Despite much improvement since 2011, the stigma and discrimination faced by people living with HIV in Viet Nam remain unacceptably high, the People Living with HIV Stigma Index shows.
The index was created by the Viet Nam National Network of People living with HIV (VNP+) in 2011 following a survey done in Dien Bien Province and the cities of HCM City, Ha Noi, Can Tho, and Hai Phong.
A second survey was conducted in 2014 to both capture the existing levels of stigma and discrimination and the changes to them since 2011.
Each time around 1,600 people were polled, including those living with HIV attending outpatient clinics, HIV-positive females who inject drugs (PWID), HIV-positive men who have sex with men (MSM), and HIV-positive female sex workers (FSWs).
Comparison of the data from the two shows that the number experiencing rights violations was down in 2014 — by 10.6 per cent in case of people living with HIV and 25.5 per cent in case of FSWs.
The percentage of respondents reporting gossip reduced from 28.9 per cent in round 1 to 19.3 per cent in round 2.
Among recently diagnosed people living with HIV, discriminatory reactions from friends, neighbours, colleagues, and employers reduced from 30.7 per cent in round 1 to 7.7 per cent in round 2.
The data also shows that the incidence of many types of stigma and discrimination remains unacceptably high, particularly against people living with HIV who also engage in transactional sex, injecting drug use and same-sex relationships.
FSWs, other women living with HIV, and PWID were most likely to have suffered rights violations, with 94 per cent of all respondents who reported such violations not seeking legal redress.
Gossip remained the most commonly reported form of stigma and discrimination, and was experienced by nearly a quarter of respondents within the last 12 months.
Insults and social exclusion were experienced by 5.8 per cent and 2.6 per cent of people living with HIV.
FSWs living with HIV and other women living with HIV were the most likely to report physical assault (6.5 per cent of FSWs and 2.8 per cent of other women) and verbal insults (13 per cent and 6.6 per cent).
People living with HIV also encounter barriers to finding and retaining employment, with no statistically significant improvements since 2011.
A total of 4.2 per cent of respondents reported losing their job or source of income, and 6.7 per cent reported being refused employment or job opportunities in the previous 12 months.
Nearly 2 per cent reported being denied health-care services and 1.3 per cent said they had been forced to relocate or unable to rent accommodation in the past 12 months.
There are very high rates of disclosure to others without the consent of the person involved, with more than one-third of respondents and nearly half of PWID reporting this.
High levels of stigma and discrimination combined with low confidence in the confidentiality of HIV tests mean that many people living with HIV only seek tests after their immune systems become extremely weak and they develop symptoms of opportunistic infections.
More than 37 per cent of all male respondents, 29.7 per cent of PWID, 21.9 per cent of FSWs, 17.9 per cent of MSM, and 17.8 per cent of all female respondents said they took a test because of suspected HIV-related symptoms.
Among recently diagnosed people living with HIV, 63.7 per cent of those interviewed in 2014 had not disclosed their status to their husband/wife/partner compared to 38 per cent in 2011.
There were also very high rates of non-disclosure by FSWs to their clients (91.1 per cent) and by PWID to their injecting drug partners (33.3 per cent).