Abstract
Objective: This thesis investigates the contributions of the Global Fund in controlling malaria in Vietnam since 2014, focusing on its multifaceted approaches, strategies, and interventions in malaria prevention, detection, and treatment, as well as overall health system strengthening.
Subject and Methods: The research employs a case study design combined with a desk review of project documents, financial reports, impact assessments, and academic literature. Qualitative methodologies, including key informant interviews and thematic analysis, are used to evaluate the advantages and disadvantages of the Global Fund's interventions.
Key Findings: The study finds that the Global Fund's contributions have significantly enhanced malaria control in Vietnam through increased funding, technical support, and infrastructural improvements. Notable successes include improved diagnostic capabilities, the introduction of rapid diagnostic tests (RDTs), and increased community awareness and engagement. However, challenges such as logistical issues, funding constraints, and the emergence of drug-resistant malaria strains were identified. The research highlights the critical role of international collaboration, government commitment, and community involvement in sustaining malaria control efforts and provides insights into effective public health interventions.
Frontiers in Psychiatry
Background: Depression is the leading burden of mental disease, especially in low-and-middle-income countries like Vietnam. The Stepped Care Model is a promising approach to managing depression in the community with low resources. This is the first study that implemented the adapted Stepped Care Model for depression management in the Vietnamese context and evaluated the initial e
Front. Psychol.
Aim: Healthcare workers have directly provided care for COVID-19 patients, and have faced many additional sources leading to poor mental health. The study aimed to investigate the mental health problems and related factors among healthcare staff in Vietnam. Methods: A descriptive cross-sectional mixed methods study, combining quantitative and qualitative research methods, was performed among 400 healthcare workers working at the National Hospital for Tropical Diseases and Ninh Binh General Hospital from the first day of treatment for COVID-19 patients to May 01, 2020. Results: The results showed that 8.0% of participants had stress, 17.5% of participants had anxiety, and 14.8% of participants had depression. Approximately 50% of participants reported that they had at least one of these symptoms. The findings illustrated that stress, anxiety, and depression were associated with the position in a hospital, health status during the COVID-19 pandemic, family members/relatives infected with COVID-19, physical and mental support from friends, family, and community, department, years of working, and the average work hours per day of healthcare workers exposed to COVID-19. Conclusion: During the COVID-19 pandemic, healthcare workers who worked in the hospital providing treatment and care for COVID-19 patients dealt with mental health problems such as stress, anxiety, and depression. It is necessary to promote mental health among healthcare workers, to contribute to the fight against the COVID-19 outbreak in Vietnam
Sang M. Nguyen, Huong T.T. Tran, Lan M. Nguyen, Oanh Thi Bui, Dong V. Hoang, Martha J. Shrubsole, Qiuyin Cai, Fei Ye, Wei Zheng, Hung N. Luu, Thuan V. Tran, Xiao-Ou Shu
Cancer Epidemiology, Biomarkers & Prevention
Background: Evidence on associations between dietary intake and risk of breast cancer subtypes is limited and inconsistent. We evaluated associations of fruit, vegetable, meat, and fish consumption with risk of breast cancer overall and by molecular subtype in the Vietnamese Breast Cancer Study (VBCS). Method: VBCS includes 476 incident breast cancer cases and 454 age-matched controls. Dietary habits over the past 5 years were assessed by in-person interviews using a validated food frequency questionnaire. Associations of food groups with breast cancer were evaluated via logistic regression for overall and molecular subtype with adjustment for age, education, income, family history of cancer, menopausal status, body mass index, exercise, total energy intake, and other potential dietary confounders. Odds ratio (OR) was used to approximate relative risk. Results: High fruit intake was inversely associated with breast cancer risk, with adjusted ORs [95% confidence intervals (CI)] of 0.67 (95% CI, 0.47–0.95) and 0.41 (95% CI, 0.27–0.61) for second and third tertiles versus first tertile, respectively (Ptrend < 0.001). This association was stronger for triple-negative than other subtypes (Pheterogeneity < 0.001). High intake of freshwater fish was inversely associated with overall breast cancer (ORT3vsT1 ¼ 0.63; 95% CI, 0.42–0.95; Ptrend ¼ 0.03). An inverse association was observed between HER2-enriched subtype and red and organ meat intake (ORT3vsT1¼0.40; 95% CI, 0.17–0.93;Ptrend¼0.04;Pheterogeneity¼0.50). Conclusions: High intakes of fruit and freshwater fish were associated with reduced breast cancer risk; association for the former was stronger for triple-negative subtype. Impact: Our findings suggest high intakes of fruit and freshwater fish may reduce breast cancer risk among Vietnamese women.
Huong Thien Ngoc Cai, Hang Thi Tran, Yen Hong Thi Nguyen, Giao Quynh Thi Vu, Thao Phuong Tran, Phuong Bich Bui, Huong Thi Thu Nguyen, Thai Quang Pham, Anh Tuan Lai, Jennifer Ilo Van Nuil, Sonia Lewycka
Frontiers in Public Health
Antibiotic use in the community for humans and animals is high in Vietnam, driven by easy access to over-the counter medicines and poor understanding of the role of antibiotics. This has contributed to antibiotic resistance levels that are amongst the highest in the world. To address this problem, we developed a participatory learning and action (PLA) intervention. Here we describe challenges and lessons learned while developing and testing this intervention in preparation for a large-scale One Health trial in northern Vietnam. We tested the PLA approach using community-led photography, and then reflected on how this approach worked in practice. We reviewed and discussed implementation documentation and developed and refined themes. Five main themes were identified related to challenges and lessons learned: understanding the local context, stakeholder relationship development, participant recruitment, building trust and motivation, and engagement with the topic of antibiotics and antimicrobial resistance (AMR). Partnerships with national and local authorities provided an important foundation for building relationships with communities, and enhanced visibility and credibility of activities. Partnership development required managing relationships, clarifying roles, and accommodating different management styles. When recruiting participants, we had to balance preferences for top-down and bottom-up approaches. Building trust and motivation took time and was challenged by limited study team presence in the community. Open discussions around expectations and appropriate incentives were re-visited throughout the process. Financial incentives provided initial motivation to participate, while less tangible benefits like collective knowledge, social connections, desire to help the community, and new skills, sustained longer-term motivation. Lack of awareness and perceived importance of the problem of AMR, affected initial motivation. Developing mutual understanding through use of common and simplified language helped when discussing the complexities of this topic. A sense of ownership emerged as the study progressed and participants understood more about AMR, how it related to their own concerns, and incorporated their own ideas into activities. PLA can be a
powerful way of stimulating community action and bringing people together to tackle a
common problem. Understanding the nuances of local power structures, and allowing
time for stakeholder relationship development and consensus-building are important
considerations when designing engagement projects
Ha-Linh Quach, Thai Quang Pham, Ngoc Anh Hoang, Dinh Cong Phung, Viet Cuong Nguyen, Son Hong Le, Thanh Cong Le, Dang Hai Le, Anh Duc Dang, Duong Nhu Tran, Nghia Duy Ngu, Florian Vogt, Cong Khanh Nguyen
Healthcare Informatics Research
Objectives: Online misinformation has reached unprecedented levels during the coronavirus disease 2019 (COVID-19) pandemic. This study analyzed the magnitude and sentiment dynamics of misinformation and unverified information about public health interventions during a COVID-19 outbreak in Da Nang, Vietnam, between July and September 2020. Methods: We analyzed user-generated online information about five public health interventions during the Da Nang outbreak. We compared the volume, source, sentiment polarity, and engagements of online posts before, during, and after the outbreak using negative binomial and logistic regression, and assessed the content validity of the 500 most influential posts. Results: Most of the 54,528 online posts included were generated during the outbreak (n = 46,035; 84.42%) and by online newspapers (n = 32,034; 58.75%). Among the 500 most influential posts, 316 (63.20%) contained genuine information, 10 (2.00%) contained misinformation, 152 (30.40%) were non-factual opinions, and 22 (4.40%) contained unverifiable information. All misinformation posts were made during the outbreak, mostly on social media, and were predominantly negative. Higher levels of engagement were observed for information that was unverifiable (incidence relative risk [IRR] = 2.83; 95% confidence interval [CI], 1.33–0.62), posted during the outbreak (before: IRR = 0.15; 95% CI, 0.07–0.35; after: IRR = 0.46; 95% CI, 0.34-0.63), and with negative sentiment (IRR = 1.84; 95% CI, 1.23–2.75). Negatively toned posts were more likely to be misinformation (odds ratio [OR] = 9.59; 95% CI, 1.20–76.70) or unverified (OR = 5.03; 95% CI, 1.66–15.24). Conclusions: Misinformation and unverified information during the outbreak showed clustering, with social media being particularly affected. This indepth assessment demonstrates the value of analyzing online “infodemics” to inform public health responses.
Frontiers in Psychiatry
Background: The COVID-19 pandemic has affected health and well-being worldwide, and its psychological effects are receiving substantial attention in the scientific literature. Research to date shows that the pandemic has increased prevalences of depression, anxiety, and stress. This study aimed to estimate the prevalence of mental health symptoms and identify the associated factors among men in a rural area of Vietnam during the COVID-19 pandemic. Methods and findings: During July 15–31, 2020, we conducted a crosssectional survey of 1,085 men from 18 years old in 11 rural districts in Thanh Hoa province, Vietnam, and assessed their mental health using the Depression, Anxiety and Stress Scale – 21 Items (DASS-21). Outcomes assessed were have a symptom of depression, anxiety, and stress; risk factors measured included age, religion, marital status, education, occupation, and financial status. Multiple linear regression was performed to determine the statistical significance of associations between risk factors and mental health symptoms. Findings showed that the prevalences of having a symptom of depression, anxiety and stress among participants were 6.39, 9.72, and 5.65%, respectively. Regression model showed being younger (95% CI: –0.030; – 0.004, p = 0.001), men had high school degree (95% CI: –0.671; –0.074, p = 0.014), men living in nearly poor houshoulds (95% CI: 0.067, 1.905, p < 0.05) and poor housholds (95% CI: 0.608; 2.721, p < 0.05) had significantly lower depression scores than others. Conclusion: Prevalences of having symptoms of depression, anxiety and stress were much higher than in similar previous research in rural Vietnam, suggesting that mental health problems among men in this setting became more common during the COVID-19 pandemic. Age, religion, level of
education and family income status were statistically significant predictors of
mental health problems. These findings provide useful insights into the impact
of pandemics on mental health.
Thao Thi Phuong Nguyen, Tham Thi Nguyen, Vu Trong Anh Dam, Thuc Thi Minh Vu, Hoa Thi Do, Giang Thu Vu, Anh Quynh Tran, Carl A. Latkin, Brian J. Hall, Roger C. M. Ho, Cyrus S. H. Ho
Frontiers in Psychology
Introduction: This study aimed to explore the mental wellbeing profiles and their related factors among urban young adults in Vietnam. Methods: A cross-sectional study was conducted in Hanoi, which is the capital of Vietnam. There were 356 Vietnamese who completed the Mental Health Inventory-5 (MHI-5) questionnaire. The Latent Profile Analysis (LPA) was used to identify the subgroups of mental wellbeing through five items of the MHI-5 scale as the continuous variable. Multinomial logistic regression was used to determine factors related to subgroups. Results: Three classes represented three levels of MHI-5 score, which included “Poor mental health,” “Fair mental health,” and “Good mental health,” were, respectively, 14.3, 46.6, and 39.0%. Compared to a low household economy, participants with an average household economy had 2.11 and 4.79 times higher odds of being in a good mental health class relative to fair and poor mental health classes. Respondents with more than two acute symptoms had 3.85 times higher odds of being in a good mental health class relative to a poor mental health class, as compared to those without acute symptoms. Regarding the measurement of the Perceived Social Support Scale (MSPSS), people having support from their family had 1.80 and 2.23 times higher odds of being in classes of fair and good mental health relative to the poor mental health class; and participants having friend support also had 1.87 times higher odds of being in a good mental health class compared with the fair mental health class, as the MSPSS score increased by 1 unit. People with Rosenberg’s self-esteem scale increased by 1 score, those who had 1.17, 1.26, and 1.47 times higher odds of being in a good compared to fair mental health class, fair compared to poor mental health class, and good compared to poor mental
health class, respectively.
Conclusion: Our findings were given to promote a new classification method
for mental health screening among the general population. The current
findings could be used as evidence to develop policies and plans that focus
on encouraging early screening for mental health problems among the
general young population in the future
Scientific Research Publishing
Background: Treatment of hip disorders during active hip tuberculosis has long been a controversial issue. Some authors have reported performing hip replacement with different strategies with very good outcomes. This study aimed to describe the surgical outcomes and necessary conditions for total hip replacement in active hip tuberculosis. Methods: We conducted a quasi-experimental study. The study enrolled 40 patients with 42 active tuberculosis hips at stage IV treated by total hip replacement from October 2016 to December 2019 at the National Lung Hospital. We followed up with the patients for at least 12 months, evaluated surgical outcomes, and investigated the factors associated with these outcomes by logistic regression analysis. Results: Surgical outcomes showed that 37 patients (88.1%) had excellent hip function, no abscesses, and no sinus tract formation. Four cases (9.5%) had sinus tract formations. One case (2.4%) had good hip function. Binary logistic regression models revealed that sinus tract formation was associated with preoperative tuberculosis infection syndrome. The average time to obtain antituberculosis drug treatment preoperatively was 4.6 weeks. Conclusion: Total hip replacement for active hip tuberculosis is a practical and promising treatment method. Surgeons should consider improving patients’ conditions before performing total hip replacement, administering antitubercular drugs, and arthrotomy to eliminate all abscesses, and decrease the risk of tuberculosis infection syndrome and the inflammatory response
Lam Duc Nguyen, Long Hoang Nguyen, Ly Thi Ninh, Ha Thu Thi Nguyen, Anh Duy Nguyen, Linh Gia Vu, Hao Si Anh Nguyen, Son Hoang Nguyen, Linh Phuong Doan, Thuc Minh Thi Vu, Bach Xuan Tran, Carl A. Latkin, Cyrus S. H. Ho, Roger C. M. Ho
BMC Pregnancy and Childbirth
Background: Self-care behaviors during pregnancy signifcantly impacts mother and children’s health. This study aimed to explore the self-care behaviors and the associations of these behaviors with the psychological well-being of women during pregnancy, as well as the mediating efects of diferent social support with these associations. Methods: A cross-sectional data of 562 pregnant women at Hanoi Obstetrics & Gynecology Hospital and Ca Mau Obstetrics & Pediatrics in Vietnam were analyzed. Questions about self-care behaviors, pregnancy characteristics, social support, and psychological well-being were asked. Multivariate regression models were performed. Structural Equation Modeling (SEM) was employed to test the mediating efects of diferent social support with the association between self-care behaviors and psychological well-being. Findings : Only 13% of pregnant women often or always did physical exercise at least three times a week, and 40% consumed enough fber and fve servings of vegetables a day. Only 78.7% always avoided alcohol drinking, and 53.9% of pregnant women avoided being exposed to second-hand smoking and 71,7% avoided using traditional medicine without physicians’ prescriptions. Around 66% of pregnant women always or often had prenatal care checkups as scheduled. Information sources, social support and childbirth expectation were major drivers for self-care practices. SEM model showed that social support mediated the relationship between maternal health behaviors and mental well-being. Conclusion: This study highlighted the remarkable gaps in self-care practices among our pregnant women, which were signifcantly associated with their mental well-being. Social support-oriented consultancy and interventions should be warranted for improving behaviors and the mental well-being of pregnant women in Vietnam. Keywords: Maternal behavior, Psychological well-being, Social support, Pregnant women, Structural equation modeling
Annals academy of medicine, singapore
Huyen Phuc Do, Thang Van Vo, Linda Murray, Philip R.A. Baker, Aja Murray, Sara Valdebenito, Manuel Eisner, Bach Xuan Tran, Bao-Yen Luong-Thanh, Lan Hoang Nguyen, Michael P. Dunne
Child Abuse & Neglect
Background: Despite the detrimental effects and life-course health consequences of violence exposure, relatively few studies have adequate capacity to investigate the evolution of violence from childhood to motherhood. Objective: This study aims to examine the cyclical nature of childhood abuse and prenatal interpartner violent victimization (p-IPV) and its adverse impact on childbirth trauma and exclusive breastfeeding (EBF) practice in Vietnam. Method: Using a prospective birth cohort, 150 pregnant women were recruited in the third trimester of pregnancy in Hue city in central Vietnam (Wave 1-Baseline) and re-interviewed approximately three months after delivery (Wave 2-Follow-up). The direct and indirect effects of violent victimization on subsequent childbirth experience (measured by Birth Memories and Recall Questionnaire) and EBF practice were estimated by using augmented-inverse-probabilityweighted models, sensitivity analysis, and structural equation model. Results: Detrimental and prolonged effects of the inter-generational cycle of violence transverse childhood to motherhood. Women who experienced either childhood abuse or p-IPV violence were more likely to experience negative emotional childbirth memories [ARR 1.21, 95 % CI (1.04, 1.39)]. Evidence also suggested that not continuing to exclusively breastfeed at 3 months post-partum was strongly associated with prenatal depression, young age, and perceived low social status during pregnancy. Perceived strong connectedness among extended family members and social networks (i.e. nexus among family, friends, and neighborhood) provided a buffering
effect by preventing EBF termination.
Conclusion: This research provides insights into the protective role of social connectedness in
improving breastfeeding practice. It is vital to establish wholistic antenatal care and social service
system to offer specialized support and response for victims of violence and mitigate the longterm sequelae of traumatic events.
The association between selective serotonin reuptake inhibitor (SSRI) treatment and lower bone mineral density (BMD) remains controversial, and further research is required. This study aimed to compare the BMD, levels of bone formation and bone metabolism markers in medicated premenopausal Singaporean women with major depressive disorder (MDD) and matched healthy controls. We examined 45 women with MDD who received SSRI treatment (mean age: 37.64 ± 7) and 45 healthy controls (mean age: 38.1 ± 9.2). BMD at the lumbar spine, total hip and femoral neck were measured using dual-energy X-ray absorptiometry. We also measured bone formation markers, procollagen type 1 N-terminal propeptide (P1NP) and bone metabolism markers, osteoprotegerin (OPG) and receptor activator of nuclear factor-kappa-B ligand (RANKL). There were no significant differences in the mean BMD in the lumbar spine (healthy controls: 1.04 ± 0.173 vs. MDD patients: 1.024 ± 0.145, p = 0.617, left hip (healthy controls: 0.823 ± 0.117 vs. MDD patients: 0.861 ± 0.146, p = 0.181) and right hip (healthy controls: 0.843 ± 0.117 vs. MDD patients: 0.85 ± 0.135, p = 0.784) between healthy controls and medicated patients with MDD. There were no significant differences in median P1NP (healthy controls: 35.9 vs. MDD patients: 37.3, p = 0.635), OPG (healthy controls: 2.6 vs. MDD patients: 2.7, p = 0.545), RANKL (healthy controls: 23.4 vs. MDD patients: 2178.93, p = 0.279) and RANKL/OPG ratio (healthy controls: 4.1 vs. MDD patients: 741.4, p = 0.279) between healthy controls and medicated patients with MDD. Chronic SSRI treatment might not be associated with low BMD in premenopausal Singaporean women who suffered from MDD. This finding may help female patients with MDD make an informed decision when considering the risks and benefits of SSRI treatment.
Preparedness and responses to infectious disease epidemics and pandemics require the understanding of communities’ and multisectoral systems’ characteristics with regards to diseases transmission and population’s vulnerabilities. This study aimed to summarize measurement profiles of existing risk assessment toolkits to inform COVID-19 control at global and national levels. An online search in different databases and online sources was performed to identify all epidemic risk and vulnerability assessment instruments. Medline/ PubMed, Web of Science databases, and websites of public health organizations were used for the searching process. Of 14 toolkits, levels of setting were mostly at the global or nation level. Components such as Governance and Legislation, Financing, Health Service Provision, and Human Resources are key domains in almost all toolkits. Some important issues for disease detection and surveillance, such as laboratory or capacity of the community for disease control, were not adequately addressed in several toolkits. Limited studies were found that validated the toolkits. Only five toolkits were used in COVID-19 studies. This study provides a summary of risk assessment toolkits to inform epidemic responses. We call for global and national efforts in developing more contextualized and responsive epidemic risk assessment scales incorporating specific-disease and -country factors to inform operational decisions making and strengthen countries’ capacities in epidemic responses.
Journal of Medical Economics
Aim: To evaluate the cost utility of adjunct racecadotril and oral rehydration solution (Rþ ORS) versus oral rehydration solution (ORS) alone for the treatment of diarrhoea in children under five years with acute watery diarrhoea in four low-middle income countries. Method: A cost utility model, previously developed and independently validated, has been adapted to Egypt, Morocco, Philippines and Vietnam. The model is a decision tree, cohort model programmed in Microsoft Excel. The model structure represents the country-specific clinical pathways. The target population is children under the age of five years presenting with symptoms of acute watery diarrhea to an outpatient clinic or general physician practice. A healthcare payer perspective has been analysed with the model parameterised with local data, where available. Most recent cost data has been used to inform the drug, outpatient and inpatient costs. Uncertainty has been explored with univariate deterministic sensitivity. Results: According to the base case models, R þ ORS is dominant (cost-saving, more effective) versus ORS alone in Egypt, Morocco, Philippines and Vietnam. The incremental cost-effectiveness ratios in each country fall in the southeast (cost-saving, more effective) quadrant and represent a cost savings of 304,152 EGP per QALY gain in Egypt; 6,561 MAD per QALY gain in Morocco; 428,612 PHP per QALY gain in Philippines and 113,985,734 VND per QALY gain in Vietnam. Univariate deterministic sensitivity analysis shows that the three most influential parameters across all country adaptations are the utility of children without diarrhea; the utility of inpatient children with diarrhea and the cost of one night of inpatient care. Conclusion: In keeping with similar findings in upper-middle and high-income countries, the cost utility of R þ ORS versus ORS is favourable in low-middle income countries for the treatment of children under five with acute watery diarrhoea
Tuan Anh Nguyen, Kham Van Trana, Ladson Hintone, Elizabeth E Rougheadb, Adrian Estermanb, Thu Ha Danga, Giang Bao Kim, Diep Bich Pham, Huong Thi Diem Nguyen, Maria Crottyg, Susan Kurrleh, Thang Pham, Tuan Le Pham, Phuong Hoang, Henry Brodaty
Aging & mental health
Objectives: This paper aimed to review and synthesise the qualitative research evidence on the experiences and perceptions of dementia in Vietnam and among the Vietnamese diaspora. Methods: Systematic searches were conducted in June 2019 using Medline, Embase, Emcare, PsycINFO and Cochrane electronic databases, as well as grey literature. Keywords and Medical Subject Headings [MeSH terms] for dementia and associated terms were combined with keywords for Vietnam and its provinces. Qualitative research articles published in English or Vietnamese were included to examine evidence on the life experiences of Vietnamese people with dementia using thematic analysis. Results: Our searches resulted in 3,940 papers, from which 21 qualitative research studies were included for final analysis. The majority of research has not been undertaken in Vietnam but with the Vietnamese diaspora in Western countries and has taken a cultural perspective to analyses. Research in Western countries has focused on the need for culturally adapted and culturally sensitive models of care. Emerging themes about the life experiences of Vietnamese people with dementia identified from the studies included: many people do not have diagnostic terms for dementia but use the descriptive language of symptoms; stigma was a reported problem and on occasions can be observed in the descriptive language used for people with dementia; cultural and traditional values create both an opportunity and a barrier, supporting compassion, family care and relaxation, but creating barriers to accessing health services or long-term residential care. Conclusions: This is the first systematic review reporting qualitative evidence on the life experiences of people with dementia in Vietnam and among the Vietnamese diaspora. Future research is needed on the voice of people with dementia themselves and their caregivers particularly in Vietnam, and low and middle-income countries with regards to living with dementia, pathways to care from diagnosis, treatment, care and support, additional social care and preparedness for end of life care for people with dementia.
Harm Reduction Journal
Introduction: The emergence of widespread amphetamine-type stimulants (ATSs) usage has created signifcant
challenges for drug control and treatment policies in Southeast Asian countries. This study analyses the development
of drug policies and examines current treatment program constraints in Vietnam to deal with ATS misuse. The aim was
to gain insights that may be useful for national and international drug-related policy development and revision.
Methods: A desk review of national policy documents and 22 in-depth key informant interviews were conducted
from 2019 to 2021. Thematic content analysis was employed to identify key themes and their connections.
Results: Analysis identifed Vietnam’s 30-year history of developing policies and formulating strategies to reduce
supply, demand, and harm from illicit drugs. With the increasing number of people who use ATS (PWUA), Vietnam
has recently promoted harsh policy and law enforcement to deter drug use and supply. This policy trend prevails in
many Asian countries. The three main constraints in dealing with ATS misuse emerged from punitive and restrictive
drug policies. First, the general public believed that Centre-based compulsory treatment (CCT) is the only appropriate
treatment for all types of illicit drug addiction despite its low-quality service provision. The rigid drug policy has led
to social persuasion with impractical expectations for CCT efectiveness. Second, the emphasis on punishment and
detention has hampered new drug treatment service development in Vietnam. CCT has become monopolistic in the
context of impoverished services. Third, people who use drugs tend to hide their needs and avoid formal treatment
and support services, resulting in declined social coherence.
Conclusion: While new drugs are constantly evolving, the current law enforcement approach potentially constrains
expertise to adopt efective treatment services. This study suggests that the top-down policing mechanism presently
hinders the development of an appropriate intervention strategy for ATS misuse and diminishes social support to
service providers
International Journal of STD and AIDS
Background: HIV and other sexually transmitted infections (STIs) have disproportionately affected communities of men who have sex with men (MSM). We describe HIV and STI prevalence and testing patterns among urban Vietnamese MSM. Methods: We conducted a cross-sectional community-based study of MSM in Hanoi, Vietnam in 2016. Participants selfreported experiences of social stigma in healthcare settings and previous HIV and STI testing. STI testing included HIV, herpes simplex virus-2 (HSV-2), syphilis, gonorrhea, and chlamydia. Results: 205 MSM participated in the study. STI prevalence was HIV (10%), HSV-2 (4%), syphilis (13%), gonorrhea (34%), and chlamydia (19%). More than half (55%) of participants tested positive for at least one STI. Most participants had been previously tested for HIV or another STI (72%), with 24% previously receiving a positive result. Perceived and enacted social stigma in healthcare contexts was negatively associated with previous HIV or STI testing (adjusted prevalence odds ratio (aPOR): 0.22; 95% confidence interval (CI): 0.10–0.48). Discussion: High prevalence of STIs was observed among Vietnamese MSM, and perceived and enacted stigma was related to HIV and STI testing. Our findings reaffirm the importance of regular STI screening among this population as well as additional outreach to promote safe HIV and STI healthcare engagement.
Kathy Trang, Tanja Jovanovic, Devon E. Hinton, Patrick Sullivan, Carol M. Worthman, Le Xuan Lam, Nguyen Kim Chi, Nguyen Cong Thanh, Tran Viet Ha, Vivian Go, Irving Hoffman and Le Minh Giang
Transcult Psychiatry
The purpose of this study was to characterize trauma exposure and mental health burden among men who have sex with men (MSM) in Hanoi, Vietnam. Participants comprise 100 HIV-positive and 98 high-risk, HIV-negative MSM, ranging from 18 to 29 years of age. Data were collected using the Childhood Trauma Questionnaire, Traumatic Events Inventory, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and PTSD Symptom Scale. A subset of participants (n = 12) were also interviewed to evaluate community perception of the prevalence, causation, and available treatment options for mental health issues within the MSM community in Vietnam. In our sample, 23.2% reported having experienced moderate-to-severe childhood physical abuse; 18.7% physical neglect; 13.6% emotional abuse; 11.1% emotional neglect; and 26.8% sexual abuse. Such trauma exposure continued into adulthood and manifested most commonly in the form of interpersonal violence. Approximately 37.4% of the sample met the criteria for probable PTSD; 26.8% for moderate-to-severe depression; and 20.2% for moderate-to-severe anxiety. Neither exposure nor mental health burden differed by serostatus. Linear regression revealed that childhood emotional abuse was the only sub-type of trauma significantly associated with depression, anxiety, and PTSD symptoms. The majority of interviewees believed that mental health burden was higher among MSM relative to the general population and attributed this to their vulnerability to interpersonal violence and lack of available coping resources. However, few believed that these mental health issues warranted clinical attention, and only one participant was able to identify a mental health service provider. Our findings suggest that trauma exposure and mental health burden are prevalent among MSM, irrespective of serostatus, and much higher than what has been previously reported among the general population in Vietnam
AIDS and Behavior
Scientifc fndings and policy guidelines recommend integrating HIV and drug addiction prevention and care into communitybased settings. Systematic capacity-building eforts are warranted to provide technical support for community health workers and improve their confdence in the integrated service provision. An intervention trial was conducted between 2018 and 2019 with 120 community health workers (CHW) from 60 communes in Vietnam’s four provinces. The 60 intervention CHW received in-person training to enhance their HIV/addiction-related service knowledge and skills. Online support groups were established between trained CHW and local HIV and addiction specialists. The intervention outcomes were assessed using mixed-efects regression models with the data collected at baseline and every 3 months for 1 year. Adjusted analyses showed that intervention CHW reported a signifcant increase in the interaction with other treatment providers than the control group at 6 months and remained at the 12-month follow-up. The diference in the improvement of confdence in HIV/addictionrelated service delivery between the intervention and control groups was signifcant at 6-month but became insignifcant at the 12-month. Male CHW were more confdent in providing services than female CHW at baseline, and gender diferences in the changing patterns were observed over time. This capacity-building intervention demonstrated promising outcomes on CHW inter-agency collaborations and confdence in service delivery. Gender divides in healthcare professionals should be attended to in future studies
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
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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
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