Treating tuberculosis has never been easy. Even for those without underlying health conditions, the journey is filled with challenges—side effects from medication, prolonged fatigue, and life disruptions. But for individuals who not only suffer from TB but also use drugs or are undergoing Methadone treatment, like Mr. N.Q.H. from Hai Phong, that fear becomes an almost insurmountable barrier.

A fear that persisted through two abandoned treatments

H. was first diagnosed with tuberculosis after joining the DRIVE* research conducted by SCDI in 2019. With support from community outreach workers, he began treatment at Hai Phong Lung Hospital. However, after just three months, he dropped out.

"At the time, I was still using drugs. Taking TB medicine completely drained me. I couldn’t work, I was always exhausted and depressed. By the third month, I couldn’t take it anymore. I was afraid of the constant fatigue, and even more afraid of taking pills every single day," H. shared.

In 2021, after coughing up blood, he was once again diagnosed with TB. Although he resumed treatment, by the fourth month, when his symptoms had subsided, he stopped taking medication again.
“I took so much medicine that I constantly smelled antibiotics on myself. Just thinking about it terrified me.”

By late 2024, as part of the DRIVE-TB*—a community-based research aimed at controlling and eventually eliminating TB among people who inject drugs in Hai Phong, Vietnam—test results showed that H. had relapsed. This time, however, he refused treatment. The trauma from the previous two treatments held him back. “I felt fine—no cough, no fever, no symptoms. And after going through treatment twice, I was terrified,” he admitted.

But things took a turn for the worse. Persistent coughing and shortness of breath finally convinced him that he was truly ill. Ms. Loan, a member of the Vong tay Be ban community group implementing the DRIVE-TB project, visited his home to encourage him to start treatment. Thanks to her support, H. agreed. “I made up my mind. This time, I won't give up halfway.”

Photo: H. attends a group TB information session at the Vong tay Be ban community office.

Overcoming fear

Treating TB in people who use drugs presents unique challenges. The interaction between TB medications and Methadone, the severe side effects, and withdrawal symptoms often make it difficult for patients to follow the treatment plan. In many cases, the inability to adjust Methadone dosage adds to the fatigue and discomfort, increasing the likelihood of patients dropping out. Additionally, limited access to information, financial difficulties due to inability to work during treatment, and other stressors often push patients to give up.

After years of implementing community-based activities, SCDI and the community outreach team have developed a deep understanding of the challenges faced by patients like H. The project tailors support to the needs of each individual and stands by them through their hardest moments.

Currently, H. is in his third week of a combined treatment regimen of Methadone and TB medication. Loan is helping coordinate with the doctors at his Methadone clinic to minimize drug interaction side effects. Although he still struggles with sleepless nights due to TB medication side effects, things are improving.
“I’m still tired, but I’m determined. I’ll see this through for my health and for my child,” he said.
“With support from Ms. Loan and the project, she reminds me to take my medicine on schedule. She even spoke to my family so they can encourage me to finish treatment and reduce the chance of relapse like before.”

Photo: Project staff visit H.'s home to encourage him, remind him about his medication schedule, and provide nutritional support during treatment.

Like Mr. H., many people with TB have received support through the DRIVE-TB project to undergo screening, receive treatment, and successfully complete their treatment journey. The project helps patients buy health insurance to ease financial burdens during treatment. It also provides nutritional packages and covers medical check-up costs for those in need.

One of the project’s highlights is the active involvement of community group members—outreach workers with firsthand experience in supporting drug users. These dedicated individuals, like Loan, visit patients weekly or monthly, monitor side effects, give nutritional advice, coordinate with Methadone clinics, remind patients of their medication schedule, and provide emotional support. These efforts have had a real, tangible impact, helping TB patients—especially those who use drugs—overcome their “fear” and win their battle against tuberculosis.

* DRIVE (Drugs and Infectious Diseases in Vietnam): Ending the HIV Epidemic Among People Who Inject Drugs in Hai Phong was a collaborative research project conducted by SCDI, Hai Phong University of Medicine and Pharmacy, University of Montpellier (France), and New York University (USA) from October 2016 to May 2020. It was funded by France’s National Institute for Health and Medical Research (ANRS|MIE), L’Initiative - Expertise France, and the U.S. National Institute on Drug Abuse (NIDA). In addition to HIV-related activities, sub-projects included: DRIVE-C – eliminating Hepatitis C among people who inject drugs, DRIVE-MIND – mental health interventions for people who use drugs

** DRIVE-TB implemented by SCDI since 2023, evaluates the effectiveness of community-based interventions in preventing and controlling TB among people who inject drugs in Hai Phong. The project aims to bridge the gap in TB elimination efforts for this group and continues to engage experienced community outreach workers who have previously worked on DRIVE since 2014.

Learn more about DRIVE-TB and its key achievements in 2024 [HERE].