Growing up Too Fast: Vietnamese Adolescents Living with HIV Must Navigate a Changing Health Care System

By Centre for Supporting Community Development Initiatives

“I have experienced the stigma since I was very young, at about four or five years old but I didn’t know why for sure. People prohibited their kids from playing with me because my parents were drug users,” said Ngoc, an adolescent girl living in a northern province in Vietnam. She looks more mature than her age. Ngoc found out about her status by participating in a study on the HIV situation among young drug users in 2015 when she was 14.

“When I first enrolled in treatment, I got services in pediatric department where I felt comfortable. Doctors are very nice, they asked about my problems and concerns, and gave me clear instructions. They even gave me a phone number I can call in cases of emergency.”

But when Ngoc turns 16, her treatment will move from the pediatric department to the general adult system, so change will be tough. “I wasn’t too shocked to find out that I am HIV positive. But I was really shocked when I had to transition to the clinic for adults, where I receive little support and care. No one has ever asked me if I had any side effects with the [antiretroviral] ARV drugs and other things. The whole process of checking my health, prescribing, and giving me medicine takes only five minutes,” said Ngoc.

“I feel broken hearing words like: ‘She looks too young to have HIV. I wonder what she did.’ whenever I go to the ART clinic which is located inside residential area,” she added.

Ngoc became demotivated from the societal stigma and neglect by health providers. She was not mentally prepared and did not feel supported to endure such lifelong and difficult treatment. And by then, she didn’t know the importance of adhering to treatment, so there was a time when she quit taking ARV for almost six months. Consequently, Ngoc partially lost her vision, and she can hardly walk without assistance.

Starting in early 2019, ARV treatment in Vietnam will be completely covered by social health insurance as international funding for ARV is rapidly withdrawn from the country. HIV patients are facing a lot of challenges: new healthcare providers as well as new hospital health and payment procedures, which are not supportive enough for HIV patients. And in terms of financial worries, HIV patients will have to buy health insurance cards and pay a portion of the cost of their ARV drugs and HIV testing because the health insurance will only cover up to 80%. Every person living with HIV should know about these disruptive changes, but many young people like Ngoc do not have the information; they continue to be left behind, not only in the HIV fight but also by the whole healthcare agenda

When asked about what she hopes for the future, Ngoc said, “I just think, if I receive decent support to continue and adhere to ARV treatment, my viral load will be undetectable. And there is no more reason for stigma and discrimination.”