Nguyen Thu Trang, Giang Thi Hoang, Duc Quang Nguyen, Anh Huu Nguyen, Ngoc Anh Luong, Didier Laureillard, Nicolas Nagot, Don Des Jarlais, Huong Thi Duong, Thanh Thi Tuyet Nham, Oanh Thi Hai Khuat, Khue Minh Pham, Mai Sao Le, Laurent Michel, Delphine Rapoud, Giang Minh Le
Harm Reduction Journal
Introduction: The COVID-19 outbreak disproportionally afects vulnerable populations including people who inject drugs (PWID). Social distancing and stay-at-home orders might result in a lack of access to medical and social services, poorer mental health, and fnancial precariousness, and thus, increases in HIV and HCV risk behaviors. This article explores how the HIV/HCV risk behaviors of PWID in Haiphong, a city with high harm reduction service coverage in Vietnam, changed during the early phase of the COVID-19 pandemic, and what shaped such changes, using the risk environment framework. Method: We conducted three focus group discussions with peer outreach workers in May 2020 at the very end of the frst lockdown, and 30 in-depth interviews with PWID between September and October 2020, after the second wave of infection in Vietnam. Discussions and interviews centered on the impact of the COVID-19 pandemic on their lives, and how their drug use and sexual behaviors changed as a result of the pandemic. Results: The national shutdown of nonessential businesses due to the COVID-19 epidemic caused substantial economic challenges to participants, who mostly were in a precarious fnancial situation before the start of the epidemic. Unsafe injection is no longer an issue among our sample of PWID in Haiphong thanks to a combination of diferent factors, including high awareness of injection-related HIV/HCV risk and the availability of methadone treatment. However, group methamphetamine use as a means to cope with the boredom and stress related to COVID-19 was common during the lockdown. Sharing of smoking equipment was a standard practice. Female sex workers, especially those who were active heroin users, sufered most from COVID-related fnancial pressure and may have engaged in unsafe sex. Conclusion: While unsafe drug injection might no longer be an issue, group methamphetamine use and unsafe sex were the two most worrisome HIV/HCV risk behaviors of PWID in Haiphong during the social distancing and lockdown periods. These elevated risks could continue beyond the enforced lockdown periods, given PWID in general, and PWID who are also sex workers in particular, have been disproportionately afected during the global crisis.
Ha V Tran, MSc MD Ha T T Nong, PhD Thuy T T Tran, PhD Teresa R Filipowicz, MPH Kelsey R Landrum, MPH Brian W Pence, PhD Giang M Le, PhD; Minh X Nguyen, PhD Dixon Chibanda, PhD Ruth Verhey, PhD Vivian F Go, PhD Hien T Ho, PhD Bradley N Gaynes
JMR Formative Research
Friendship Bench, Vietnam, Assessment-Decision-Adaptation-Production-Topical Experts-Integration-Training-Testing, ADAPT-ITT, common mental disorders, people living with HIV, PWH, people who inject drugs, PWID, methadone maintenance treatment, MMT, depression, anxiet
Background: The prevalence of common mental disorders (CMDs) among people living with HIV and people who inject drugs
is high worldwide and in Vietnam. However, few evidence-informed CMD programs for people living with HIV who inject drugs
have been adapted for use in Vietnam. We adapted the Friendship Bench (FB), a problem-solving therapy (PST)–based program
that was successfully implemented among patients with CMDs in primary health settings in Zimbabwe and Malawi for use among
people living with HIV on methadone maintenance treatment (MMT) with CMDs in Hanoi, Vietnam.
Objective: This study aimed to describe the adaptation process with a detailed presentation of 4 phases from the third (adaptation)
to the sixth (integration) of the Assessment-Decision-Adaptation-Production-Topical Experts-Integration-Training-Testing
(ADAPT-ITT) framework.
Methods: The adaptation phase followed a qualitative study design to explore symptoms of CMDs, facilitators, and barriers to
conducting FB for people living with HIV on MMT in Vietnam, and patient, provider, and caretaker concerns about FB. In the
production phase, we revised the original program manual and developed illustrated PST cases. In the topical expert and integration
phases, 2 investigators (BNG and BWP) and 3 subject matter experts (RV, DC, and GML) reviewed the manual, with reviewer
comments incorporated in the final, revised manual to be used in the training. The draft program will be used in the training and
testing phases.
Results: The study was methodologically aligned with the ADAPT-ITT goals as we chose a proven, effective program for
adaptation. Insights from the adaptation phase addressed the who, where, when, and how of FB program implementation in the
https://formative.jmir.org/2022/7/e37211 JMIR Form Res 2022 | vol. 6 | iss. 7 | e37211 | p. 1
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JMIR FORMATIVE RESEARCH Tran et al
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MMT clinics. The ADAPT-ITT framework guided the appropriate adaptation of the program manual while maintaining the core
components of the PST of the original program throughout counseling techniques in all program sessions. The deliverable of this
study was an adapted FB manual to be used for training and piloting to make a final program manual.
Conclusions: This study successfully illustrated the process of operationalizing the ADAPT-ITT framework to adapt a mental
health program in Vietnam. This study selected and culturally adapted an evidence-informed PST program to improve CMDs
among people living with HIV on MMT in Vietnam. This adapted program has the potential to effectively address CMDs among
people living with HIV on MMT in Vietnam
J Health Soc Sci
Vietnam Journal of Preventive Medicine
This study aimed to describe mental health service utilization and examine associated factors among students in Vietnam. Data were collected at eight universities in Hanoi, Vietnam, in 2018 using an administered questionnaire. The total number of participants was 9,120 (95.1% response rate). Among stu dents participating in our survey, 12.5% (95% CI: 10.9–14.1) with depression and/or anxiety symptoms used mental health service in the last 12 months. In the multivariable regression models, significant factors associated with mental health ser vice utilization were marital status, types of housemate, men tal health problems, physical activity, smoking status, and alcohol drinking. Our study made recommendations to stake holders for improving mental health services utilization among students in Vietnam. These findings had important implica tions for future research on factors associated with mental health service utilization among university students.
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