UCLA Chancellor Gene Block (first row, center), and his wife Carol (to his left), enjoyed a visit on July 1, 2014, with Le Minh Giang, MD, PhD (back, second from right), a co-principal investigator on ISAP’s Vietnam HIV/Addiction Technology Transfer Center (VHATTC), which is housed at Hanoi Medical University (HMU). ISAP collaborated with UCLA’s Center for World Health to send two UCLA medical students, Becky Lee and Trang Dinh (back row, second and third from left, respectively) to HMU to conduct research with Dr. Giang as part of a short-term training project that supports UCLA medical students with interests in global health research. Chancellor Block, who was on a goodwill tour across Asia, happened to learn of ISAP’s collaborations with HMU and the UCLA School of Medicine (Program in Global Health), and so arranged this visit. Others in the photo are VHATTC colleagues of Dr. Giang.
Vietnam-HIV Addiction Treatment Transfer Center (VHATTC)
With support from the United States PEPFAR (President’s Emergency Plan for AIDS Relief) and SAMHSA (Substance Abuse and Mental Health Services Administration), Hanoi Medical University, in collaboration with ISAP (Integrated Substance Abuse Programs) of the University of California, Los Angeles, initiated the Vietnam – HIV Addiction Technology Transfer Center (VHATTC) at the end of 2011. Our mission is, first, to build our own training capacity to help with the expansion of the methadone maintenance program in Vietnam and then to enhance Hanoi Medical University’s competence in addiction science, in general, and substance abuse, in particular, which will contribute to the control and prevention of HIV/AIDS infection in Vietnam.
According to the Vietnam Ministry of Health, by June 2012, there were over 200.000 people living with HIV countrywide, including 58.000 AIDS patients; more than 60.000 people died of HIV/AIDS. Despite a significant increase of infection through sex, unsafe injection drug use remains the driver of the epidemic. Almost 40% of the people living with HIV are injection drug users. Many others who have HIV are partners of these users. Unsafe injection drug use, therefore, plays an important role in the expansion and maintenance of the HIV pandemic in Vietnam. In addition, the trend of drug use becomes more complicated with the use of amphetamine-type stimulants, such as crystal methamphetamine, ecstasy (MDMA), or ketamine—all of which are substances with long-term harmful effects on people’s health (including HIV infection and risk for unsafe sex)—which are becoming more and more popular among youth in big cities.
From mid-1990, Vietnam has tried series of intervention models to lessen the burden of injection drug use on people’ health and society, including community-based and institution-based detoxification, distribution and exchange of clean syringes, and methadone treatment for opioid dependence. Since 2008, from two pilot sites in Hai Phong and Ho Chi Minh city, the program has widely expanded to over 11 provinces and cities, with almost 10,000 patients. The plan of the Ministry of Health is that by 2015, more than 80,000 heroin addicts will be treated with methadone in over 200 clinics countrywide. In addition, the efforts of the Ministry of Labor, Invalids and Social Affairs, to set up and open community-based centers for voluntary treatment is also an important strategy to change the addiction treatment model in closed settings.
One challenge for these meaningful strategies is to ensure high quality of workers who can meet the technical requirements of their job, who have essential expertise in their field, and who can get continuing education. In the past years, the Vietnam Ministry of Health, in collaboration with PEPFAR, Global Fund, and the World Bank, through organizations such as FHI360 and SCMS, has organized a series of methadone maintenance treatment training courses that helped to meet the program’s development needs. However, this activity was not in line with the system of medical and public health training in Vietnam, in that there was limited participation of practical clinics; for example, there was low involvement of the psychiatric hospital system. Therefore, the VHATTC was initiated.
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Vietnam Screening, Brief Intervention, and Referral to Treatment (SBIRT)
In September 2013, UCLA ISAP was awarded an administrative supplement by the National Institute on Drug Abuse ("SBIRT for Substance Abuse in Mental Health Treatment Settings”) in the amount of $99,700 over one year in order to implement two methods of conducting screening, brief intervention, and referral to treatment (SBIRT) in three different HIV treatment and testing centers in Vietnam. These supplemental funds move research beyond the scope of the original Vietnam HIV – Addiction Technology Transfer Center (VHATTC; see http://vhattc.org/) grant to include settings that deliver HIV testing and treatment.
In this supplement, the UCLA ISAP and HMU teams will achieve the following goals: (1) Develop an SBIRT protocol adapted for the Vietnamese culture and translated into the Vietnamese language; (2) Train peer educators and research staff in Vietnam to administer the SBIRT protocol and collect study data; (3) Administer the SBIRT protocol to 600 individuals receiving services in a hospital-based HIV outpatient clinic (OPC), a free standing OPC, and a voluntary HIV counseling and testing center (VCT); (4) Compare two methods of administering the screening: a self-administration of a screening instrument (likely the ASSIST), using a tablet PC, and paper-and-pencil administration of the same screening instrument by a peer educator.
The supplement will provide information on the feasibility of conducting SBIRT in HIV treatment and testing centers in Vietnam; the types and amount of drug and alcohol use in these HIV settings; and a short-term assessment of the impact of brief interventions (81) on drug/alcohol use and entry into treatment for those referred. The information collected in this supplement will provide the foundation for a NIDA implementation sciences R-01 application to study different implementation models for integrating SBIRT into HIV testing and treatment centers.
For more information, please visit: http://vhattc.org/