A community-based intervention to decrease the prevalence of HIV viremia among people who inject drugs in Vietnam

Huong Thi Duong, Jean Pierre Moles, Khue Minh Pham, Roselyne Vallo, Giang Thi Hoang, Vinh Hai Vu, Oanh Thi Hai Khuat, Thanh Tuyet Thi Nham, Duc Quang Nguyen, Catherine Quillet, Delphine Rapoud, Philippe Van de Perre, Joëlle Castellani, Jonathan Feelemyer, Laurent Michel, Didier Laureillard, Don Des Jarlais, Nicolas Nagot

Research output: Contribution to journalArticlepeer-review


Background: In most low-to-middle-income countries, HIV control at the population level among people who inject drugs (PWID) remains a major challenge. We aimed to demonstrate that an innovative intervention can identify HIV-positive PWID in the community who are not treated efficiently, and get them treated efficiently. Methods: Between 2016 and 2020, we implemented an intervention consisting of mass HIV screening of PWID using three annual respondent-driven sampling surveys (RDSS) and a post-intervention evaluation RDSS in community-based organisation (CBO) sites, coupled with peer support to facilitate/improve access to antiretroviral and methadone therapy in Haiphong, Vietnam. The primary outcome was the proportion of identified uncontrolled HIV-positive PWID who achieved viral control. We also estimated the potential effect of the intervention on the proportion of PWID with HIV RNA >1000 copies/mL among all PWID during the study period. Findings: Over the three RDSS, 3150 different PWID were screened, i.e. two-thirds of the estimated population size. They all injected heroin, their median age was of 39 years, 95% were male, 26.5% were HIV-infected, and 78.6% of the latter had HIV RNA ≤1000 copies/mL. Among the 177 PWID identified with an unsuppressed viral load, 73 (41.2%) achieved viral suppression at the final visit. HIV viremia decreased from 7.2% at baseline to 2.9% at the final RDSS (p<0.001). Up to 42% of this observed reduction may be explained by the intervention, in the absence of any external intervention targeting PWID during the study period. Interpretation: Mass community-based screening using RDSS coupled with CBO support is a powerful tool to rapidly identify untreated HIV-positive PWID and (re)link them to care. Funding: NIDA (USA) and ANRS (France).

Original languageEnglish (US)
Article number100538
JournalThe Lancet Regional Health - Western Pacific
StatePublished - Oct 2022


  • Community based organization
  • HIV elimination
  • Linkage to care
  • People who inject drugs
  • Testing
  • Viral suppression

ASJC Scopus subject areas

  • Internal Medicine
  • Pediatrics, Perinatology, and Child Health
  • Health Policy
  • Obstetrics and Gynecology
  • Public Health, Environmental and Occupational Health
  • Geriatrics and Gerontology
  • Psychiatry and Mental health
  • Infectious Diseases


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