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Policy dialogue Conference in Nha Trang on the implementation of HIV/AIDS, drugs and prostitution policies

Sept. 10, 2018

On May 17th 2017, Conference on HIV/AIDS, drugs and prostitution policies in Nha Trang was held at the Luxury Hotel, 24 Tran Phu, Nha Trang, Khanh Hoa. This was held at the Central, belonging to a serial of events that had taken place in the North (Hanoi) and the South (HCMC) (click to see article)
 
Delegates included Mr. Dang Thuan Phong, Vice Chairman of the National Assembly's Committee for Social Affairs, representatives from the Department of Social Evils Prevention (DSEP), Vietnam Administration for AIDS Control (VAAC), Center for Supporting Community Development Initiatives (SCDI) and the congressional delegates of Lang Son, Quang Ngai and representatives of community groups such as Bo Cong Anh (Dandelion), We are women, Sac mau bien (Colors of the sea), Hoa nang (Sun flower), La do (Red leaf).
 
At the conference, the communities contribute their voices to the dialogue. A prominent issue in the IDU and PLHIV community is the persistence of discrimination in hospitals, difficulties in obtaining loans, paperwork, reintegrating the society, difficulties of patients with or without health insurance. Because of concerns about disclosure of personal information, many customers refuse to buy health insurance. HIV positive clients suffer from hardship, many cases are not treated right away and they are required to have test, at a high cost, leaving the community with no money for testing to be ignored and become untraceable, and when this happens, the ability to transfer HIV to others will be very high. Other issues, such as difficulty to buy health insurance, expired health insurance, shortage of medicine... also reflected.
 
"More than 90% of people who use drugs don’t have a job, many of them don’t know about Government support policies. People discharged from compulsory drug detox center are not allowed to have personal documents done, are not registered for ARV and methadone treatment. "
Tran Duy Khanh (Dandelion Group)
 
Transgender communities are facing many barriers, such as discrimination from the society; which leads to difficulties in getting an official job, so they mainly work on temporary jobs, such as prostitution, street singing, and this behavior leads to an increase in HIV prevalence. In addition, according to a report from the MSM-TG community, methamphetamine is used frequently, which can lead to unsafe sex. Between 2016 and now, the HIV-positive rate is on the rise among MSM-TG community, requiring an effective prevention measure for this community.
 
In the sexworker communities, although street sexworkers are no longer arrested and sentenced unreasonably, they still have many problems of having no papers, they often hire motorbikes when working so they usually have to pay the bike owners; the unreasonable money seizure is still rampant . According to the policy, sex workers are allowed to borrow money but in the reality, they’re often refused to get loans, many cases of violence against sex workers are not yet solved...
 

 


Delegates from PAC, VAAC, and DSEP actively received comments from the community. Mr. Dang Thuan Phong outlined the issues of the communities as follows:
 
- About identification and barriers to health insurance: The officials will look for a solution to support the purchase of health insurance for people without official documents. There is no health insurance yet for drugs addicts, only for people with HIV, but the law on health insurance is universal. People who use drugs are no longer considered social evils, but patients instead, therefore they need health insurance and the policy will need to be revised. The definition of drug addicts has been diverted, so the policy has to be revised too.

- About accessing to harm reduction services: It is difficult to buy health insurance for households because many people without a residence permit will not be able to register for households to purchase health insurance. About interconnected ARV treatment: Many people who buy health insurance in the province but are forced into the commune, therefore many shortcomings will prevail and need to consider. About support policy: There are written policies but the implementation did not bring much benefit due to procedural barriers, furthermore, the psychological complex also causes patients to hesitate to receive support. Funding for HIV test cost is a challenge for the Government, and it is necessary to consider thoroughly, and the participation of not only from the Government, but also from insiders and their families, is critically important. The solution that allows peer groups to help clients will also be recognized for inclusion in the policy study.
 
- For challenges in borrowing loans and reintegration: Although the policy has been there, the capital is large but the disbursement is still not as effective. Therefore, this is a matter for the Government to improve, especially in the way of creating livelihoods, and it is necessary to continue completing other following procedures. Procedures of loan procurement in communes and wards are still difficult, so the KP still don’t have access to capital, the disbursement is still low, which needs action to remove the redundant procedures set up by the commune, and adjust the policy if needed. It is also necessary to adjust the support for community reintegration: The unjustified “protection cost”, exploitation and punishment of sex workers are problems detected in the police at grassroots level and need to be reviewed and revised.
 


In KP, according to Mr. Phong, "Stigma and discrimination are still prevalent, we advocate for social change in awareness and behavior but we must also change ourselves to sympathize with the KP. It is also necessary for you (the KP) to overcome yourself; therefore the society can understand you better". The participants noted the problem that transgenders are encountering as well as the risk of HIV transmission and will consider these when constructing the Transgender policy (click to read article).

About high possibility of HIV transmission among KP groups, especially MSM: it’s important to promote the mass communication. The charge for methadone maintenance treatment (MMT) is also a matter of further discussion.
 
Previously, on May 16th 2017, a previous discussion on drug, prostitution and HIV related issues had taken place in preparation for the policy dialogue Conference on May 17th 2017, with the participation of Dr. Nguyen Hoai Huong, SCDI Deputy Director and Nguyen Thi Kim Dung, SCDI Network Program Manager and representatives from the above mentioned community groups.
 


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