Report of the Special Rapporteur on the right to health, A/HRC/20/15/Add.2, 4 June 2012: Viet Nam
V. PREVENTION AND CONTROL OF HIV/AIDS
43. Problems of data collection and intervention design are exacerbated by the stigmatization of vulnerable groups. The Commission on AIDS in Asia confirmed that the HIV epidemic in Asia is largely driven by vulnerable groups, including female sex workers (FSWs), injecting drug users (IDUs) and men who have sex with men (MSM). Stigmatization and discrimination of IDUs, FSWs and MSM often arises from, and is perpetuated by, criminalization (or de facto criminalization) of the activities of these groups. Stigma contributes to the spread of the epidemic by deterring affected individuals from accessing such health services as HIV testing and treatment for fear of criminal sanctions, violence and discrimination. Furthermore, stigmatization and discrimination present barriers to the development and implementation of preventative measures tailored to the needs of these vulnerable groups.
C. Participation in decision-making
59. Participation in health-related decision-making is also critical to empowering vulnerable groups. Empowerment of affected populations, particularly IDUs, FSWs and MSM, will encourage community-guided and community-led initiatives towards raising awareness of the issues faced by these groups. Such initiatives will also help combat the stigmatization and discrimination in the society. This will assist with the rehabilitation of IDUs and their reintegration into the wider community, ultimately improving the health outcomes of these populations. Moreover, other experiences show that community-led initiatives are more sustainable in the long run. For these reasons, the Special Rapporteur encourages the Government to facilitate the participation of vulnerable populations, including IDUs, FSWs and MSM, in the formulation and implementation of all decisions affecting their health. The Special Rapporteur also encourages community-based peer groups of current and former PWUD and FSWs, such as those currently operating in Hanoi, Hai Phong and Ho Chi Minh City, which offer support to PWUD and FSWs through group meetings, small loans, overdose prevention and connections to health and harm-reduction services.
VI. CONCLUSIONS AND RECOMMENDATIONS
63. The Special Rapporteur urges the Government to consider the following recommendations in the area of HIV/AIDS:
- Ensure accurate and complete epidemiological surveillance and data collection regarding HIV/AIDS;
- Eliminate stigmatization and create an enabling environment, in which at-risk populations, including injecting drug users, female sex workers and men who have sex with men, are able to effectively access health care, by de-penalizing drug use and sex work;
- Develop a strategy to account for reductions in international assistance in order to ensure that access to HIV/AIDS prevention, treatment and care is maintained and expanded;
64. The Special Rapporteur urges the Government to consider the following recommendations with respect to people who use drugs and rehabilitation centres:
- Close all “05” and “06” rehabilitation centres, with a view to replacing the current practice of compulsory detention and non-consensual treatment with alternative forms of treatment, care and support in compliance with international human rights standards;
- Support and encourage community-based peer groups of current and former people who use drugs and female sex workers that offer support through group meetings, small loans, overdose prevention and connections to health and harm-reduction services.
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