河内当局拨款50亿越南盾（24.3万美元）取缔色情行业。资金的一半将用于建立性工作者康复中心，其中包括吸毒人员和艾滋儿童。其它一部分资金还将用于宣传用品的印刷与制作，例如教育手册、报纸和文件，以提高性工作者的认知。在该资金的支持下，河内警局也将对公共场所的非法按摩院以及色情场所进行突击。5月12日，越南政府在其官方网站上发布取缔色情业的五年计划，目标至2015年降低40%。预算高达6.29万亿（3005万美元）的项目经费将关闭国内各乡镇的色情行业，把对社会造成的损害降至最低。

    越南政府表示，在打击色情行业的过程中将融入一系列针对性工作者设计的服务，包括建立康复和医疗中心，提供职业培训，并提高公众对该行业的认知。

Asia Report 翻译

原文链接: http://www.thanhniennews.com/2010/Pages/20110601115436.aspx

  Hanoi authorities on Tuesday allocated VND5 billion (US$243,000) for a program to crack down on prostitution.

  Half of the funding will support a rehab center to treat sex workers, including those addicted to drugs, and HIV-infected children.

  Money will also be spent on propaganda such as leaflets, newspapers and documents aiming to raise awareness of sex workers.

  Hanoi police department will also be supported to strengthen crackdown on secret brothels and prostitutes in public places.

  On May 12, the government unveiled on its website a five-year plan to reduce prostitution by an initial 40 percent by 2015.

  With a budget of VND629 billion ($30.5 million), the program looks to free communes and towns from prostitution and minimize harms on society.

  Rehab and healthcare centers, job training for former sex workers and public awareness are among the measures the government said will be taken to battle prostitution.

Weblink: http://www.thanhniennews.com/2010/Pages/20110601115436.aspx

    在5月17日国际不再恐惧同志日这天，专家们在越南河内举行的研讨会上呼吁公众一同行动抵制针对性取向的歧视。"由于对同性恋缺乏认识以及社会偏见，很多同性恋者遭受家庭暴力。"越南志愿者小组ICS的联络与服务官员Huynh Minh Thao表示，她服务的志愿者小组致力于在越南社会为同性恋者塑造一个积极健康的形象。"如果大家都对同性恋有所了解，那么在父母发现自己的还是是同性恋者时，就能避免一些不必要的愤怒和困惑。"她补充道："改变固有观念是一个任重道远的工作，但是如果我们从家庭和社区层面一步步展开倡导和宣传，最终的结果还是可以很乐观的。"

    2008年越南社会、经济与环境研究所（the Institute for Studies of Society, Economy and Environment- ISEE）对越南3000名女同性恋者和变性者进行调查。结果显示20%受访者表示他/她们曾遭其他家庭成员殴打。

    该研究所高级研究员Nguyen Thi Thu Nam表示，产生自行政管理的偏见阻碍了国际机构为越南同性恋群体提供帮助。"主要障碍来自于医护工作者，不仅是医生，就连管理和行政人员也充满偏见。"

    Nam告诉本报国际家庭健康组织（Family Health International--FHI）对胡志明市和河内市的25名医护人员开展培训，教育他/她们如何发现针对同性恋的歧视。然而，受训者反馈表示在其工作的医院和诊所歧视的案例还是屡屡发生。

    美国国际开发署，越南社会、经济与环境研究所和国际家庭健康组织联合开展的调查报告显示，医护工作者中对男男性行为者（MSM）所持的歧视最高。该报告两位作者--联合国艾滋规划署的Chris Fontaine和国际家庭健康组织的Caroline Francis在本次研讨会上陈述了这份名为《污名化和歧视如何加速HIV感染--区域和全球证据回顾》的报告。

    Francis解释说这种污名化不仅仅发生在医疗机构。她在会议上说："无论你去任何地方，这种污名化都以不同形式存在。"该定性研究由8名来自胡志明市和9名来自河内的志愿者共同参与调查。结果显示对同性恋的歧视导致很多男同性恋者吸毒、偷窃、进行不安全性行为、斗殴、自杀、辍学，并引起沮丧和压抑的情绪。

    报告中充足的证据也显示了越南卫生系统内部持续存在的"恐同"情绪。"男女之间的性行为是正常的，但是男男或女女之间的性行为非常不正常，令人恶心。很多人都觉得非常不健康，我也这样认为。"在河内社区健康中心工作的22岁的工作人员告诉研究者。
报告中引用了某同性恋者的讲述："我朋友去医院治疗肛门溃疡，医生却冲他吼道：'肛门是用来排便的，而不是发生性行为的。'"

    越南是亚洲第一个、世界第二个批准加入《儿童权利公约》的国家，但最新的研究发现，参与研究的17个人中，其中13人曾遭受来自家庭、老师和朋友暴力。

    在越南艾滋病传染主要集中于注射吸毒人员、性工作者和男男性行为者（MSM）。越南卫生部估计截止2012年全国艾滋感染人口达28万，其中5670人为儿童。

研究者敦促越南领导人发展和实施全方位沟通项目，针对警察、教育从业者和与同性恋者关系亲密的人开展交流活动，帮助他们更深入地了解暴力和歧视所导致的后果。

    他们也号召为MSM群体开展心理、健康、就业、教育和法律咨询服务。来自胡志明市的男同性恋Buu表示："需要采取行动为同性恋者竖立一个积极的形象。""我们的社会不应该区别对待同性恋和异性恋者，我希望大家能够认同同性恋者之间的真诚的爱。"

Asia Report 翻译

组织：Family Health International (FHI)--国际家庭健康

原文链接：http://www.thanhniennews.com/2010/Pages/20110525141452.aspx

On Tuesday (May 17), experts called for renewed action against sexual discrimination at a forum in Hanoi. The event coincided with the International Day Against Homophobia and Trans-phobia.

 "A significant proportion of homosexuals suffer violence in their family because of limited awareness and social prejudices," said Huynh Minh Thao, communication and service manager of ICS - a volunteer group working to foster a positive image of homosexuality in Vietnam. "If everyone was better informed, we could help avoid some of the anger and confusion that occurs when parents discover their child is homosexual."

"Changing such perceptions is a big job but it is possible if it's done step-by-step at the familial and community levels," she added.

In 2008, the Institute for Studies of Society, Economy and Environment (ISEE) surveyed 3,000 gay, lesbian and transgender Vietnamese.

Twenty percent of the respondents said they had been beaten by their family members.

Nguyen Thi Thu Nam, a senior researcher at ISEE, said that administrative prejudices have hindered international organizations from providing assistance to Vietnamese homosexuals.
"There have been major barriers from medical workers--not just doctors but administrators and other officials working at medical facilities," she said.

Nam said 25 medical workers in Ho Chi Minh City and Hanoi were trained by Family Health International (FHI) about how to detect and diffuse discrimination against homosexuals.
However, the trainees have reported that the practice continues to exist in their hospitals and clinics.

According to a joint report by the United States Agency for International Development (USAID), ISEE and FHI, discrimination against men who have sex with men (MSM) persists among medical workers.

The findings, entitled "How stigma and discrimination drive HIV: A review of the regional and global evidence" were presented at the forum by authors Chris Fontaine of the UN's AIDS-fighting agency UNAIDS and Caroline Francis of FHI.

Francis explained that such stigmas go beyond medical facilities.

"It doesn't matter where you go, this stigma exists in different forms," she told the forum.
The qualitative research was collected with help from eight participants in HCMC and nine in Hanoi.

Their findings indicate that homosexual discrimination has pushed some gays to drug use, pickpocketing, unsafe sex, fighting, suicide, stress, depression and dropping out of school.
The report also presented ample evidence that homophobic attitudes continue to exist in Vietnam's healthcare system.

"Sex between a man and a woman is normal but sex between two men or two women is not normal... I think it's something sick. Many people in society think it's not healthy; I do too," a 22-year-old officer at Hanoi Community Health Care told the researchers.

The report quotes one homosexual as saying: "My friend sought treatment for a sore anus and the doctor yelled at him: 'the anus is for bowel movements, not for having sex.'"

Vietnam is the second country in the world and the first in Asia to ratify the Convention on Child Rights, but the recent study found that 13 out of 17 participants in the research reported suffering violence from family, teachers and friends during their formative years.

Vietnam's HIV epidemic is concentrated among people who inject drugs, sex workers and the MSM. The Vietnamese Health Ministry estimates there will be around 280,000 people living with HIV by 2012, including 5,670 children.

The researchers urged Vietnamese leaders to develop and implement comprehensive communications programs that target police, education practitioners and the intimates of homosexuals to help them better understand the consequences of violence and discrimination.

They also called for the creation of psychological, health, employment, education and legal counseling services for MSM.

"Action should be taken to create a positive image of homosexuals," Buu, a gay man in HCMC, told researchers. "Society shouldn't think of a gay couple as being any different from a straight one. We wish society would recognize that true love exists between homosexuals."

Organization：Family Health International (FHI)--国际家庭健康

Weblink: http://www.thanhniennews.com/2010/Pages/20110525141452.aspx

Ninh Binh province was home to Viet Nam's first imperial capital in the tenth century, but its past glory means little to Chi Hong.*  An HIV-positive widow who lives with her two school-age children in a small village, she cannot regularly get her AIDS medicines locally and so must travel three hours north to the modern capital, Hanoi. Supporting her family with a small vegetable stall, Chi Hong struggles to scrape together resources to pay for her trips to the doctor. Some months she has been unable to go.


Chi Hong's story is a common one in rural areas and isolated villages across Viet Nam and throughout Asia. Even when healthcare is available, those under treatment for HIV must often deplete their meager savings to travel grueling distances, an economic burden that weighs heavily on women like Chi Hong, who contracted HIV from her now-deceased husband and raises her children alone.

Enter the Ninh Binh savings groups

Recognizing that treatment access often hinges on the simple ability of patients to get to the doctor, TREAT Asia set up a small fund in 2008 to support medical transporation for members of two local HIV women's self-support groups. But that money eventually ran dry. Casting about for a way to make the emergency fund sustainable, TREAT Asia community manager Jennifer Ho considered microfinance, a system that makes small loans available to low-income people, often women who want to establish a small business.


Interested but Wary


The women of Ninh Binh weren't thinking about commerce, but they occasionally needed modest sums of money to keep their lives on track. Why not set up a savings-and-loan--a sort of borrowing collective--financed and organized by the women themselves so that they could help each other out in the event of health-related emergencies? Ho made a suggestion to two groups: each woman could put in 10,000 Vietnamese dong per month (US $0.75), borrow against the fund if they needed to, and pay the loan back with only modest interest. At the end of the year, group members would get their money back with an equal share of the interest generated from the loans.


The women were interested but they were wary. Microfinance was an unfamiliar concept in Viet Nam, and personal trust between group members was a question as well. "They raised issues like, what if the person in charge of the money spent it, or what if they didn't give it to the right person?" remembered Nguyen Thi Diu of World Concern Vietnam, who worked with TREAT Asia to implement the community savings program.


To help ensure transparency and accountability, the women's groups developed their own guidance on the types of loans they would make and the process of repayment. "We suggested that not just one person would keep all the money but maybe two or three in the group, and that they would decide together who would borrow the money," said Diu. "So then it was OK for them. Before then, the women's groups had a strong sense of solidarity, but now they really had to learn to trust each other."


The two Ninh Binh savings groups were established in mid-2009 with around 15 women in each group. Although the original idea was to support medical care, members soon decided to extend help to women like Chi Thuy, a widow whose seasonal income as a rice farmer made it difficult for her to pay school fees up front for her two young children, one of whom is HIV positive. "Living with HIV and bringing up children is very difficult," explained Diu. "So the women agreed to lend money sometimes for school fees as well."

After one year, the two community savings projects far exceeded expectations: more than 90 percent of the women contributed to the funds on a regularly basis and they repaid 100 percent of their loans. "By encouraging the participants to develop the habit of saving, they were able to provide each other with much needed financial assistance," said Ho.

Although the TREAT Asia project in Ninh Binh officially ended in 2010, the women's community savings projects live on. "Our goal was to help create a stronger community for HIV-positive women," said Ho. "Now, they've taken that goal into their own hands."

*Chi Hong and Chi Thuy's names have been changed in this story to preserve their privacy.

Weblink: http://www.amfar.org/world/treatasia/article.aspx?id=9679

Organization: TREAT Asia

    Ninh Binh省是10世纪越南第一帝国首都，但历史的辉煌对于Chi Hong, 一名携带艾滋病毒的寡妇来说却毫无意义。她与她的两个正在上学的孩子共同生活在一个小村子里，在那里她如果要获得艾滋病药物，必须乘车向北行3个小时到越南北部首府河内市。Chi Hong经营一个小蔬菜摊以维持家用，为了凑足旅费去河内看病，她尽全力东拼西凑，可还是有好几个月因经济状况窘迫而无法获得治疗。

    Chi Hong的经历在越南，甚至整个亚洲的边远的农村地区并不稀奇。尽管有关部门向病患提供医疗护理，但是那些接受艾滋治疗的病人常常需要把每一分钱花在去城市看病的长途旅行上，对于像Chi Hong这样的妇女来说，这是一个巨大的经济负担。她通过已去世的丈夫感染上艾滋病毒，目前正独自养育两个孩子。

进入Ninh Binh市存款互助小组

    由于是否能够获得治疗途径常常取决于病人求医的能力，因此2008年TREAT Asia组织为两个当地的艾滋妇女互助小组提供了医疗运输服务。但该款项很快用尽。为了保持资金的持续性，TREAT Asia社区项目经理Jennifer Ho考虑利用小额贷款，这是一种为低收入群体提供小型贷款的金融系统，很多妇女希望获得小型贷款以开展小规模的买卖。


感兴趣的同时也需保持谨慎

    Ninh Binh市的很多妇女并没有从事商业活动的想法，但她们时常需要一定数额的资金以支持其生活走上正轨。因此，当出现紧急的健康状况时，妇女们为什么不能自己组织起一个存贷系统，或者说一个集体借款系统来互相帮助走出困境呢？Ho对这两个小组提出建议：每人每月向集体交纳1万越南盾（0.75美金），在需要的时候以非常低的利率向该基金贷款。每年年底，小组成员从基金中收回自己的投资，并平分贷款所产生的利息。

    妇女们对此表示出了兴趣，但同时也保持一定的谨慎态度。在越南小额贷款还是一个新兴的概念，而且小组成员间的互信也是一个问题。国际非政府组织World Concern 越南办事处代表Nguyen Thi Diu 回忆："她们关心的问题是：如果管理贷款的人把钱花光怎么办？或者没有把钱交给负责的人保管怎么办？" 该组织与TREAT ASIA共同实施社区存款项目。

    为了确保项目的透明度和可靠度，妇女小组自行设计贷款种类指南和还款程序。 "我们建议指派二至三名小组成员来管理钱财，而不是把所有款项交予一人，几名管理员共同决定是否向申请人拨款。" Diu表示："这样对她们来说就放心一些。在此之前，妇女小组内部团结度很高，但现在她们不得不学习如何信任彼此。"

    2009年中旬NInh Binh市两个妇女存款小组成立，每个小组成员约15人。小组设立之初的想法是解决妇女面临的医疗问题，很快她们决定扩展项目救助领域，为Chi Hong这样的寡妇提供服务，因为依靠大米种植所获得的季节性收入根本无法支付她两个孩子（其中一人感染了艾滋病毒）的教育费用。Diu解释道："本身携带艾滋病毒，同时还要抚养孩子是非常困难的，所以妇女们一致同意为她提供所需的学费。"

    项目开展一年之后，两个社区存款项目的成果远远超出了预期：超过90%的妇女定期上缴存款，还款率更是高达100%。Ho表示"通过鼓励参与者养成存款的习惯，她们现在能够相互提供金融互助。"

    虽然TREAT Asia在Ninh Binh市开展的项目2010年就结束了，但妇女们的存款小组并未因此解散。"我们的目标是建立一个更强的艾滋妇女社区"Ho表示："现在她们通过自己的努力让这个想法成为了现实。"


（为保护个人隐私，文中 Chi Hong, Chi Thuy为化名）


AsiaReport 翻译


原文链接：http://www.amfar.org/world/treatasia/article.aspx?id=9679


组织：TREAT ASIA

VietNamNet /Viet Nam News

 

Nguyen Thanh Trung (not his real name), a gay man who lives in Ha Noi, was very upset by the way doctors discriminated against him when he was undergoing an anal health test in one of the city's many health clinics.

"The doctor told me to my face that having sex with men is not a natural act and asked me why I did it," Trung recalled.

"I was so upset that I left the clinic and will never return," he said.

 

This story was just one of many recounted by the Chair of the National Men who have Sex with Men (MSM) Technical Working Group Phan Huy Hien at a conference in Ha Noi timed to coincide with yesterday's International Day Against Homophobia.

"This is a very typical case in the MSM community," Hien said, "Most feel isolated and then refuse to go to such places."

"There's no doubt that societal stigma and discrimination are preventing MSM from obtaining their basic rights when it comes to accessing information and health services, especially for HIV/AIDS prevention and treatment of sexual transmitted diseases," said Hien.

 

A survey conducted last November by the Institute for Studies of Society, Economy and Environment of 25 health staff at several targeted health care clinics in Ha Noi and HCM City showed that some forms of stigma persisted despite efforts to serve clients in the best possible manner.

Doctors believed, for example, that becoming a homosexual was a fashion statement. They teased gay patients, and criticised anal sex despite training on gay issues, the survey revealed.

Le Van Thanh, head of a support group in central Da Nang, said few of the members of his group visited health clinics. Thus they had a serious shortage of information on how to prevent HIV/AIDS.

"There are many weird questions we receive, such as whether HIV/AIDS can be transmitted via sharing glasses of water or whether sexual lubricant could help prevent the spread of the virus," he said.

 

Figures from HCM City's Department of Health and the Family Health International in Viet Nam from last March showed at least 19,000 MSM aged from 15 to 49 were living in HCM City.

About 16.4 per cent of them tested positive for HIV/AIDS in 2009, an increase of 10 per cent on 2006.

The rate of those who used condom was only 24 per cent.

According to Hien, the National MSM Technical Working Group, together with its volunteers, mostly MSM, have carried out consultative work on HIV/AIDS prevention including supplying condoms and sexual lubricant free of charge for MSM in nine provinces and cities nationwide.

In addition, a guideline for comprehensive HIV/AIDS interventions for MSM has been completed and submitted for approval to the Vietnam Administration of HIV/AIDS Control. This would help improve the efficiency of the consultative work, he said.

Doctor Vo Thanh Trung, vice director of Da Nang City's AIDS Prevention Centre, said dissemination of information to doctors and health staff on legal issues over MSM should be stepped up at a grassroots level.

Brochures on MSM and relevant issues should be supplied to the community to eliminate stigma and discrimination, he said.

"It's time to act to create conditions for MSM to get the same rights as other citizens," he said.

 

Weblink: http://english.vietnamnet.vn/en/society/8367/gay-rights-group-tackles-insensitive-medical-care.html

Organization: Family Health International (FHI)

VietNamNet /Viet Nam News

  

         居住在河内的男同性恋者Nguyen Thanh Trung（化名）对自己在进行肛门健康测试时所遭受到来自医生的歧视感到非常难过。他回忆到："医生当着我的面说和男性发生性行为非常不正常，并问我为什么要这样做。我很沮丧所以立刻离开了诊所，并决定再也不去那里看诊了。"

 

    在【国际不再恐惧同志日】当天河内召开的会议上，越南国家男男性行为（MSM）技术支持小组主席Phan Huy Hien陈述了这个事例，他表示此类事件在越南屡屡发生。"这是MSM社区遭遇的典型案例。" Hien表示："很多人感觉遭到社会孤立，因此拒绝再去那一类场所。社会污名和歧视妨碍MSM群体获得基本的权利，特别是获得有关艾滋、性病防治的信息和健康服务的权利。"

 

    去年11月由越南社会、经济和环境研究所开展一项调查显示，25名来自河内与胡志明市的数个参与调查的医疗诊所的医护人员对同性恋持有固有成见，并未履行应对患者提供最佳诊治的责任。

 

    调查显示，一些医生认为成为同性恋是一种时尚标志。他/她们取笑同志病患，非但不对男同相关问题提供有用的咨询，反而还指责肛交行为。

 

    Da Nang市支持小组组长Le Van Thanh反映他的组员很少去诊所看病，因此他们严重缺乏如何预防艾滋病传播的知识。他说："我们听到过很多奇怪的问题，例如：艾滋病毒是否会通过同饮一杯水传播？或是润滑油是否能帮助预防病毒传播？"

 

    胡志明市卫生部与国际家庭保健组织越南办（Family Health International）的数据显示，2010年3月至今居住在胡志明市的年龄在15至49岁之间的MSM人口达19000人。其中16.4%于2009年艾滋病检测呈阳性反应，该数值较2006年上升了10%。另外，只有24%使用安全套。

 

    Hien表示越南国家MSM技术支持小组与志愿者（多数为MSM人群）共同开展防艾宣传咨询服务，活动包括在越南9个省市为MSM群体免费提供安全套和润滑油。另外，他们制作了《MSM艾滋全面干预指导手册》，并获得越南艾滋控制管理局的认可。他表示这大大提高了小组开展咨询工作的效率。

 

    Da Nang市艾滋预防中心副主任Vo Thanh Trung医生表示，对医生和医护人员宣传MSM相关法律议题需要与基层相结合。需要在社区分发MSM相关信息手册以减少污名和歧视。他说："是时候为MSM群体创造平等的条件，让他们获得和其他公民一样的权利。"

Asia Report 翻译

原文链接： http://english.vietnamnet.vn/en/society/8367/gay-rights-group-tackles-insensitive-medical-care.html

组织： Family Health International (FHI)--国际家庭健康

HANOI, 9 May 2011 (IRIN) - International health experts criticize Vietnam's estimated 70 compulsory drug treatment centres.

The centres are part of a government strategy aimed at "correcting the illegal behaviours of drug use and sex work", according to UNAIDS.

They are believed to hold 20,000-70,000 drug addicts and/or former sex workers, said a Hanoi-based health expert familiar with Vietnam's drug treatment procedures.

Vietnam's compulsory treatment centres "are counterproductive on every single level," said Simon Baldwin, a former senior technical officer for HIV and drugs, at the US NGO Family Health International, which is working on drug treatment in Vietnam.


More than 90 percent of injecting drug users held at these centres relapse into drug addiction upon release, according to UNAIDS.


Beneficiaries at the centres, which began opening in the mid-2000s, are supposed to receive counselling, health checks, and vocational training to assist recovery and prevent relapse. But according to health experts, employees are not trained to treat drug addiction, and the fear of being sent to the centres encourages drug users to go underground.

Stigma

When Vietnamese heroin addicts leave compulsory treatment centres, they face a "palpable and substantial" societal stigma against drug use, said Robert Ali of the World Health Organization's (WHO) Collaborating Centre for Research into the Treatment of Drug and Alcohol Problems.

Vietnam has made significant drug policy reforms since the mid-1990s, but most Vietnamese citizens and officials still see drug addiction as a "moral weakness" or "social evil" rather than a medical disease with a social dimension, Ali said.

Health experts say compulsory treatment centres coupled with widespread social stigma around drugs make it difficult for outreach workers to access the most vulnerable drug-user populations.

"The people who use drugs are a very marginalized and vulnerable population," said Ali. "One of the challenges for Vietnam is recasting and understanding what drug addiction is and being more accepting of people in the [drug-using] community."

Nguyen Thi Huynh, former chief of the Harm Reduction Department, Vietnam Administration of HIV/AIDS Control, said tolerance for drug addiction in Vietnam had improved over the last 20 years as a result of government interventions: "We have done a lot of outreach on television programmers, and the understanding of Vietnamese citizens about HIV and drug-use issues has changed a lot. The stigma is not as bad as it was before."
Methadone clinics opened
In the shadow of its controversial compulsory treatment centres, Vietnam has since 2008 opened 13 methadone clinics for heroin addicts.

The clinics will not replace the treatment centres but health experts hope Vietnam will move away from the compulsory treatment model towards a holistic drug treatment model which includes voluntary methadone treatment.

Methadone, a substitution therapy used to treat opioid dependence, helps assuage withdrawal symptoms for heroin addiction and prevent the spread of HIV among injecting drug users.

"Methadone treatment in Vietnam appears to be modelled on best practices," said WHO's Ali. "Individuals can determine whether they want to be in treatment, and they're provided with good clinical support and guidance."

Health experts commend Vietnam's methadone clinics as a positive step forward in drug-treatment policy, but the government's motives for introducing the clinics remain controversial.

"The government has rolled them out more out of concern over HIV/AIDS than for the lives of drug users themselves," said a Hanoi-based methadone expert who preferred anonymity.
Roughly a quarter of a million people are HIV-positive in Vietnam, and the figure is rising, according to a 2010 presentation by Kevin P. Mulvey, a substance abuse treatment adviser at the US embassy in Hanoi. Health experts say Vietnam's rate of HIV infection among injecting drug users, which UNAIDS reports is 57 percent, is among the highest in South Asia.

Vietnam's methadone clinics receive support from the US President's Emergency Plan for AIDS Relief (PEPFAR).

More than 2,000 patients were receiving methadone treatment across Vietnam in September, according to a 2010 presentation by Nguyen Thi Minh Tam, deputy head of the Harm Reduction Department, Vietnam Administration of HIV/AIDS Control.

Roughly 80,000 patients will receive methadone treatment at a minimum of 245 sites by 2015, according to a November decree by the Vietnamese health minister, Nguyen Quoc Trieu.

Hong Kong and Thailand implemented methadone treatment programmes in the 1970s. China and Malaysia followed suit in the mid-2000s, and Cambodia opened a pilot methadone clinic in September.


Weblink: http://www.irinnews.org/report.aspx?reportID=92599

Organization: Family Health International (FHI)

【IRN】


    国际健康专家对越南70所强制戒毒治疗中心提出批评。

    据联合国艾滋规划署称，这些中心属于政府"纠正非法药物使用行为以及性工作"的策略的一部分。来自河内的健康专家表示，在这些戒毒中心治疗的药物成瘾着和前性工作者人数达2-7万人。该专家对越南戒毒程序非常熟悉。

    来自美国非政府组织国际家庭健康（Family Health International）的艾滋病与毒品前高级技术官员Simon Baldwin表示，越南强制戒毒治疗中心对戒毒工作在越南国内开展"在每一个层面上都起到了反作用"。根据联合国艾滋规划署资料显示，90%以上的注射吸毒者在结束治疗后又再度复吸。

    这些在2005年前后运营的戒毒中心本应为就诊人员提供咨询、健康检查、职业培训等服务，以帮助病人康复并防止其再度复吸。但健康专家表示戒毒中心的工作人员并未接受过相关戒毒治疗培训，同时，许多毒品成瘾者由于害怕被强行送往戒毒所，只得转为地下。

污名化

    世界卫生组织（WHO）毒品与酗酒问题治疗研究协调中心的Robert Ali称，在离开强行戒毒所后越南海洛因成瘾者面临"明显的、大量的"社会对毒品成瘾者的污名化。Ali表示尽管在上世纪90年代中期越南进行了卓越的毒品政策改革，但大多数越南民众和官员仍对吸毒人员持有"道德堕落"或"邪恶"这一类的偏见，而非把吸毒问题看作为社会层面的医学疾病。

    健康专家称强行戒毒中心所持有的这种对吸毒人员的污名化使得扩展工作人员很难接触到那些最为脆弱的药物成瘾人群。Ali表示"药物成瘾者是非常脆弱的群体，他们总是处于社会边缘。越南所面临的一大挑战是重新塑造对毒品成瘾的认识，并提高对毒品成瘾群体的接受度。"

    越南艾滋防治管理局减害部（the Harm Reduction Department）前任首席执行官Nguyen Thi Huynh表示，在过去20年中，由于政府的持续干预，越南对毒品成瘾的社会宽容度已有明显提高。他说："我们在电视上做了大量宣传，越南民众对艾滋病和毒品问题的理解已发生了很多改变，目前社会污名化已不像过去那么严重了。"

美沙酮诊所

    在强制戒毒所相继建立的同时，自2008年起越南开设了13所美沙酮诊所，主要治疗海洛因成瘾。诊所不会取代强制戒毒中心，但健康专家希望越南能够改变强制戒毒这一模式，而采用更全面的毒品治疗模式，其中就包括非强制的美沙酮治疗。

    美沙酮作为阿片类物质依赖（opioid dependence）治疗的替代疗法，能够帮助减缓海洛因成瘾的脱瘾症状，并预防艾滋病毒在毒品注射者间传播。来自世卫组织的Ali表示："在越南美沙酮治疗被视为最佳疗法。病人可以决定是否需要治疗，他们能够获得良好的临床服务和指导。"

    健康专家认为越南的美沙酮诊所是戒毒治疗政策的一大进步，但政府对引进这种模式的动机仍还在讨论中。一位不愿透露姓名的河内美沙酮专家表示："政府对艾滋病毒的关注远远大于对毒品成瘾者生命本身的关注。"

    根据河内美国大使馆药物滥用治疗专家Kevin P. Mulvey在2010年的陈述，越南大约有25万艾滋病毒携带者。健康专家指出根据联合国艾滋规划署报告显示，越南毒品注射者的艾滋感染率高达57%，居南亚之首。

    越南美沙酮诊所受美国总统防治艾滋病紧急救援计划（PEPFAR）的支持。越南艾滋防治管理局减害部首席执行官Nguyen Thi Huynh在2010年的一次报告陈述中指出，2010年9月越南全国超过2000名患者接受了美沙酮治疗。根据越南健康部部长Nguyen Quoc Trieu颁布的11月法令，至2015年底，大约8万名患者将在全国245个治疗点接受美沙酮治疗。

    上世纪70年代香港和泰国就已开展美沙酮治疗项目。中国内地和马来西亚会后在2005年开展该项目，柬埔寨也于去年9月开设了美沙酮示范诊所。



Asia Report 翻译

原文：http://www.irinnews.org/report.aspx?reportID=92599

机构：国际家庭健康（Family Health International）