Despite significant progress in HIV prevention and treatment, infections are rising among key populations, including men who have sex with men (MSM), and stigma in health care settings remains a major barrier to prevention, treatment and care. A new project led by researchers at the University of Pittsburgh School of Public Health aims to address this challenge through a culturally tailored intervention in Vietnam that could offer a scalable model for reducing HIV stigma globally.
Supported by a three-year award from the NIH Fogarty International Center, the project—Adapting an Intervention to Reduce Stigma among MSM and Healthcare Providers in Vietnam—will use an evidence-based program to improve HIV prevention, testing and treatment in Hanoi. The study applies implementation science to generate insights that could inform strategies to reduce HIV stigma and improve services in the United States and beyond.
Although overall HIV prevalence in Vietnam remains relatively low, the epidemic is increasingly concentrated among key populations. MSM now account for more than half of new HIV infections in the country, and prevalence within this group has risen significantly over the past decade. Similar disparities persist in the U.S., where Black and Latino MSM and other disproportionately affected groups continue to bear a disproportionate burden of new HIV infections.
“Vietnam has made important progress in reducing HIV overall,” said Toan Ha, MD, DrPH, assistant professor of infectious diseases and microbiology and the project’s principal investigator. “However, transmission continues to increase, particularly among men who have sex with men.”
Stigma also prevents many people from seeking testing, prevention and treatment services—including pre-exposure prophylaxis (PrEP), a medication that can prevent HIV infection—or staying engaged in care, Ha said. The research team will adapt FRESH (Finding Respect and Ending Stigma around HIV), a workshop-based intervention, into a culturally tailored program called DONGHANH, which translates to “walking together.” The program will bring MSM community members and health care providers together to encourage dialogue and build mutual understanding. To extend the program’s reach, the project will also develop a digital platform that allows participants to access resources and share the intervention more broadly.
“We want to create a space where community members and health care providers can openly discuss their experiences and perspectives,” Ha said. “By fostering empathy and understanding, we hope to reduce stigma and improve access to prevention, treatment and care.”
The work builds on long-standing collaborations with Vietnamese partners, including the Institute for Social and Medical Studies in Hanoi, local health agencies and both non-government organization-supported and community-led clinics.
“This project strongly aligns with our department’s ongoing mission in global health and with our strategic partnerships with key medical and public health institutions in Vietnam,” said Suresh Kuchipudi, PhD, MBA, professor and chair of the Department of Infectious Diseases and Microbiology at Pitt Public Health. “It reflects the kind of impactful, internationally engaged research we aim to advance—work that addresses urgent public health challenges, strengthens implementation science, and generates knowledge that can improve health far beyond a single setting. The lessons learned through this collaboration have the potential to inform more equitable and effective HIV care, both globally and here in the U.S.”
For Ha, who was born in Vietnam, the project carries both scientific and personal significance. “Stigma doesn’t respect borders,” he said. “What we learn in Vietnam can help improve HIV prevention, treatment and care for vulnerable communities everywhere. This project reflects both a commitment to advancing implementation science and an opportunity to strengthen international collaboration to end the HIV epidemic.”
-Clare Collins