‘Social evils’ and harm reduction: the evolving policy environment for human immunodeficiency virus prevention among injection drug users in China and Vietnam

Abstract

Ongoing challenges and lessons learned include the persistence of tensions between drug control and harm reduction that may have negative effects on programs until a fully harmonized policy environment is established. Excessive reliance on law enforcement and forced detoxification will not solve the problems of substance abuse or of HIV among drug users. Ongoing evaluation of harm reduction programs, as well as increased levels of multi-sectoral training, collaboration and support are also needed.

Exploring the Social Meaning of Curing HIV: A Qualitative Study of People Who Inject Drugs in Guangzhou, China

“…16,17 The emergence of national ''champions'' encouraged a culture of pragmatic, evidence-based practice that has spurred collaboration across public health, police, and drug sectors. 16,17 However, HIV continues to hold a powerful cultural meaning in China as the modern-day plague.…”

“…16,17 The emergence of national ''champions'' encouraged a culture of pragmatic, evidence-based practice that has spurred collaboration across public health, police, and drug sectors. 16,17 However, HIV continues to hold a powerful cultural meaning in China as the modern-day plague. 18 Fear of infection and death are magnified by its association with stigmatized behaviors, 19 which continue to hinder progress in HIV care.…”

The Development of Social Work in Vietnam: The Role of International Collaboration

“…There is an increase in drug abuse and the spread of HIV/AIDS. Drug abuse in Vietnam, together with prostitution and gambling, is considered a 'social evil' (Hammett et al, 2008;Nguyen and Scannapieco, 2008) for which responses such as crackdowns, mass arrests, and forced detoxification are used (Hammett et al, 2008). Drug use was originally prevalent mainly in rural mountainous areas but has spread to urban areas making it one of the most common social problems in the country (Nguyen and Scannapieco, 2008).…”

Monstrous Fears

“…4 Methadone substitution treatment, a relatively new intervention, was first introduced at two pilot sites in Vietnam in 2009 and is currently being scaled up but is not yet nationally available. 5 Government provision of support to drug users can only be fully understood in terms of current state discourse, whereby sex work and other "undesirable" behavior have historically been classified as "social evils" (Hammett et al, 2007;Tran, Detels, Long, & Lan, 2005). This categorization means that drug users and sex workers are highly stigmatized, by the state and the general population, and are conceived of more as criminals rather than vulnerable individuals in need of support (Vijeyarasa, 2010).…”