My name is Doan Thanh Tung, and I’m 27 years old. I’m the Director of Lighthouse, an organisation by and for LGBT people in Vietnam. We offer welcoming HIV services for men who have sex with men and others at risk of HIV. I’m a gay man myself. As a young boy, I suffered bullying, stigma, violence and isolation. In the first year that I had sex, I wasn’t aware of the risks and didn’t use a condom. But when I heard about HIV, I began to panic. Fortunately, I learned about Lighthouse at a community event and received advice and support from their counsellors. I have stood with them ever since.
I listened to people’s stories
Nine years ago, I started at Lighthouse as a volunteer. Then I became an outreach worker, peer educator, trainer, researcher, counsellor and tester. In each role, I connected with the community, listened to people’s stories and was able to support them. This has been the motivation to continue my work. I have had many career opportunities, but I chose to stay with Lighthouse.
Disrespectful behaviour in healthcare
HIV rates are alarmingly high among Vietnamese LGBT people. Many don’t access healthcare because they fear stigmatisation and discrimination. Besides lacking knowledge about LGBT people’s needs, language and culture, health workers are often prejudiced and consider LGBT people evil. People look down on others who seem to deviate from the social norm. All of this leads to disrespectful behaviour and different treatment in healthcare settings, even refusal to provide services. For example, a client of Lighthouse told me that one day he went to a public hospital with anal complaints and told the doctor that he had had sex with men. The doctor expressed his scorn and stated that homosexuality is a disease. The man felt very offended and never went back.
People look down on others
who seem to deviate from the social norm
A lot of misinformation about HIV
Every year, thousands of men who have sex with men move from the provinces to the cities and join our community. Social media makes it easy for them to get information. But there is a lot of misinformation, and the information that is available is often presented rigidly without using the language of the community. I see that many projects in Vietnam only focus on finding new HIV cases, but they also need to raise awareness about sexual health, risks and accessible services.
Discrimination at work
Vietnam doesn’t have enough HIV services for LGBT people specifically. Existing services are often unwelcoming to men who have sex with men, and available psychological counselling is lacking. The system of laws and policies related to the LGBT community is a barrier as well. We do have a law on HIV and AIDS prevention, but it isn’t applied properly. That’s why many LGBT people still suffer discrimination at school or at work and are refused use of medical services. The community, the government, non-governmental organisations, donors and other stakeholders must join forces. If we don’t come up with collaborative strategies, I’m afraid we’ll have an HIV outbreak in Vietnam soon.
HIV services are often unwelcoming to men who have sex with men
Support for people who access testing
Lighthouse is the first organisation in Hanoi, Vietnam that works to end HIV in the LGBT community. I’m extremely proud of our bold efforts. Lighthouse is run by LGBT community members. Our office is a safe space where LGBT people can share their story, get information and make use of quality healthcare services. We also provide PrEP, PEP, condoms and lubricant. And we offer psychological counselling and support for people who access HIV testing and treatment. Lighthouse has become a trusted place, a home for many LGBT people.
Counsellors with a friendly attitude
We work with trained counsellors who are members of the community themselves. They have the knowledge and skills to answer questions about HIV and related subjects. Our counsellors are patient and have a friendly attitude. After HIV testing, we share the test results and explain the follow-up procedure with clients in such a way that they will understand it. So far, all people who tested HIV-positive at Lighthouse have been successfully referred to treatment services. Every month, we support ten to fifteen new people in starting HIV treatment.
We also focus on small subgroups
At Lighthouse, we offer solutions in which the community members themselves are involved and which also empower them. Trained peer educators reach out to people at risk of HIV, online and in-person at events and hotspots. People can easily make an appointment via Facebook, telephone, a chatting app or in-person at our office. To reach community members effectively, we identify new community trends. In addition to working with the general LGBT community, we also focus on small subgroups who are often overlooked, such as LGBT people who sell sex and those who use drugs.
Peer educators reach out to people at risk of HIV,
online and in-person
Lighthouse makes health workers aware of diversity
Vietnamese health workers often don’t know how to communicate with LGBT people. So, we’ve developed sensitisation training programmes for them. One participant said: ‘Thanks to the training, I’m now aware of the diversity of genders and sexual behaviour and the existence of community languages. From now on, LGBT people will definitely feel better when they meet me.’
Service providers make change happen
Besides implementing the training, Lighthouse also assessed the situation in one clinic before and after sensitisation. We saw that, after the training, the clinic had moved the counselling room to a more private area. Also, the waiting room now contains information materials for the community of men who have sex with men, and the clinic is decorated according to the taste of the community. Clinic staff reported that, after about one year, the number of LGBT people using the services had nearly doubled and the level of satisfaction had increased. The service providers themselves made these positive changes happen. This is really great.
We talk with the government
I see encouraging developments in Vietnam that give me hope for the future. Many HIV services have become more welcoming for LGBT people, thanks to our training programmes for health workers. And Lighthouse staff is empowered to talk with the Vietnamese government about HIV programming and community rights. We know how to connect health and rights.
Solidarity is crucial
I think that we can stop the HIV epidemic in Vietnam. Solidarity between key population communities and the government is crucial, as well as the empowerment of these communities to take the lead in the fight against HIV. Bridging the Gaps is the first project in Vietnam that builds the capacity of the LGBT community to meaningfully participate in the HIV response. I sincerely hope that donors will continue to finance this programme – it will be an investment in community development and sustainable HIV programming.
Text: Anna Maria Doppenberg
Photos: Quoc Ahn Nguyen