Stigma Index in Vietnam featured in Positive Action Challenges Fund
Case Study: Responding to stigma and discrimination among key populations in Vietnam
The case study below is shown as an example of good practice by the Positive Action Challenges Fund. They are seeking applications here
In 2011 and 2014, the Vietnam Network of People Living with HIV (VNP+) conducted the PLHIV Stigma Index survey to assess both current stigma and discrimination and changes over that period. Sampling was undertaken among people who inject drugs (PWID), men who have sex with men (MSM) and female sex workers (FSWs).
The Stigma Index revealed concerns about the quality and confidentiality of healthcare and HIV testing: many PLHIV (60.1% of all respondents in 2014) reported not having been able to discuss their treatment with a healthcare worker. FSWs are particularly vulnerable, with 3.6% being denied healthcare services. Of particular concern is the fact that 3.1% of respondents (and 5.6% of PWID) said that they were coerced into testing, while 7.6% of all respondents were tested without their knowledge. Additionally, high rates of disclosure to others without consent persist, with over one-third of all respondents (37.5%) and nearly half of PWID (45.3%) reporting this.
The results among MSM living with HIV often stood out with higher levels of stigma and discrimination linked to their sexual orientation. MSM were more likely to report issues with health care, including a lack of access. They had very low rates of talking to healthcare workers (only 16.6% reported having done so) and a total of 28.3% reported avoiding going to local clinics because of self-stigma. Finally, MSM reported even less confidence in the confidentiality of their test results than other respondents, and a decrease since 2011.
Some of the key recommendations included:
- Specific measures to increase the confidentiality of test results in order to reduce the fear of disclosure without consent, while increasing the likelihood that people will be tested early enough to maximise the preventative benefits of treatment
- The quality of healthcare for people living with HIV, particularly interactions with healthcare workers (especially for MSM living with HIV), should be improved through education and training for healthcare workers (in collaboration with networks of PLHIV.)
- Healthcare services and VNP+ member groups should establish a collaborative mechanism to refer and support PLHIV who have experienced stigma and discrimination at the hands of healthcare workers