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Tran HV, Filipowicz TR, Landrum KR, Nong HTT, Tran TTT, Pence BW, Go VF, Le GM, Nguyen MX, Verhey R, Chibanda D, Ho HT, Gaynes BN. Stigma experienced by people living with HIV who are on methadone maintenance treatment and have symptoms of common mental disorders in Hanoi, Vietnam: a qualitative study. AIDS Res Ther 2022; 19:63. [PMID: 36517849 PMCID: PMC9753276 DOI: 10.1186/s12981-022-00491-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 12/08/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Stigma around human immunodeficiency virus (HIV), injection drug use (IDU), and mental health disorders can be co-occurring and have different impacts on the well-being of people living with HIV (PWH) who use drugs and have mental health disorders. This stigma can come from society, health professionals, and internalized stigma. A person who has more than one health condition can experience overlapping health-related stigma and levels of stigma which can prevent them from receiving necessary support and healthcare, serving to intensify their experience with stigma. This study investigates HIV, drug use, and mental health stigmas in three dimensions (social, internalized, and professional) around PWH on methadone maintenance treatment (MMT) who have common mental disorders (CMDs) including depression, anxiety, and stress-related disorders in Hanoi, Vietnam.Please check and confirm whether corresponding author's email id is correctly identified.The cooresponding author's email is correct METHODS: We conducted semi-structured, in-depth interviews (IDIs) (n = 21) and two focus group discussions (FGDs) (n = 10) with PWH receiving MMT who have CMD symptoms, their family members, clinic health care providers, and clinic directors. We applied thematic analysis using NVIVO software version 12.0, with themes based on IDI and FGD guides and emergent themes from interview transcripts. RESULTS The study found evidence of different stigmas towards HIV, IDU, and CMDs from the community, family, health care providers, and participants themselves. Community and family members were physically and emotionally distant from patients due to societal stigma around illicit drug use and fears of acquiring HIV. Participants often conflated stigmas around drug use and HIV, referring to these stigmas interchangeably. The internalized stigma around having HIV and injecting drugs made PWH on MMT hesitant to seek support for CMDs. These stigmas compounded to negatively impact participants' health. CONCLUSIONS Strategies to reduce stigma affecting PWH on MMT should concurrently address stigmas around HIV, drug addiction, and mental health. Future studies could explore approaches to address internalized stigma to improve self-esteem, mental health, and capacities to cope with stigma for PWH on MMT. TRIAL REGISTRATION NCT04790201, available at clinicaltrials.gov.
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Affiliation(s)
- Ha V. Tran
- The University of North Carolina-Vietnam Office, Hanoi, Vietnam
| | - Teresa R. Filipowicz
- grid.410711.20000 0001 1034 1720Department of Epidemiology, University of North Carolina, Chapel Hill, USA
| | - Kelsey R. Landrum
- grid.448980.90000 0004 0444 7651Faculty of Environmental and Occupational Health, Hanoi University of Public Health, Hanoi, Vietnam
| | - Ha T. T. Nong
- The University of North Carolina-Vietnam Office, Hanoi, Vietnam
| | - Thuy T. T. Tran
- grid.448980.90000 0004 0444 7651Faculty of Environmental and Occupational Health, Hanoi University of Public Health, Hanoi, Vietnam
| | - Brian W. Pence
- grid.448980.90000 0004 0444 7651Faculty of Environmental and Occupational Health, Hanoi University of Public Health, Hanoi, Vietnam
| | - Vivian F. Go
- grid.410711.20000 0001 1034 1720Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, USA
| | - Giang M. Le
- grid.56046.310000 0004 0642 8489Center for Research and Training in HIV/AIDS, Hanoi Medical University, Hanoi, Vietnam
| | - Minh X. Nguyen
- grid.56046.310000 0004 0642 8489Epidemiology Department, Hanoi Medical University, Hanoi, Vietnam
| | - Ruth Verhey
- grid.56046.310000 0004 0642 8489Epidemiology Department, Hanoi Medical University, Hanoi, Vietnam
| | - Dixon Chibanda
- grid.13001.330000 0004 0572 0760Department of Psychiatry & Research Support Centre, University of Zimbabwe, Harare, Zimbabwe ,grid.8991.90000 0004 0425 469XLondon School of Hygiene & Tropical Medicine, London, UK
| | - Hien T. Ho
- grid.448980.90000 0004 0444 7651Faculty of Clinical Medicine, Hanoi University of Public Health, Hanoi, Vietnam
| | - Bradley N. Gaynes
- grid.448980.90000 0004 0444 7651Faculty of Environmental and Occupational Health, Hanoi University of Public Health, Hanoi, Vietnam ,grid.410711.20000 0001 1034 1720Department of Psychiatry, University of North Carolina, Chapel Hill, USA
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Tran HV, Nong HTT, Tran TTT, Filipowicz TR, Landrum KR, Pence BW, Le GM, Nguyen MX, Chibanda D, Verhey R, Go VF, Ho HT, Gaynes BN. Adaptation of a Problem-solving Program (Friendship Bench) to Treat Common Mental Disorders Among People Living With HIV and AIDS and on Methadone Maintenance Treatment in Vietnam: Formative Study. JMIR Form Res 2022; 6:e37211. [PMID: 35802402 PMCID: PMC9308082 DOI: 10.2196/37211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 06/14/2022] [Accepted: 06/22/2022] [Indexed: 11/13/2022] Open
Abstract
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 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. Trial Registration ClinicalTrials.gov NCT04790201; https://clinicaltrials.gov/ct2/show/NCT04790201
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Affiliation(s)
- Ha V Tran
- The University of North Carolina, Vietnam Office, Hanoi, Vietnam
| | - Ha T T Nong
- The University of North Carolina, Vietnam Office, Hanoi, Vietnam
| | - Thuy T T Tran
- Faculty of Environmental and Occupational Health, Hanoi University of Public Health, Hanoi, Vietnam
| | - Teresa R Filipowicz
- Department of Epidemiology, University of North Carolina, Chapel Hill, NC, United States
| | - Kelsey R Landrum
- Department of Epidemiology, University of North Carolina, Chapel Hill, NC, United States
| | - Brian W Pence
- Department of Epidemiology, University of North Carolina, Chapel Hill, NC, United States
| | - Giang M Le
- Center for Research and Training in HIV/AIDS, Hanoi Medical University, Hanoi, Vietnam
| | - Minh X Nguyen
- Faculty of Epidemiology Department, Hanoi Medical University, Hanoi, Vietnam
| | - Dixon Chibanda
- Department of Community Medicine & Research Support Centre, University of Zimbabwe, Harare, Zimbabwe
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Ruth Verhey
- Department of Community Medicine & Research Support Centre, University of Zimbabwe, Harare, Zimbabwe
| | - Vivian F Go
- Department of Health Behavior, Gillings, School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States
| | - Hien T Ho
- Faculty of Clinical Medicine, Hanoi University of Public Health, Hanoi, Vietnam
| | - Bradley N Gaynes
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, United States
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Tuberculosis risk factors and Mycobacterium tuberculosis transmission among HIV-infected patients in Vietnam. Tuberculosis (Edinb) 2019; 115:67-75. [PMID: 30948179 DOI: 10.1016/j.tube.2019.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 12/18/2018] [Accepted: 02/03/2019] [Indexed: 01/28/2023]
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Strengthening advocacy efforts with empirical evidence: A case example of the conduct, uptake and utilisation of research in drug policy decision-making in Vietnam. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2017; 49:41-47. [PMID: 28910608 DOI: 10.1016/j.drugpo.2017.07.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 06/27/2017] [Accepted: 07/26/2017] [Indexed: 11/21/2022]
Abstract
During the last decade, international aid agencies and advocates have been working with Southeast Asian governments to move away from punitive responses towards people who use drugs to more public health, humane approaches. The lack of local scientific evidence about the effectiveness of different treatment approaches has made this advocacy work more challenging. This paper reflects on a generation of treatment research evidence and how it can assist advocacy efforts. The case example is the cost-effectiveness research, comparing centre-based compulsory treatment with community-based voluntary methadone maintenance treatment in Vietnam (2012-2015). Using our long-term and on-going connections with key Vietnamese decision-makers and government agencies, our collective experiences in drug policy advocacy and our unique insight into the working of government in Vietnam, we have used strategies to maximise opportunities for research to inform policy discussions. We have made an assessment here about the extent to which study findings have contributed to policy change in Vietnam and the challenges that impede progressive policy implementation. In doing this, we hope to make a contribution to the research evidence use literature.
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Nong VM, Boggiano VL, Nguyen LHT, Nguyen CT, Nguyen LH, Xuan Bach T, Nguyen HV, Hoang CD, Latkin CA, Vu MTT. Ability to join the workforce and work productivity among drug users under methadone maintenance treatment in a mountainous area of Northern Vietnam: a cross-sectional study. BMJ Open 2017; 7:e016153. [PMID: 28751487 PMCID: PMC5642751 DOI: 10.1136/bmjopen-2017-016153] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 06/09/2017] [Accepted: 06/13/2017] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES A major measure of treatment success for drug users undergoing rehabilitation is the ability to enter the workforce and generate income. This study examines the absenteeism and productivity among people who inject drugs (PWID) enrolled in methadone maintenance treatment (MMT) in Northern Vietnam. SETTING We conducted a cross-sectional study in two clinics in Tuyen Quang province. PARTICIPANTS A total of 241 patients enrolled in MMT. PRIMARY AND SECONDARY OUTCOME MEASURES Patients' work productivity was measured using the WPAI-GH instrument (Work Productivity and Activity Impairment Questionnaire: General Health V2.0). We also collected additional characteristics about participants' employment history, such as proficient jobs, whether they actively found a new job and be accepted by employers. RESULTS Most of the participants (>90%) were employed at the time of the study. Rates of absenteeism (missed work), presenteeism (impairment while working) and overall loss of productivity were 15.8%, 5.6% and 11.2%, respectively, as measured by the WPAI-GH questionnaire. The most proficient job was 'freelancer' (17.5%), followed by 'blue-collar worker' (10.6%) and 'farmer' (10.2%). Only 26.8% of patients reported that they actively sought jobs in the past. About half of them had been refused by employers because of their drug use history and/or HIV status. We found no statistically significant difference between patients enrolled in MMT for <1 year and those who had been enrolled >1 year. Factors associated with higher work productivity included not endorsing problems in mobility, self-care or pain; being HIV-negative and having greater MMT treatment adherence. CONCLUSION Our study highlights the high employment rate and work productivity among PWID in MMT programmes in remote areas of Northern Vietnam. The results can help to improve the quality and structure of MMT programmes across Vietnam and in other countries.
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Affiliation(s)
- Vuong Minh Nong
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam
| | - Victoria L Boggiano
- University of California Berkeley School of Public Health, Berkeley, California, USA
| | - Lan Huong Thi Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam
- School of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam
| | - Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam
| | - Long Hoang Nguyen
- School of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam
| | - Tran Xuan Bach
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Hung Van Nguyen
- Authority of HIV/AIDS Control, Ministry of Health, Hanoi, Vietnam
| | - Canh Dinh Hoang
- Authority of HIV/AIDS Control, Ministry of Health, Hanoi, Vietnam
| | - Carl A Latkin
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Minh Thuc Thi Vu
- Department of Immunology and Allergy, National Otolaryngology Hospital, Hanoi, Vietnam
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Trinh QM, Nguyen HL, Do TN, Nguyen VN, Nguyen BH, Nguyen TVA, Sintchenko V, Marais BJ. Tuberculosis and HIV co-infection in Vietnam. Int J Infect Dis 2016; 46:56-60. [PMID: 27044521 DOI: 10.1016/j.ijid.2016.03.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 03/24/2016] [Indexed: 10/22/2022] Open
Abstract
UNLABELLED Tuberculosis (TB) and human immunodeficiency virus (HIV) infection are leading causes of disease and death in Vietnam, but TB/HIV disease trends and the profile of co-infected patients are poorly described. METHODS We examined national TB and HIV notification data to provide a geographic overview and describe relevant disease trends within Vietnam. We also compared the demographic and clinical profiles of TB patients with and without HIV infection. RESULTS During the past 10 years (2005-2014) cumulative HIV case numbers and deaths increased to 298,151 and 71,332 respectively, but access to antiretroviral therapy (ART) improved and new infections and deaths declined. From 2011-2014 routine HIV testing of TB patients increased from 58.9% to 72.5% and of all TB patients diagnosed with HIV in 2014, 2,803 (72.4%) received ART. The number of multidrug resistant (MDR)-TB cases enrolled for treatment increased almost 3-fold (578 to 1,532) from 2011-2014. The rate of HIV co-infection in MDR and non-MDR TB cases (51/1,532; 3.3% vs 3,774/100,555; 3.8%; OR 0.77, 95% CI 0.7-1.2) was similar in 2014. CONCLUSIONS The care of TB/HIV co-infected patients have shown sustained improvement in Vietnam. Rising numbers of MDR-TB cases is a concern, but this is not "driven" by HIV co-infection.
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Affiliation(s)
- Q M Trinh
- Marie Bashir Institute for Infectious Diseases and Biosecurity (MBI), The University of Sydney, Sydney, Australia; NSW Mycobacterium Reference Laboratory, Centre for Infectious Disease and Microbiology - Public Health, ICPMR, Westmead Hospital, Sydney, Australia; Vietnam National Institute of Hygiene and Epidemiology, Hanoi, Vietnam.
| | - H L Nguyen
- Vietnam Administration of HIV/AIDS Control, Hanoi, Vietnam
| | - T N Do
- Vietnam Administration of HIV/AIDS Control, Hanoi, Vietnam
| | - V N Nguyen
- Vietnam National TB Program, Hanoi, Vietnam
| | - B H Nguyen
- Vietnam National TB Program, Hanoi, Vietnam; International Union Against Tuberculosis and Lung Diseases, Paris, France
| | - T V A Nguyen
- Vietnam National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - V Sintchenko
- Marie Bashir Institute for Infectious Diseases and Biosecurity (MBI), The University of Sydney, Sydney, Australia; NSW Mycobacterium Reference Laboratory, Centre for Infectious Disease and Microbiology - Public Health, ICPMR, Westmead Hospital, Sydney, Australia
| | - B J Marais
- Marie Bashir Institute for Infectious Diseases and Biosecurity (MBI), The University of Sydney, Sydney, Australia
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