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HIV law comes under fire in
Vietnam
By Tran Dinh Thanh Lam
HO CHI MINH CITY - A draft law that would
force people living with HIV/AIDS to inform their
spouses of their health status is under fire from
community health workers who claim the proposed
legislation is unrealistic and ignores the
realities in Vietnam.
The draft ordinance,
currently in the National Assembly's Standing
Committee states: "In case the HIV carrier refuses
to inform his or her spouse about their heath
condition, the local health center has the
responsibility to inform the spouse within 30 days
after receiving the HIV positive test."
But Hoang Thi Hanh, a community health
worker here, said convincing people to take an HIV
test is hard enough and the new draft law is
simply unrealistic. "It's already difficult to
tell the patient that he's got HIV; so I don't
know how I could ask him to tell the bad news to
his spouse," Hanh told Inter Press Service.
Nguyen Oanh, 26, is living with HIV (human
immunodeficiency virus) and he recalled the
difficulty of even getting health workers to
reveal the true results of his HIV test.
"When the doctors started treating me
strangely and kept me at a distance, I realized
something was wrong. They could not even tell me I
was HIV positive until I asked them," he said.
The first HIV case was detected in Vietnam
in 1990. According to official figures, there are
now 88,400 Vietnamese living with the virus that
causes AIDS, of which 14,000 have developed
full-blown AIDS, and nearly 8,000 have died.
But many international agencies believe
these figures are under estimated, mainly because
of under reporting and a lack of comprehensive
data collection - obstacles that are complicated
by a perception among some policymakers that
HIV/AIDS is associated with "social evils" -
namely prostitution and intravenous drug use.
The World Health Organization (WHO) said
the number HIV-infected people in Vietnam is
increasing rapidly, with the number of reported
HIV infections rising from 17,500 in 2000 to
86,000 in 2004. The WHO attributed the increase to
intravenous drug abuse, unprotected sex and
transmission through blood transfusions.
Only recently have people started to
become aware that women could contract HIV and
pass it on to their children if their infected
spouses hide their illness and take no protective
measures during sex. The draft legislation, which
is a revised version of the first ordinance on
HIV/AIDS promulgated in 1995, aims to limit these
cases.
In her appraisal report, Nguyen
Hoai Thu, director of the National Assembly's
Social Affairs Committee, remarked that the
revised provisions would be impractical if people
continued to regard HIV/AIDS as a "social evil".
Because of its association with sex and
death, community workers have found that what they
call the HIV/AIDS epidemic has also been
accompanied by an epidemic of fear, ignorance, and
denial, leading to stigmatization and
discrimination against people with the disease and
their family members. That perpetuates the culture
of silence and fear that surrounds the disease,
health workers say, and can prevent individuals
from being tested and treated for HIV/AIDS and
associated infections.
Deputy Minister of
Health Tran Chi Liem said the draft ordinance aims
to fight such stigmatization and discrimination.
"It respects human rights and the basic principles
of international law on HIV/AIDS prevention," he
said.
Meanwhile, Thu has suggested that
the ordinance should encourage young people to be
tested for HIV before getting married. She also
said the law could facilitate women having the
test before deciding to have a baby.
But
health worker Hanh disagrees. "If the draft
ordinance says a HIV test is compulsory for people
before they get married or for a woman before she
has a baby, it's against the basic principles of
international law on HIV/AIDS prevention," she
said, though she agreed that if such a test were
not compulsory, it would be "very difficult" to
convince people to take it.
While the
draft ordinance intends to force people who have
tested positive for HIV to inform their spouses of
their status, voluntary counseling and testing
centers (VCTCs) here have been doing it all along
- albeit more gently.
Many VCTCs have been
established all over Vietnam, providing patients
with free HIV testing and counseling. One started
last year at Bach Mai Hospital in Hanoi with the
support of Family Health International, funded by
the United States Agency for International
Development, has so far provided free testing and
consulting to some 3,100 people. About 23% have
tested positive for HIV.
"All records of
clients are kept confidential," said Dr Ngo Quang
Huy, who added that doctors and counselors meet
weekly to review cases for follow-up counseling
and support.
Ta Kim Anh, 24, who has
worked as a counselor at the Bach Mai Hospital's
VCTC convinced Nguyen Van Thanh, a 22-year-old
intravenous drug user suspected to be HIV
positive, to persuade his girlfriend to be tested
at the center.
"The first meeting is the
most important one as the counselor helps the
client to clearly understand the nature of HIV and
its implications. This helps condition the
person's mind for the test," said Kim Anh.
The VCTC informs people of their HIV
positive status only after they are ready to
receive the news. The center then refers them for
treatment at special hospitals and introduces them
to support clubs for people living with HIV/AIDS,
such as Bright Future and Sunflower.
Nationwide, VCTCs increase awareness about
the deadly disease through television, radio and
newspapers. They also train and employ people
living with HIV/AIDS to work at the centers as
counselors and managers and engage them in support
group activities.
They have also started
hotline services for queries related to HIV/AIDS.
"They [VCTCs] have worked effectively in
preventing and controlling HIV/AIDS," said Nguyen
Thanh Long, head of the Ministry of Health's
HIV/AIDS Control and Prevention Department.
Community health worker Hanh urged the
government to follow the VCTCs' example. "VCTCs
have informed the spouses of HIV-positive people
without any constraints. And they have done it
humanely, not causing too much grief."
(Inter Press
Service) |
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