a whole lot of acronyms

Today was spent in Hai Duong (pronounced: "high zoong") for a field trip for our HIV/AIDS class. We toured an out-patient clinic (OPC), a methadone maintenance therapy clinic (MMT) and a voluntary counseling and testing center (VCT).

At the OPC, we were able to ask questions about how they ran the clinic, who funded their projects and some of their projects. They are funded by Live Gap (a Vietnamese health program), Global Fund, and the Clinton Foundation. The problem with all the international funding is that it will eventually dry up. Also, the money can only be allocated for resources that the donor approves. At the OPC, they run testing for HIV and for opportunistic infections that take advantage of a person living with HIV's weakened immune system. They also provide antiretroviral (ARV) medicines. Patients at the OPC can come pick up their ARVs monthly. There is a needle exchange program run out of the OPC that provides intravenous drug users (IDUs) with clean needles and collects the old ones to prevent HIV infection by needle sharing. This facility was unique in that it also had an in-patient clinic to treat for opportunistic infections and when a person's HIV infection has progressed to full-blown AIDS.

The MMT is a fascinating program. Every morning, the patients come to the MMT clinic daily to receive their methadone and then go about their days. This prevents drug users from using needles, breaks the dependence on heroine, sets up a system where dependents can step down off the methadone and reduces the incidence of new HIV infection. I would just like to take this moment to say that needle exchange programs and MMT are genius. There has been a lot of controversy about whether making these services available will lead to increased numbers of drug users or not. I've done the research. I've seen the clinics. I can say without a doubt that these programs do not encourage drug use and are proven to decrease the number of new HIV infections. These programs should be more widely used in the States. It's the long-range approach to a problem that is not going to go away quietly.

The VCT was also incredibly interesting. They use peer educators (those who were IDUs and female sex workers) to go out into the community to educate their peers about risk behaviors and the importance of getting tested. There's a lot of stigma and fear surrounding those who utilize the testing center, but this is all due to a lack of knowledge. These peer educators are trained with communication skills, how to clean needles, how to use condoms, and how to operate effective outreach. They have certain goals each month for condom and syringe distribution as well as referring at-risk people to the VTC.

Overall, it was an enlightening day. I've got a much better grasp on the HIV epidemic in Vietnam and what's being done to combat it. At lunch, we had some good times with chicken heads.

Also, I just chased a mouse out of my room. Well, I stood on the bed while Maeve's roommate chased it out of my room, but I was definitely integral to the whole process.