind by paying attention to the needs of the most vulnerable persons”, Dr. Wai emphasized.
I would like to congratulate Viet Nam for its timely action and acknowledge the great efforts made so far in improving the access of people living with HIV to appropriate treatment.
In spite of this important decision, more than half of the people living with HIV in Viet Nam are not yet covered by health insurance. The broader health sector encourages all people in Viet Nam, including the people living with HIV, to join the national Health Insurance.
WHO launches new guidelines on HIV self-testing and assisted partner notification to reinvigorate the global HIV response, ahead of the World AIDS Day 2016
On World AIDS Day 2016, WHO reiterates its call for people to be informed of their HIV status. Globally, more than 14 million people with HIV, or 40% of all people with HIV, do not know their HIV status. WHO launched new guidelines on HIV self-testing and partner notification services to increase testing for people at greater risk of HIV, to support earlier diagnosis, and to support access to treatment and prevention.
The guidelines' key recommendations are:
- HIV self-testing should be offered as an additional approach to HIV testing services.
- Voluntary assisted partner notification services should be offered as part of a comprehensive package of testing and care to people with HIV.
HIV self-testing has been shown to be an empowering, discreet, and highly acceptable option for many users - this includes men, young people, health workers, pregnant women, and general population groups. The WHO guidelines stress that as with any HIV testing approach, self-testing should always be voluntary and non-coercive. Anyone with a positive self-test result should seek confirmatory tests at a health clinic, be provided with information about HIV, and be provided with timely support to counselling on prevention, treatment, and care services.
Further, WHO advises that people living with HIV be encouraged and assisted to inform their partners about their potential exposure to HIV infection, either personally or with the help of health workers. This process is called HIV partner notification – it aims to encourage people living with HIV to help their sexual and drug-using partners test for HIV, so that they too can benefit from treatment, if they have HIV. These tests must always be voluntary and with the explicit consent of the person living with HIV.
In Viet Nam, many people living with HIV still do not know their HIV status. Late diagnosis and late treatment initiation are still common, leading to people and communities to receive limited benefits of ART. These new WHO recommendations have important implication for Viet Nam and should be translated into its national HIV response.
The effectiveness of community-based testing and treatment demonstrated in Viet Nam
Like other countries in the Region, Viet Nam’s epidemic is concentrated among key populations. Knowing that the HIV response must address barriers preventing key populations from accessing services, the Viet Nam Authority of HIV/AIDS Control (VAAC) has been collaborating with WHO since 2011 to model the benefits of early ART initiation. The key focus is on people who inject drugs and other key populations. In addition, the services are focused on providing community-based HIV testing services in challenging locations.
In Thanh Hoa province, village health workers were trained to provide testing services to key populations and their partners in their communities to overcome the difficulties in accessing health clinics in the mountainous areas. In Thai Nguyen province, peer educators were trained to provide testing and prevention services to overcome the stigma and discrimination at health facilities. In both provinces, individuals with positive results were linked to health care facilities for confirmation testing and treatment, and care services.
The pilot implementation in Thanh Hoa and Thai Nguyen demonstrated the feasibility of community-based HTS in accessing “hard to reach” high risk key populations. In 2015, the community-based approach yielded a HIV prevalence that was six times higher among those tested than the facility-based approach. Viet Nam’s national guidelines on HIV testing are being updated to include this approach.
The community-based HIV testing service approach, which can also incorporate HIV self-testing, is an important step for Viet Nam to reach the first of the United Nation’s 90–90–90 targets – for 90% of all people living with HIV to know their HIV status by 2020.
Terminology:
Antiretroviral therapy (ART) consists of the combination of antiretroviral (ARV) drugs to maximally suppress the HIV virus and stop the progression of HIV disease. ART also prevents onward transmission of HIV.
90/90/90 is a treatment target to help end the AIDS epidemic. By 2020, 90% of all people living with HIV will know their HIV status; 90% of all people with diagnosed HIV infection will receive antiretroviral therapy; and 90% of all people receiving antiretroviral therapy will have viral suppression.
The experiences of the community based HIV testing service in Viet Nam is also featured in the WHO’s Progress report 2016: Prevent HIV, test and treat all - WHO support for country impact.
Feature story: Test early and treat all to eliminate AIDS: Viet Nam demonstrates community-based testing and treatment