On December 27, 2024, the Center for Research and Training on Substance Abuse and HIV (CREATA-H), Hanoi Medical University, SHP Clinic (Hanoi Medical University Hospital), and the WeCare Social Enterprise (SE) collaborated with Lighthouse SE Clinic to organize a training workshop titled “Screening, Brief Interventions, and Referral to Treatment for Substance Abuse.” This training targeted professionals currently working at Lighthouse SE Clinic. Participants in the training came from diverse professional backgrounds, including psychology, nursing, medicine, social work, and other related fields. These individuals brought extensive experience working in the PrEP program and engaging with various community groups. The workshop’s training team included notable experts such as Dr. Nguyễn Hữu Anh, a researcher in the Substance Abuse Specialist Group at CREATA-H, and Mr. Trần Văn Hưởng, a PrEP program counsellor at SHP Clinic. This initiative exemplifies the collaborative effort among stakeholders to enhance technical expertise and broaden the impact of the PrEP program, ultimately contributing to improved public health outcomes.

Trainees listening to the lecture on the process of SBIRT

During the training, the instructors shared in-depth knowledge on key topics, including: (a) Overview of addictive substances; (b) Stages of behavioral change and Motivational Interviewing; (c) Introduction to the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) toolkit; (d) Brief Intervention and Referral to Treatment (BIRT); and (e) SBIRT implementation procedure and experiences implementing at SHP clinic. In addition to theoretical content, the training featured practical activities such as scenario-based discussions and role-playing exercises. These activities enabled participants to not only understand the theoretical framework but also practice applying SBIRT procedures effectively.

Trainees participating in practical role-playing activities

The training concluded successfully, thanks to the active participation of the attendees. It provided an opportunity to share and discuss specialized knowledge, paving the way for the effective application of the SBIRT model in addressing substance use among clients participating in the PrEP program.

The meeting was attended by Assoc. Prof. Dr. Le Minh Giang, Deputy Director of the Center for Training and Research on Substance Abuse – HIV (CREATA-H) of Hanoi Medical University, which manages and provides technical coordination for SHP Clinic; MSc. Dr. Hoang Nam Thai; and MSc. Dr. Ramona Bhatia, Dr. Serena Yang Zhao from the CDC Atlanta, USA, along with management staff from both organizations.

At the opening of the program, Assoc. Prof. Dr. Le Minh Giang delivered a speech introducing the purpose and significance of the meeting, emphasizing the importance of data systems in optimizing the effectiveness of the PrEP program.

Following this, Dr. Bui Thi Minh Hao and MSc. Dr. Dang Thi Huong presented the HIV pre-exposure prophylaxis program at SHP and the system for managing and utilizing program data to monitor and evaluate service quality at  SHP Clinic. During the session, MSc. Dr. Van Dinh Hoa and MSc. Dr. Dang Thi Huong provided practical demonstrations and insights into the operation and utilization of the data system.

The meeting concluded with an exchange, discussion, and Q&A session on data management and usage for the HIV pre-exposure prophylaxis program at SHP, moderated by MSc. Dr. Hoang Nam Thai, MSc. Dr. Ramona Bhatia, and Dr. Serena Yang Zhao.

The event offered valuable insights and contributed to guiding improvements in the PrEP data management system, ensuring the program’s sustainability and effectiveness in the future

1. Organizing and Collaborating Units

The Nam Health initiative is coordinated by the Center for Training and Research on Substance Abuse – HIV at Hanoi Medical University, in partnership with WECARE Social Enterprise and the Faculty of Creative Writing – Journalism at Hanoi University of Culture. The program aims to nurture and support a core group of students to carry out communication activities, promoting health knowledge among male students at Hanoi University of Culture and expanding to other universities in the area.

2. Objectives and Content

The Nam Health Program focuses on providing knowledge on topics such as raising awareness on gender issues, gender diversity, and sexual orientation; sexual health and the importance of sexual safety; HIV and STI prevention; equipping students with knowledge and skills for HIV and STI prevention; community work; reaching at-risk groups; and supporting referrals when necessary. The core student team from Hanoi University of Culture participates in training sessions to gain knowledge and communication skills, becoming the pioneering force in spreading messages on health and sexual safety within the student community.
The program utilizes creative communication formats like short videos with embedded messages, photo contests, and group activities within school communities. It also enhances the use and dissemination of messages on social media platforms favored by young people.

3. Program Results and Significance

After three months of implementation, the program organized four training sessions for the Nam Health Team on topics such as HIV and STIs, gender and gender sensitivity, community outreach skills, and skills for organizing and producing health education communication products. Mr. Dau Sy Nguyen, the program coordinator, noted, “The program selected seven outstanding students from Hanoi University of Culture to form the Nam Health Team. These members participated in training, gaining knowledge and skills to implement communication activities and spread messages on gender, sexual diversity, and sexual health and safety. They then became the link to share what they learned with their communities.”

Mr. Dau Sy Nguyen, the program coordinator

After training, the Nam Health Team members planned, organized, and successfully coordinated four knowledge-sharing sessions on health through various creative and engaging formats, attracting the participation of over 400 young students from major universities in Hanoi, including the University of Foreign Trade, the University of Transport, the University of Technology, and Hanoi University of Culture.

 Biệt đội Sức khỏe nam sinh gồm 7 thành viên

Within the program framework, the creative photo contest “Photovoice: PrEPared for Life” was also successfully organized, receiving more than 50 entries. Many of these entries delivered meaningful messages, promoting positive health messages among young people in Hanoi.

The program’s online communication activities reached over 6,000 social media users, demonstrating the powerful spread of effective and positive communication products created by the participating students.

TTalkshow: “On PrEP – From Awareness to Effectiveness”

Additionally, the program has successfully reached, informed, and referred 11 young male students in Hanoi to register for PrEP and other health services at the SHP Clinic, Hanoi Medical University Hospital. This impressive number demonstrates the program’s effectiveness in increasing knowledge and access to preventive and sexual safety measures for students.

Mr. Pham Van Tam, Deputy Head of Student Affairs at Hanoi University of Culture

Mr. Pham Van Tam, Deputy Head of Student Affairs at Hanoi University of Culture, commented, “Hanoi University of Culture strongly supports health promotion programs for students, reflected in our curriculum and comprehensive health activities for students. We believe that quality programs like Nam Health will provide valuable health benefits for our students’ physical and mental well-being.”

Dr. Do Thi Thu Thuy, Head of the Faculty of Creative Writing and Journalism

Dr. Do Thi Thu Thuy, Head of the Faculty of Creative Writing and Journalism, emphasized, “Health communication for students is essential, especially since young students lack experience and skills to protect themselves. The Faculty of Creative Writing and Journalism is honored to collaborate with CREATA-H, WECARE Social Enterprise, and the SHP Clinic to bring positive values and improve student health within the Faculty and Hanoi University of Culture as a whole.”

Student Nguyen Duy Do, a member of the Nam Health Team

Student Nguyen Duy Do, a member of the Nam Health Team, shared, “Before participating in this program, I didn’t have much knowledge about sexual safety, especially preventive measures. After engaging in the program’s beneficial activities, I gained valuable knowledge to keep myself safe. I also feel more confident speaking in front of groups, sharing my thoughts and what I’ve learned with my friends and teachers.”

During the program, achievements in HIV prevention through PrEP in 2022 were shared, along with the facilitators, challenges encountered during the implementation, and future plans for 2023. According to the shared content, Vietnam is among the countries with the best PrEP delivery outcomes in the Asian region. The representatives from the U.S. CDC office in Vietnam also shared effective PrEP models from around the world and expressed their expectations for their application in Vietnam in the near future.

The organizations directly involved in the PrEP program for high-risk communities shared their models, discussing the advantages and challenges of different PrEP prevention programs, such as providing PrEP at healthcare facilities, mobile PrEP, and Tele-PrEP. The participating organizations included An Phu Hospital in Thai Nguyen province, Hai Dang Clinic, Nam Tu Liem District Health Center, and SHP Clinic at Hanoi Medical University.

In the presentation titled “Diverse Service Delivery Models with Customer-Centric Approach,” the Access and Communication management staff shared about the diverse service package available at a single visit, where customers can receive support from various experts in different fields to meet their diverse needs. Additionally, strategies such as enhancing the introduction of new service packages, expanding service delivery facilities, and extending customer support timeframes were discussed. Regular collection of customer feedback to improve service quality was also emphasized as one of the intervention program’s strategies with a customer-centric approach. Moreover, establishing codes of conduct and participating in regular training sessions to enhance skills and expertise in working with target clients were implemented to ensure the provision of the best customer-centric services in the comprehensive service delivery model.

At the end of the workshop, the organizers and participating representatives put forth recommendations and potential strategies for implementing PrEP programs in the community in the future. With the goal of reducing the risk of HIV transmission in the community, SHP Clinic will strive even harder to provide the best services and support to our clients!

The delegation included Mr. Hoang Nam Thai, M.D., a technical officer from CDC Vietnam, EPIC project officers from the central level, and 10 officers from CDC Can Tho and CDC Kien Giang. It was a great privilege for SHP Clinic to receive healthcare units from CDC Can Tho and CDC Kien Giang for a visit and to learn from the comprehensive clinic model for the target community.

During the exchange session, Prof. Le Minh Giang, representing SHP Clinic and Hanoi Medical University, delivered a welcoming speech to the delegation from the southern provinces. Prof. Giang emphasized that this was an opportunity for the SHP Clinic to share experiences and learn from colleagues in different localities to enhance the clinic’s operations in the future.

In the same session, Ms. Bui Thi Minh Hao presented the service delivery model and the strategy to attract the target group to utilize the services at the clinic. Subsequently, the members of the delegation had discussions, exchanged ideas, and posed questions to the clinic officers regarding the implementation experiences of service packages such as screening, care, and treatment of sexually transmitted infections (STIs), screening, intervention, and referral of substance abuse and chemsex cases, mental health issues, as well as ideas and approaches to communication strategies for promotion and attracting more clients to utilize the services at the clinic. The delegation then visited, talked, and had direct exchanges with the service providers at SHP Clinic.

We hope that this delegation’s visit will serve as a foundation for collaboration and development among many clinics providing OSS comprehensive healthcare services, specifically tailored for the target group, in various localities across the country in the future.

Speaking at the opening of the press conference, Assoc. Prof. Le Minh Giang, MD. PhD. – Head of Postgraduation Management and Training Department, Head of Epidemiology Department, Deputy Director of the Center for Training and Research on Substance Abuse – HIV emphasized the special importance of equipping knowledge about sex education for students of Hanoi Medical University. “Because you are the doctors, the future health workers, you have a decisive role in caring and protecting the health of the people. Having knowledge about safe sex, gender identity, gender sensitivity and prevention measures also means ensuring safety for yourself and the community”, said Assoc. Prof. Le Minh Giang.

The talkshow was also honored to receive the presence of Mr. Dang Quang Tan, Member of the Executive Committee of the Youth Union, Secretary of the Communist Youth Union of School of Preventive Medicine and Public Health. Mr. Dang Quang Tan shared that he will always accompany and encourage useful extracurricular activities for students and hope that there will be more meaningful and practical programs like today’s talkshow in the future, so that the students have the opportunity to access and update their knowledge and gain experience.

At the talkshow, Dr. Van Dinh Hoa. MD. MPH, Lecturer of Epidemiology Department, Physician at SHP clinic and Dr. Nguyen Duc Khanh. MD. – Physician at SHP Clinic gave interesting talks on gender identity, sexual orientation and safe sex, as well as prevention of HIV and sexual transmitted infections, especially about PrEP (pre-exposure prophylaxis).

Besides providing students with knowledge about gender, sexual health and the benefits of safe sex practice with PrEP, the talkshow is also a place where students can openly share their stories, listen to the opinions of the insiders and the experts. Here, the students also participated in an interesting Q&A game related to the topic of the seminar with extremely attractive gifts.

This is a new milestone in the long-term co-operation between the two partners in the field of HIV and other infectious diseases control in Vietnam. Hanoi Medical University Hospital is youthful but always tries to apply new treatment methods and trains them to many Vietnamese doctors. Therefore having an infectious disease department is very important.

Speaking at the event, Assoc. Prof. Nguyen Lan Hieu. MD. PhD, Director of Hanoi Medical University Hospital, thanked the US Embassy, ​​US CDC and other parties for their efforts and support to the hospital to formally establish a department for the treatment of infectious diseases, and in addition, carry out extensive activities to help patients’ lives such as assisting HIV patients to reintegrate into the community. This is what sets the department special to other infectious diseases departments.

Chargé d’Affaires of the US Embassy in Vietnam, Ms. Marie Damour, reaffirmed the US and US CDC’s strong commitment to building the health capacity of organizations in Vietnam. The US appreciates and is proud of the cooperation relationship and appreciates the Hanoi Medical University Hospital as one of the strong units in research and training. Ms. Damour believes that the newly established department will be a great unit for new patients and expects good results from the pilot models that the department has and will deploy in the near future.

The Department of Tropical Diseases and Harm Reduction was established in January 2021. The department currently includes a COVID-19 screening area, a tropical disease clinic, and a Sexual Health Promotion clinic (abb. SHP Clinic, specializing in consulting and treating sexual transmitted infections). Some functions and tasks of the department include examination and treatment of acute infectious diseases, chronic viral hepatitis (VGB, HCV); HIV screening, diagnosis, treatment and prevention, drug harm reduction, implementation of scientific research, related training and education.

Strong partnership

Since October 2012, the US Centers for Disease Control and Prevention has sponsored the Hanoi Medical University (HMU) and Hanoi Medical University Hospital (HMUH) in activities that play an important role in controlling the disease. HIV epidemic control in Vietnam, contributing to supporting experts in substance abuse treatment and HIV prevention in key populations, and scaling up the capacity of university research centers.

“In nine years, our total funding amounted to almost $5 million. In addition to finance, the cooperation is also technical. Experts from CDC and Hanoi Medical University have worked and contributed to HIV prevention in Vietnam. We are very proud of this,” said Dr. Eric Dziuban, director of the US CDC in Vietnam.

From 2017-2019, the US CDC funded an important study on HIV incidence among men who have sex with men (MSM) in Hanoi. The results showed that for every 100 MSM, 7 people could be infected with HIV within a year. These data also helped guide the strategic direction of the PEPFAR Program (U.S. President’s Emergency Plan for AIDS Relief) on HIV prevention among MSM.

Realizing the need for HIV prevention services for the MSM community, in 2019, the US CDC initiated support for pre-exposure prophylaxis (PrEP) at the SHP Clinic of Hanoi Medical University Hospital. PrEP is a medication that people at high risk for HIV take to remain HIV-negative. This is the first time that a university hospital’s clinic in Vietnam has prescribed HIV drugs, and Hanoi Medical University Hospital is still the only academic institution that has performed ARV prescriptions so far. In the past year, SHP Clinic has provided PrEP to nearly 3,000 clients.

To create opportunities to access treatment for infectious diseases and continue to be “a one stop shop model” to provide comprehensive services for MSM and other key populations, Hanoi Medical University Hospital has continued to further develop the clinic, added services to treat infectious diseases, hepatitis B and C, medical services for people living with HIV and other services for key populations at the newly established Department of Tropical Diseases and Harm Reduction (DTDHR).

Efforts to support HIV patients during the pandemic

Dr. Eric Dziuban added that the US CDC and Hanoi Medical University as well as Vietnamese health agencies have made many cooperative efforts to support HIV/AIDS patients during the COVID-19 pandemic.

“During COVID-19, because of social distancing measures, HIV/AIDS patients may be no longer able to access services and medicines. So our teams have worked tirelessly to help them overcome these barriers. Sometimes it’s about receiving larger amounts of medicine so they don’t have to go to the clinic too frequent, in addition, there is TelePrEP service to help support and counsel for patients remotely.

We are also working with the Vietnamese Ministry of Health so that people living with HIV can be given priority to get vaccinated, because they are at high risk for COVID-19 and when infected, they are also more susceptible to become severe.”

According to Chargé d’Affaires Marie Damour, the establishment of the Department of Tropical Diseases and Harm Reduction at Hanoi Medical University Hospital with the support of CDC this time will help people living with HIV with safe and healthy lives, while reducing the spread of the disease. The model of providing comprehensive services so that not only people living with HIV but also those in other infectious disease risk groups, in fear of discrimination, can have the services they need is a very important thing..

According to VTC News

Image source: Zing News

The U.S. Food and Drug Administration approved Apretude (cabotegravir extended-release injectable suspension) for use in at-risk adults and adolescents weighing at least 35 kilograms (77 pounds) for pre-exposure prophylaxis (PrEP) to reduce the risk of sexually acquired HIV. Apretude is given first as two initiation injections administered one month apart, and then every two months thereafter. Patients can either start their treatment with Apretude or take oral cabotegravir (Vocabria) for four weeks to assess how well they tolerate the drug.

“Today’s approval adds an important tool in the effort to end the HIV epidemic by providing the first option to prevent HIV that does not involve taking a daily pill,” said Debra Birnkrant, M.D., director of the Division of Antivirals in the FDA’s Center for Drug Evaluation and Research. “This injection, given every two months, will be critical to addressing the HIV epidemic in the U.S., including helping high-risk individuals and certain groups where adherence to daily medication has been a major challenge or not a realistic option.”

According to the U.S. Centers for Disease Control and Prevention, notable gains have been made in increasing PrEP use for HIV prevention in the U.S. and preliminary data show that in 2020, about 25% of the 1.2 million people for whom PrEP is recommended were prescribed it, compared to only about 3% in 2015. However, there remains significant room for improvement. PrEP requires high levels of adherence to be effective and certain high-risk individuals and groups, such as young men who have sex with men, are less likely to adhere to daily medication. Other interpersonal factors, such as substance use disorders, depression, poverty and efforts to conceal medication also can impact adherence. It is hoped that the availability of a long-acting injectable PrEP option will increase PrEP uptake and adherence in these groups.

The safety and efficacy of Apretude to reduce the risk of acquiring HIV were evaluated in two randomized, double-blind trials that compared Apretude to Truvada, a once daily oral medication for HIV PrEP. Trial 1 included HIV-uninfected men and transgender women who have sex with men and have high-risk behavior for HIV infection. Trial 2 included uninfected cisgender women at risk of acquiring HIV.

Participants who took Apretude started the trial with cabotegravir (oral, 30 mg tablet) and a placebo daily for up to five weeks, followed by Apretude 600mg injection at months one and two, then every two months thereafter and a daily placebo tablet.

Participants who took Truvada started the trial taking oral Truvada and placebo daily for up to five weeks, followed by oral Truvada daily and placebo intramuscular injection at months one and two and every two months thereafter.

In Trial 1, 4,566 cisgender men and transgender women who have sex with men received either Apretude or Truvada. The trial measured the rate of HIV infections among trial participants taking daily cabotegravir followed by Apretude injections every two months compared to daily oral Truvada. The trial showed participants who took Apretude had 69% less risk of getting infected with HIV when compared to participants who took Truvada.

In Trial 2, 3,224 cisgender women received either Apretude or Truvada. The trial measured the rate of HIV infections in participants who took oral cabotegravir and injections of Apretude compared to those who took Truvada orally. The trial showed participants who took Apretude had 90% less risk of getting infected with HIV when compared to participants who took Truvada.

Side effects occurring more frequently in participants who received Apretude compared to participants who received Truvada in either trial include injection site reactions, headache, pyrexia (fever), fatigue, back pain, myalgia and rash.

Apretude includes a boxed warning to not use the drug unless a negative HIV test is confirmed. It must only be prescribed to individuals confirmed to be HIV-negative immediately prior to starting the drug and before each injection to reduce the risk of developing drug resistance. Drug-resistant HIV variants have been identified in people with undiagnosed HIV when they use Apretude for HIV PrEeP. Individuals who become infected with HIV while receiving Apretude for PrEP must transition to a complete HIV treatment regimen. The drug labeling also includes warnings and precautions regarding hypersensitivity reactions, hepatotoxicity (liver damage) and depressive disorders.

Apretude was granted a Priority Review and Breakthrough Therapy designation. The FDA granted the approval of Apretude to Viiv.

The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency also is responsible for the safety and security of our nation’s food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.

Source:  FDA – U.S Food & Drug Administrator – https://www.fda.gov

Captured that achievement, on 9^th April, CREATA – H in collaboration with Infectious Disease and Harm Reduction Department, Hanoi Medical University hospital organized a training course “Gender sensitivity in providing friendly health service for key population” for 38 medical staff, with its end of increasing capacity working with clients from LGBTIQ community. At the opening remarks, Assoc. Le Minh Giang, Deputy Director of CREATA-H thanked the participants for their presences in busy working schedule and emphasized the importance of understanding the community we served.

The enthusiastic and informative training course was conducted by Mr. Doan Thanh Tung, Director of Lighthouse Social Enterprise, one of the leading experts in HIV-related services for key population.

Skills and counseling strategies to work with key population, in particularly for LGBTIQ community were discussed and practiced by role playing in healthcare setting mockup. This training course is a good opportunity for medical staff further understands their clients, from that, bring friendly services for them.

Opening remarks, Assoc. Dr. Le Minh Giang, PhD. made a speech about the necessity and importance of HIV self-testing for the 95-95-95 goal and ending the AIDS epidemic by 2030 of the National Strategy on HIV Prevention and Control.

Dr. Nguyen Thi Thuy Van, PhD – WHO representative in Vietnam shared about the plan to pilot the project of providing self-testing kits via website and the project’s significance in encouraging the community to self-test HIV at home.

MSc. Vo Hai Son – VAAC representative presented about HIV testing strategies in Vietnam, which emphasized the application of diverse solutions for HIV / AIDS testing counseling models in health facilities and in the community. Self-testing at home is one of the preeminent solutions in the context of the ongoing COVID-19 epidemic in Vietnam, as well as addressing the key population’s fears of stigma and discrimination when coming for HIV testing at medical centers.

Models of HIV self-testing at home through self-test kits via website have also been deployed in many different countries around the world and have been proven with  feasibility and effectiveness.

At the workshop, the delegates were introduced to the website www.tuxetnghiem.vn and given instructions on how to register to receive oral self-test kits. All information of the customers are committed to confidentiality. This model has been piloted in Can Tho since November 2020 and received many positive feedbacks. Customers with non-reactive results may access preventive services (such as: PrEP, condoms, lubricants). Customers with “reactive” results are transferred for confirmation HIV tests and access to HIV/AIDS treatment services. In Hanoi, the pilot project of providing HIV self-testing via website will be implemented at SHP Clinic – Hanoi Medical University Hospital from April to the end of December 2021.

Some pictures of the workshop: