Intersecting Stigmas among HIV-Positive People Who Inject Drugs in Vietnam

Mai Do; Hien Thi Ho; Ha Thu Dinh; Ha Hai Le; Tien Quang Truong; Trung Vu Dang; Duong Duc Nguyen; Katherine Andrinopoulos

doi:10.1177/11786329211013552

Intersecting Stigmas among HIV-Positive People Who Inject Drugs in Vietnam

Health Serv Insights. 2021 Apr 30:14:11786329211013552. doi: 10.1177/11786329211013552. eCollection 2021.

Authors

Mai Do¹, Hien Thi Ho², Ha Thu Dinh³, Ha Hai Le⁴, Tien Quang Truong³, Trung Vu Dang⁵, Duong Duc Nguyen⁵, Katherine Andrinopoulos¹

Affiliations

¹ Tulane School of Public Health and Tropical Medicine, New Orleans, LA, USA.
² Faculty of Clinical Medicine, Hanoi University of Public Health, Hanoi, Vietnam.
³ Faculty of Social and Behavioural Sciences, Hanoi University of Public Health, Hanoi, Vietnam.
⁴ At the time of the study, Dr. Le was with Hanoi University of Public Health, Hanoi, Vietnam.
⁵ USAID, Hanoi, Vietnam.

Abstract

HIV-related stigma remains a barrier to ART adherence among people living with HIV (PLWH) globally. People who inject drugs (PWID) may face additional stigma related to their behavior or identity; yet, there is little understanding of how these stigmas may co-exist and interact among these key populations. This study aims to explore the existence of multiple dimensions of HIV-related stigma, and how they may intersect with stigma related to drug injection. The study took place in Vietnam, where the HIV epidemic is concentrated among 3 key population groups; of those, PWID account for 41% of PLWH. The vast majority (95%) of PWID in Vietnam are male. Data came from in-depth interviews with 30 male PWID recruited from outpatient clinics, where they had been receiving ART medications. Deductive, thematic analysis was employed to organize stigma around the 3 dimensions: enacted, anticipated, and internalized stigma. Findings showed that HIV- and drug use-related stigma remained high among participants. All 3 stigma dimensions were prevalent and perceived to come from different sources: family, community, and health workers. Stigmas related to HIV and drug injection intersected among these individuals, and such intersection varied widely across types of stigma. The study revealed nuanced perceptions of stigma among this marginalized population. It is important for future studies to further investigate the influence of each dimension of stigma, and their interactive effects on HIV and behavioral outcomes among PWID.

Keywords: HIV; Vietnam; intersectionality; people who inject drugs; social stigma.