Drug users in Hanoi, Vietnam: factors associated with membership in community-based drug user groups

Abstract

BackgroundA syndemic conjoins injection drug use, incarceration, and HIV in Vietnam, where there is a need for programs that empower people who use drugs to minimize the harms thereby produced. Here we present a post-hoc evaluation of the organizing efforts of the Centre for Supporting Community Development Initiatives (SCDI) with two community-based drug user groups (CBGs) in Hanoi.MethodsMembers (n = 188) of the CBGs were compared to non-member peers (n = 184) on demographic, psychosocial, behavioral and knowledge variables using a face-to-face structured interview that focused on issues of quality of life and harm reduction. Bivariate analyses were conducted, and variables significantly associated with membership at p < 0.10 were included in a multivariate model.ResultsVariables associated with membership in the CBGs in the multivariate model included increased self-efficacy to get drug-related health care (OR 1.59, 1.24-2.04), increased quality of life in the psychological (OR 2.04, 1.07-3.93) and environmental (OR 2.54, 1.31-4.93) domains, and greater history of interactions with police about drugs (OR 3.15, 1.79-5.52). There was little difference between members and non-members on injection-related harms except in the domain of knowledge about opioid overdose. Among the 114 current injectors (30.6% of the sample), low rates of unsafe injection practices were reported, and low statistical power limited the ability to conclusively assess association with membership.ConclusionsAlthough the CBG members displayed higher levels of well-being and access to healthcare than non-members, further longitudinal study is required to determine if these are a result of membership. The CBGs should pay more attention towards meeting challenges in responding to specific health issues of those who continue to use drugs including HIV, hepatitis, and drug overdose.

Coalition building by drug user and sex worker community-based organizations in Vietnam can lead to improved interactions with government agencies: a qualitative study

“…The services provided by the CBOs were considered by peer educators, government officials, and healthcare providers to positively influence CBO members’ quality of life. This is consistent with data collected from participants in CBO programs in Hanoi [ 20 ]. All groups agreed that CBO members enjoyed multiple benefits, such as educational workshops, support for social interaction with family and neighbors, referral to healthcare services, and general socio-emotional support.…”

Characteristics of persons who inject drugs and who witness opioid overdoses in Vietnam: a cross-sectional analysis to inform future overdose prevention programs

“…As distribution of overdose-reversal drugs are expanded in Vietnam, interventions to train drug users on how to recognize an overdose, how to distribute naloxone, and how to administer it will need to be developed [ 9 ]. In a recent study in Hanoi, Vietnam, knowledge about overdose, including how to identify someone experiencing an overdose and what steps to take to prevent death from an overdose, varied greatly [ 4 ]. The development and implementation of these trainings in Vietnam would support recent recommendations from the World Health Organization that countries should expand access to naloxone so that laypersons could acquire it [ 2 ].…”

“…Individuals referred their peers to the study which limits our ability to generalize to the larger drug-using population in Vietnam. Other studies conducted in this area of Vietnam have found that 97% of PWID are male [ 4 ]. Self-report of witnessing an overdose is an additional limitation of these data as it may have introduced social desirability bias as well as recall bias; thus, the number of individuals who have been a witness to an overdose may be higher than is presented here.…”

“…The most frequently used drug in this area is heroin. Heroin is inexpensive in Vietnam and readily available in this part of the world because of the geographic location of the trade route from the Golden Triangle [ 4 ].…”

“…Opioid overdose prevalence estimates are limited in large part because of the hard-to-reach drug using population. Many overdoses are never reported as people who witness an overdose often do not contact health authorities due to fear of arrest for drug-using behavior [ 4 , 5 ].…”