Viet Nam

Health and HIV Situation

It is estimated that there were 293,000 people living with HIV in Viet Nam in 2007. The national HIV prevalence among the general population is estimated at 0.53%. Cumulative reported data has indicated that there were 132,628 HIV infection cases, 26,828 AIDS cases and 15,007 deaths due to AIDS as of 31 August 2007. Out of all reported HIV infection cases, 78.9% are in the 20-39 age group and 85.2% were among men.

There are concerns that HIV infections among young people are on the rise as well as HIV transmission through heterosexual contact.

Viet Nam currently experiences a concentrated epidemic with at-risk populations including injecting drug users (IDUs), female sex workers (FSWs) and men who have sex with (MSM). The national HIV prevalence rate among IDUs has been estimated at 28.6%, and at 4.4% for FSWs. In 2006, the HIV prevalence rate among MSM was 9.4% in Ha Noi and 5.3% in Ho Chi Minh City.

Studies show that IDUs have engaged in unprotected sex with different partners, including FSWs. Unprotected sex between IDUs and FSWs reached 55% in An Giang and 54.8% in Ho Chi Minh City. The rate of condom use between street FSWs and their clients was low at 37%, and condom use among MSM remains also low. There are concerns on the high rate of FSWs injecting drugs.

The Ministry of Health of Viet Nam has estimated that 72,970 people living with HIV will need to receive ARV treatment by 2010.

National HIV Programme and Response

The first national strategy for Viet Nam's response to HIV/AIDS, the National Strategy on HIV/AIDS Prevention and Control in Viet Nam up to 2010 with a Vision to 2020, sets clear strategies and ambitious goals to control the spread of HIV.

It uses a comprehensive set of prevention, care and treatment interventions, harm reduction programmes, and provisions for access to ARV treatment for people living with HIV/AIDS (PLWHA). High risk groups, such as injecting drug users and sex workers are the National Strategy's main targets.

The National Strategy's goals include: integrating HIV/AIDS prevention and control into local social economic development plans across the country; reaching out to people with HIV prevention activities in rural, urban and mountainous areas; implementing a comprehensive intervention programme to control HIV transmission from high-risk groups to the general population. It also ensures care and appropriate treatment for PLWHA so that 90% of HIV/AIDS adults, 100% HIV infected mothers, and 100% of HIV/AIDS infected or affected children receive appropriate care, treatment and counselling services.

The strategy also aims to provide 70% of AIDS patients with ARV treatment and to improve the surveillance, monitoring and evaluation systems for HIV/AIDS prevention and control.

In addition, the condom promotion programme has been implemented.

However, major challenges remain in the national response to the epidemic. Legal regulations on HIV prevention need to be harmonized and implemented by key sectors at all levels.

On HIV and mobility, the National Strategy aims to collaborate with neighbouring countries on HIV prevention and control and to expand intervention measures to mobile populations.

In 2007, the Government Decision on Cross-Border HIV/AIDS Prevention and Control was approved and, like the other nine ASEAN Member Countries, Viet Nam signed the ASEAN Declaration on the Protection and Promotion of the Rights of Migrant Workers.

Viet Nam's Labor Law stipulates that Vietnamese employment agents should provide migrant workers with orientation prior to their departure. Mandatory tests including HIV testing are required as requested by receiving countries. No pre- or post-test counseling is ensured and breach of confidentiality of results remains an issue.

Vietnamese migrant workers have almost no access to health information in destination countries, mainly due to language barriers and lack of information. Migrants returning with HIV or TB face discrimination. No medical, social and financial services are in place to help them reintegrate. The issue of referral services for migrants who test HIV positive abroad still remains to be addressed.

Migration Patterns

Viet Nam is a major sending country of migrant workers to South-East and East Asia with Malaysia and Taiwan the top destination countries. The Ministry of Labour, War Invalids and Social Affairs (MOLISA) estimates that 400,000 Vietnamese workers were abroad by mid 2006.

There were 37,941 recorded migrant workers in Malaysia in 2006 compared to 24,605 in 2005, and 22,784 migrants employed in Taiwan in 2005 compared to 14,127 in 2006. To a lesser extent, Vietnamese migrant workers are employed in the Republic of Korea, Japan and in the Gulf countries.

Estimates from MOLISA refer to officially deployed migrant workers; however many have moved to bordering Cambodia, Lao PDR and China without going through official channels.

Although there is lack of reliable data on the number of Vietnamese workers in Cambodia, it is estimated that there are at least 150,000 of them there.

As in the Philippines, migration in Viet Nam is considered a socioeconomic strategy to alleviate poverty. Recent estimates show that remittances from Vietnamese migrant workers amounted to USD 6.82 billion in 2006 and are expected to exceed USD 7.5 billion in 2008.

Viet Nam has become a source and destination country for trafficked men, women and children. Although substantive information on its scope and health risks is lacking, the migration phenomenon of Vietnamese brides to the Republic of Korea and Taiwan raises trafficking, abuse and HIV vulnerability concerns.

Thousands of Vietnamese refugees are abroad and internal displacement remains an issue. UNHCR estimates that there were 374,000 Vietnamese refugees as of January 2007, one of the highest recorded worldwide.

HIV Response for Migrant Populations: Gaps and Opportunities

HIV and mobility issues have been recognized in Viet Nam, but provisions on pre-departure HIV prevention, care, treatment, support, counseling and VCT services for migrants and mobile populations are lacking. Migrants and mobile populations have been included in the National Strategy, but specific HIV interventions among this group remain to be developed.

Greater national efforts to mainstream HIV/AIDS interventions among migrants and mobile populations are needed.

Quality pre-departure HIV information and prevention, counseling, and referral services remain to be put in place. Referral services for migrants, and provision of HIV prevention, care and treatment, are also needed for returning migrants.