A STORY OF CHANGE IN VIETNAM

In Vietnam, an estimated 256,000 people are living with HIV. Key populations are disproportionately affected: 11 per cent of men who have sex with men and 17 per cent of transgender people are HIV-positive. These groups experience numerous challenges. Without effective solutions, HIV rates are expected to rise in Vietnam. Lighthouse, an organisation by and for LGBT people, successfully works toward improving access to HIV services for at-risk groups.

Fear of health staff’s rude behaviour

Vietnamese gay and bisexual men, male sex workers and transgender people are at a higher risk of contracting HIV than other groups, yet they face huge barriers to HIV services. Discrimination and stigmatisation by health workers is a major obstacle. Research reveals that, due to fear of health staff’s rude behaviour, men who have sex with men are very reluctant to access HIV testing, treatment and care. They feel unwelcome and rejected at health centres and so they don’t seek services such as testing for HIV and other sexually transmitted infections (STIs).

Key populations have limited access to essential services

According to the Vietnam Administration of HIV/AIDS Control (VAAC), 41.3 per cent of gay men have been tested for HIV. The VAAC also noted that, during the three-month period preceding their survey, only 11.7 per cent had accessed STI screening. This indicates that access to essential services is limited for this group.

Sensitivity programmes for Vietnamese health workers

Fortunately, in Vietnam barriers are being removed one by one. Thanks to the brave efforts of Lighthouse, the country now sees a growing number of trained healthcare workers offering quality HIV services to LGBT people. Creating welcoming environments free of stigmatisation and discrimination appears to be a major factor in reaching key populations with HIV services. That’s why Lighthouse, in collaboration with G-Link, developed training and sensitivity programmes, as well as tools, for Vietnamese healthcare providers. Before each training, Lighthouse conducted an assessment to assist clinics in identifying gaps in service delivery.

Lighthouse has rolled out its training project

So far, 22 health workers in two clinics in Hanoi have been trained. As a result, the number of men who have sex with men and transgender people accessing services in those clinics has significantly increased. Using the model developed as part of the Bridging the Gaps programme, Lighthouse has now rolled out its training and sensitivity project in eight provinces of Vietnam.

Lighthouse defends the human rights of LGBT people in Vietnam

Identifying the challenges

In 2016, the Bridging the Gaps programme hosted a Theory of Change workshop in Vietnam with LGBT people, sex workers and people who use drugs. Challenges in accessing HIV services were identified. Although services are available for at-risk groups and there is a robust response to HIV, accessing services continues to be a challenge in Vietnam. People who use drugs face stigmatisation and judgement by healthcare workers, which discourages them from accessing HIV services. Male sex workers are a hard-to-reach group. And men who have sex with men and transgender people experience stigmatisation and discrimination, often due to lack of knowledge among healthcare providers.

Rights-based services

During the workshop, the programme partners developed an approach for delivering quality, rights-based and sensitive services for LGBT people. The strategy for moving forward includes increasing knowledge of good models for healthcare delivery and providing comprehensive services for men who have sex with men and transgender people.

Raising awareness about LGBT rights

A significant effort of Lighthouse is raising awareness among LGBT people. To this end, the organisation organised workshops on sexual orientation and gender identity and events on Vietnamese laws and LGBT rights in which lawyers from Hanoi participated. Lighthouse also works on uniting LGBT people around health and rights. The ‘Out and Proud’ event held in 2017 offered a safe space where LGBT people could share personal experiences and unite around outstanding issues in their life, creating a sense of community.

Training on implementing research

In the past few years, Lighthouse has strengthened its research capacity to understand the needs of the community, the gaps and the opportunities to be able to provide effective solutions. Organisation staff participated in the Action for Access project, a community-based participatory research initiative to train community-led organisations on carrying out research.

The impact of Lighthouse’s work

Lighthouse’s work demonstrates that connecting rights to health is vital in the HIV response. Thanks to training and sensitivity programmes, a growing number of health workers are now delivering approachable and rights-based HIV services. Lighthouse has effectively changed attitudes towards Vietnamese LGBT people. This key population group now experiences fewer barriers when accessing HIV testing, treatment and care facilities.

Lighthouse Social Enterprise

Lighthouse is a community-based organisation in Vietnam by and for LGBT people. The organisation focuses on the prevention of HIV and other STIs and the promotion of sexual health. It also defends the human rights of LGBT people. Moreover, Lighthouse carries out community-participatory research, which contributes to its advocacy work. They are a partner in Bridging the Gaps through COC Netherlands and MPact (formerly known as MSMGF).

Lighthouse’s achievements – striking figures for 2017

  • Over 3,000 men who have sex with men and transgender people accessed health services, including HIV services. Before the training, in 2016, this number was 1,700.
  • Some 2,400 (80 per cent) of them are now using HIV and other STIs services at the two clinics.
  • At Lighthouse, 1,054 LGBT people received sexual health counselling; 452 were tested for HIV; all people who tested positive are now receiving HIV treatment.
  • Over 10,000 LGBT people signed up on Gtown, a web page with information on sexual health and community rights.
  • 300 LGBT people attended ‘Out and Proud’, a rights and advocacy event in Hanoi.

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Text: Anna Maria Doppenberg
Photos: Quoc Ahn Nguyen