By 2020, the Vietnamese government has committed to having 90% of patients receiving ART as well as 90% of those on ART having successful viral suppression. Factors that influence adherence to ART among patients are essential to allowing the adequate care. This study was conducted across 8 outpatient clinics in Hanoi and Nam Dinh province and included 1133 patients living with HIV. Socioeconomic factors such as marital status, education, employment as well as health-related quality of life improvements were investigated as potentially being associated with adherence rates of ART patients. Through multivariate logistic regression analysis with self-reported ART adherence and VAS scores, this study was able to identify marital status and employment as two factors associated with positive adherence scores. Similarly, health problems, stigmatization, and duration on ART were associated negatively with ART adherence. Knowing that these factors may be linked to adherence rates, they can be preemptively managed with patients to enhance adherence rates and achieve successful viral suppression.

The Tobacco Harm Prevention Law has been promulgated in 2012 in Vietnam, prohibiting smoking in public places such as restaurants except for designated smoking areas. However, currently, evidence about Vietnamese customers’ and restaurants’ compliance with the Law is constrained. This study aimed to explore customers’ perceptions; attitudes and practices towards the compliance with tobacco control regulations in the restaurants in Hanoi, Vietnam. A cross-sectional study was performed in October 2015 with 1746 customers in 176 communes in Hanoi, Vietnam. Data about customers’ perceptions on how restaurants comply with the smoking control law and whether customers smoking actively or experienced SHS in restaurants in the last 30 days were collected. Multivariable mixed effects logistic regression model was used to determine the factors related to smoking in the restaurant. Most customers were aware of the law on Tobacco Harm Prevention (79%; n = 1320) and regulations that prohibited smoking in restaurants (78.4%; n = 1137). While 75.8% (n = 1285) of customers perceived that they did not see or rarely saw no-smoking signs, 17.7% (n = 481) of customers reported that they frequently saw direct marketing of tobacco in visited restaurants. About one-fourth of customers witnessed that the staff reminded customers not to smoke inside restaurants (28.8%; n = 313), and 65% (n = 1135) sometimes or always were exposed to secondhand smoke in their visited restaurants. People who were female (OR = 0.02, 95% CI = 0.01–0.05) were less likely to report their smoking in the restaurant than their counterparts. Those having higher age (OR = 1.03; 95% CI = 1.01–1.06), high school education (OR = 2.14, 95% CI = 1.07–4.26), being office workers (OR = 3.24, 95% CI = 1.33–7.92) or unemployed (OR = 4.45; 95% CI = 1.09–18.15) had a higher likelihood of reporting to be restaurant smokers than those having lower high education or students, respectively. This study highlighted a low level of perceived compliance with the smoke-free law in Vietnamese restaurants. Improving the monitoring systems for the enforcement of the smoking law in restaurants should be prioritized; restaurant owners should implement 100% smoke-free environments as following the best practice towards the tobacco control law along with educational campaigns to promote the awareness of restaurant owners and customers about the tobacco control law.

Due to their geographical characteristics, the mountainous areas of Vietnam are particularly vulnerable to illicit drug use. Drug users in remote areas are also more likely to engage in risky sexual behaviors. This study aimed to describe the prevalence and characteristics of substance use and sexual behaviors and explored their related factors among newly admitted drug users in three mountainous provinces of Vietnam. A cross-sectional study was conducted on 300 newly-admitted drug users registering for Methadone Maintenance Treatment (MMT) at 6 clinics in three provinces: Dien Bien, Lai Chau and Yen Bai from October 2014 to December 2015. Information about the socio-demographic characteristics, history of substance use, and sexual behaviors were collected. The multivariate logistic regression model was used to identify potential predictors of four outcomes, which included: drug injection, re-use of needles, using condoms during the last time of having sex, and having sexual intercourse with female sex workers. The proportion of injecting drug users was 68.3%; of those 9% never re-used needles. Of note, 69% of those who reported having sex with female sex workers in the last month did not use condoms. Regression models showed that those who injected drugs and had health problems in last 30 days had greater odds of having sex with female sex workers. Drug users in mountainous settings acknowledged the high prevalence of human immunodeficiency virus (HIV)-related risk behaviors and a demand for physical and psychological care. Scaling up MMT services is key to approaching this high-risk group; however, at the same time, comprehensive harm-reduction interventions, counseling, and health care services should also be made accessible and effective in this setting.

Methadone Maintenance Treatment (MMT) program has been considered a medium through which human immunodeficiency virus (HIV) risks assessment and prevention on drug use/HIV-infected population can be effectively conducted. Studies concerning the implementation of such idea on patients in remote, under-developed areas, however, have been limited. Having the clinics established in three mountainous provinces of Vietnam, this study aimed to evaluate the changes in knowledge of HIV, perceived risk, and HIV testing uptake of the patients. A longitudinal study was conducted at six MMT clinics in three provinces with a pre- and post-assessments among 300 patients. Outcomes of interest were compared between baseline and after 12 months. The magnitude of changes was extrapolated. The proportion of participants reporting that their HIV knowledge was not good fell by 4.4% (61.3% at the baseline vs. 56.8% at 12 months). The significant improvement seen was in the knowledge that needle sharing was a mode of transmission (82.7% vs. 89.6%). Nevertheless, the majority of participants reportedly considered mosquitoes/insect and eating with the HIV-infected patient were the route of transmission at both time points (84.7% vs. 89.1%, 92.2% vs. 93.3%, respectively). This study found a limited improvement in HIV knowledge and testing uptake among MMT patients following a 12-month period. It also highlighted some shortcomings in the knowledge, attitudes and practices (KAP) of these patients, in particular, incorrect identification of HIV transmission routes, among patients both at program initiation and follow-up. The findings lent support to the argument for enhancing education and counseling efforts at MMT clinics regarding HIV, as well as for improving access to preventive and health care services through the integration of MMT/HIV services.

BackgroundGlobally, people who inject drugs are highly vulnerable to HIV transmission. Methadone maintenance treatment (MMT) programs are one of the most cost-effective mechanisms to substitute opioid use and improve the quality of life of patients. Since the coverage of MMT is still limited and even for those patients who are treated, improving their knowledge on HIV and maintaining healthy behaviors are key to maximizing the outcomes of HIV harm reduction programs. This study examined the knowledge on HIV, perceived risk and HIV testing among drug users accessing methadone maintenance services in three Vietnamese mountainous areas.MethodsA cross-sectional study of 300 people enrolling for MMT services in three provinces in Vietnam was conducted. The factors associated with the knowledge, attitudes, and practices of respondents about HIV/AIDS were exploited using multivariable logistic model.ResultsOf the 300-people surveyed, 99% knew of HIV and 60.6% were identified as having good knowledge. While 75.2% identified that injecting drugs was a risk factor for HIV, 52.2% thought they were not at risk of HIV mainly as they did not share needles. 92.6% had undergone HIV testing with 17.4% being positive, a number which was significantly lower than Vietnam’s national average for people who inject drugs. Age, ethnicity and education were associated with knowledge of HIV while ART treatment was linked to self-assessed HIV status.ConclusionsThis study sheds new light on the knowledge attitudes and practices of people who inject drugs, particularly males in mountainous areas of Vietnam regarding HIV prevention. Overall, knowledge was good with most conducting safe practices towards transmission. Enhanced education and targeting of minority groups could help in increasing the numbers receiving MMT and HIV services.