Social and Health Benefits of HIV Research with People Who Inject Drugs: The Experience of the Drive-in Initiative in Vi

1. Social and health benefits of participating in HIV research with people who inject drugs: Experience of the Drugs and Injections in Vietnam - Initiation (Drive-in) Nguyen Thi Phuong Thao, KhuatThi Hai Panh,, Don Des Jarlais, Marie Jauffret-Roustide, Duong Thi Huong, Pham Minh Khue, Le Bach Duong, NhamThiTuyetTHanh, Hoang ThiGiang, Didier Laureillard, Nicolas Nagot

2. Content Background Objectives Objects and Methodology Results & Discussion Conclusion Recommendation

3. Background • HIV epidemic in Vietnam has concentrated highly in the groups of injecting drug users, men who have sex with men (MSM) and female sex workers (FSWs). • Hai Phong: • Is the biggest industrial city, the 4th biggest urban area in the country • Is in a convenient position for both sea and road traffic; is the gateway for drugs to get to Vietnam  Is one of the provinces with the highest population of injecting drug users

4. Background • Existing research projects have: • Focused on providing services: treatment and harm reduction • Few research projects on approach methods, especially with difficult-to-approach groups such as: • MSM who are injecting drug users • FSWs who are injecting drug users

5. Objectives To identify measures to improve the efficiency of different approach and sample selection methods for research purpose To gain understanding on the motivation of the participants

6. Methodology • Context: • This research is a part of the qualitative module that was carried out in the Respondent Driven Sampling (RDS) period of the multi-national project on drugs’ impact (Drive-in). • Methodology • Qualitative: Ethnigraphic observation and face-to-face in-depth interviews • Study objects: Selected from 603 participants in RDS • Study sample: 30 including new injecting drug users (8), long-term injecting drug users (8), MSM injecting drugs (7) and FSWs injecting drugs (7)

7. Results Demographic – social characteristics of the research participants

8. Demographic – social characteristics of the research participants(continued)

9. Benefits for participants • Economic benefits are not all “ In the beginning I have to say to honestly people invited each other to go for 200,000d so I thought I would be able to get that. But now money is not so important anymore. It’s not because of this 200,000 that I have come all the way from Do Son to here. Yes, like this morning, yesterday she called me she told me about the allowance of 200,000 for my travel but I don’t think that I come here because of that 200 but … basically I want to do everything again, all what I have lost”.

10. Benefits for participants (continued) • Health benefits • More knowledge on HIV and STIs • Get HIV, HCB, HCV tests • Get support in accessing Methadone treatment

11. Benefits for participants (continued) • Stigma is a barrier • Stigma from their family and community “in their looks, their way of speaking and their attitudes” • Stigma against their drug injection, HIV status and their work “Well in general it’s common that people keep distance and stigmatize. It feels like… it’s very difficult to describe. But that’s their thoughts, I don’t really know what those thoughts are. Sometimes I am very ashamed. Very ashamed. Who wants to beg anyone for anything really?” (case01)  A small number of participants was hiding their drug use situation.

12. Benefits for participants (continued) • Experience when paritcipating in the research • For most participants this is the first time they take part in a research project • The first time they can talk about themselves, their family, drug use and their life in general “ I feel that I can share my stories. It is often for drug users like us, not because I desire it that much, it’s not desire, but it’s family issues or work issues that make us stressed and come back to drugs… For many people when I say that they cannot understand, but when I talk to people like me I can share everything, I can be honest.” • Feel relaxed because they are not judged

13. Benefits for participants (continued)  To adjust the organizing and implementing process for the future phases • To identify the most effective approach method • Location: Railway area in the centre of the city, Quay bridge, Niem bridge • Time: 4 – 5 pm • Method: community-based

14. Results and Recommendations In addition to intervention activities, qualitative research modules help better identify more effective approach method and the participants’ motivation for their involvement in the research Community-based approach method helps expand and diversify the recearch participant group. Injecting drug users normally have limited social relationships due to stigma The research participation is an opportunity for injecting drug users to share and reflect upon their lives, hence encourages them to want to receive treatment and escape drug dependence situation.

15. Thank you!