Substance Abuse Journal
Background: Patients report that familial support can facilitate initiation and maintenance of antiretroviral therapy (ART) and medications for opioid use disorder (MOUD). However, providing such support can create pressure and additional burdens for families of people with opioid use disorder (OUD) and HIV. We examined perspectives of people with HIV receiving treatment for OUD in Vietnam and their family members. Methods: Between 2015 and 2018, we conducted face-to-face qualitative interviews with 44 patients and 30 of their family members in Hanoi, Vietnam. Participants were people living with HIV and OUD enrolled in the BRAVO study comparing HIV clinic-based buprenorphine with referral to methadone treatment at 4 HIV clinics and their immediate family members (spouses or parents). Interviews were professionally transcribed, coded in Vietnamese, and analyzed using a semantic, inductive approach to qualitative thematic analysis. Results: Family members of people with OUD and HIV in Vietnam reported financially and emotionally supporting MOUD initiation and maintenance as well as actively participating in treatment. Family members described the burdens of supporting patients during opioid use, including financial costs and secondary stigma. Conclusions: Describing the role of family support in the lives of people living with OUD and HIV in the context of Vietnam enriches our understanding of their experiences and will support future treatment efforts targeting the family unit.
J Ethn Subst Abuse
Integration of substance use disorder (SUD) treatment and HIV care can increase antiretroviral therapy coverage among people with opioid use disorder (OUD). However, implementation of integrated treatment models remains limited. Stigma towards people with OUD poses a barrier to initiation of, and adherence to, HIV treatment. We sought to understand the extent of stigma towards SUD and HIV among people with OUD in Vietnam, and the effect of stigma on integrated OUD and HIV treatment services utilization. Between 2013 and 2015, we conducted in-depth interviews with 43 patients and 43 providers at 7 methadone clinics and 8 HIV clinics across 4 provinces in Vietnam. We used thematic analysis with a mixed deductive and inductive approach at the semantic level to analyze key topics. Two main themes were identified: (1) Confidentiality concerns about HIV status make patients reluctant to receive integrated care at HIV clinics, given the requirements for daily buprenorphine dosing at HIV clinics. (2) Provider stigma existed mostly toward people with OUD and seemed to center on the belief that substance use causes a deterioration in one’s morals, and was most frequently manifested in the form of providers’ apprehensive approach towards patients. Concerns regarding stigmatization may cause patients to feel reluctant to receive treatment for both OUD and HIV at a single integrated clinic. Interventions to reduce stigma at the clinic and policy levels may thus serve to improve initiation of and adherence to integrated care
P Todd Korthuis, Caroline King, Ryan R Cook, Tong Thi Khuyen, Lynn E Kunkel, Gavin Bart, Thuan Nguyen, Dinh Thanh Thuy, Sarann Bielavitz, Diep Bich Nguyen, Nguyen Thi Minh Tam, Le Minh Giang
J Subst Abuse Treat
Journal of Behavioral Health Services & Research
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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