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Viet Nam

 The following is an excerpt from the ANCD report:

The link between amphetamine-type stimulant use and the transmission  of HIV and other blood-borne viruses in the Southeast Asia region

The Socialist Republic of Viet Nam has a population of 86.1 million. The country is bordered by China in the north, Lao PDR to the northwest and Cambodia to the southwest. The capital is Hanoi with a population of 6.5 million. Viet Nam is a signatory to the IDADIN.

Amphetamine-type stimulant use

While heroin and opium remain the drugs of most concern in Viet Nam, the use of both crystal methamphetamine and ATS pills is increasing. ATS collectively are the third ranked drugs of concern. In 2009 ATS drug users comprised 4 per cent of all drug users (United Nations Office on Drugs and Crime, 2010b). The use of crystal methamphetamine was first recorded in Viet Nam in 2008 and most crystal methamphetamine users are young people living in cities such as Ho Chi Minh and Hanoi (United Nations Office on Drugs and Crime, 2010b). The use of ATS pills is also reported to be high among construction and mining workers and those in the transport industry.

Manufacture, trafficking and seizures

The United Nations Office on Drugs and Crime (2010b) reports that a large but unspecified quantity of ATS is manufactured in Myanmar and trafficked by land through Cambodia and into Viet Nam. Almost 4kg of crystal methamphetamine and 6kg of pills plus 500 000 pills were seized in 2009 (United Nations Office on Drugs and Crime, 2010b). This represents a significant increase in seizures for Viet Nam. The country is also concerned with the increase in activities involving international criminal drug organisations, in particular from Africa (United Nations Office on Drugs and Crime, 2010b).

Injecting drug use

Viet Nam has an estimated 125 000 people who inject drugs (0.25% prevalence among 15–64 year olds), mostly injecting heroin and to a lesser extent opium (United Nations Office on Drugs and Crime, 2010b). No information on the injection of ATS was available.

Drug-related arrests

During 2009 there were more than 25 000 drug-related arrests. Unfortunately drug arrests were not separated by drug type or gender (United Nations Office on Drugs and Crime, 2010b).

Drug treatment

Viet Nam has 70 provincial drug treatment centres and more than 700 drug treatment units at the district level (Hagarty, 2010; United Nations Office on Drugs and Crime, 2010b). Of the estimated 65 000 drug users in treatment in 2009, 98 per cent were admitted for opiate use and 1 per cent for ATS use (Devaney, Reid & Baldwin, 2006). Information on specific drug treatment for ATS was not available.

In an updated Viet Nam Country Report (Viet Nam Ministry of Health, 2010), it was noted that a series of measures had been taken in 2009 to improve treatment and rehabilitation including developing ‘diversified and socialised’ models of treatment, improved skills and capacity for staff and applied remedial methods, and concentrated rehabilitation programs (p.6). More than 8000 people were admitted for compulsory treatment compared to 1900 who volunteered for treatment. The report noted however that the relapse rate following all treatment remained high and ‘there have remained limitations and shortcomings’ (p.9).

HIV in the community and among injecting drug users

The population HIV prevalence in Viet Nam is 0.53 per cent equating to 132 000 cases (Viet Nam Ministry of Health, 2010). The unsafe injection of heroin and opium is thought to be responsible for 55–70 per cent of HIV cases in Viet Nam and the overall estimated prevalence of HIV infection among PWID is 29 per cent (United Nations Office on Drugs and Crime, 2010b). Viet Nam’s HIV epidemic is concentrated among key populations considered to be at high risk of exposure to HIV: injecting drug users; sex workers and their partners; and MSM (Viet Nam Ministry of Health, 2010). Approximately 4 per cent of female sex workers and 9 per cent of MSM are HIV-infected. The interaction between unsafe injecting practices and unprotected sex, in particular among young men, is considered to drive the epidemic in Viet Nam.

HIV testing

Testing for HIV among high-risk groups remains low. Among FSW, MSM and male PWID, 15, 16 and 11 per cent respectively reported being tested for HIV and knowing the results (Viet Nam Ministry of Health, 2010).

HIV anti-retroviral treatment

Treatment for HIV is available in all 64 provinces in Viet Nam, although in 2007 only 28 per cent of those needing treatment were receiving it (Viet Nam Ministry of Health, 2010). Treatment is available for PWID infected with HIV but participation is low at four per hundred PWID (UNAIDS, 2010a).

Prevention education

Two-thirds of FSW, one-quarter of MSM and 43 per cent of male PWID are reported to have participated in HIV prevention programs (Viet Nam Ministry of Health, 2010). Condom use on the last sexual encounter among male and female sex workers was high at 97 per cent. The figure for MSM was lower at 61 per cent, while only one-third of PWID reported using a condom on the last sexual encounter.

Harm reduction

During 2009 up to 95 per cent of PWID accessed needle and syringe programs at a rate of 189 needles and syringes per PWID per year. Between 20.5 million and 34.9 million needle and syringe units were distributed in 2009 (Viet Nam Ministry of Health, 2010).