AIDS epidemic shifts, Vietnam makes policy change

HANOI, Dec 25 (Reuters) A stocky woman in blue jeans with spiky, gelled black hair dances on stage at one of Vietnam's rural rehabilitation centres, leading a hip-hop style chant.

''Hold hands together, we'll stop AIDS together,'' shouted the former heroin addict patient who returned to the rehabilitation centre to encourage over a thousand recovering drug users and prostitute inmates, a third of whom have HIV or AIDS.

People face stigma and discrimination when they leave the minimum security centres, especially if they are infected with HIV or have AIDS. HIV-infected people are often refused employment and their children denied schooling.

''Everybody should unite in combating this disease,'' said Danh Thu Hanh, 36, a former addict who spent two years as an inmate.

Hanh works as a supporter of a self-help group called Cactus Blossom, one of about 30 that have emerged in recent years in Vietnam to represent people living with HIV and AIDS.

Vietnam's epidemic is less advanced than its Southeast Asian neighbours Cambodia and Thailand, but the United Nations estimates there are at least 280,000 HIV infections in a population of 84 million.

Health authorities report that the number of new cases is rising rapidly at 100 new infections per day. There were an estimated 14,000 AIDS-related deaths in Vietnam in 2005.

More infections are now caused by sexual transmission than by injecting heroin with unsterile needles and syringes, a worrying change in the course of the epidemic as the Communist-run country works to prevent it spreading into the general population.

In the southern commercial hub of Ho Chi Minh City and in northeastern Haiphong city and Quang Ninh province on the border with China, the epidemic is becoming generalised, experts say.

NEW HIV/AIDS LAW On January 1, a new law comes into effect that experts say is a broad policy framework for HIV/AIDS prevention and treatment in underdeveloped Vietnam.

The law strengthens the rights of people with HIV, calls for AIDS education in the workplace and HIV medicines to be included in health plans.

It also provides for condom distribution, clean-needle exchange programmes and the heroin substitute methadone as part of the response to the epidemic.

''There is certainly hope of reducing the epidemic because the knowledge level about HIV in Vietnam is high, programmes are expanding and use of condoms is going up,'' said UNAIDS country head Nancy Fee.

Places such as ''Education Labour Social Centre Number 2'' -- a cluster of mustard yellow buildings with red roofs in the lush green countryside near the capital Hanoi -- have existed for years to incarcerate heroin addicts and prostitutes.

But facing a drug use relapse rate of 70 to 90 per cent, coupled with the doubling of HIV infections in the past five years, the government is debating further reforms of the centres.

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