Seek, Test, Treat Strategies for Vietnamese Drug Users: A Randomized Controlled Trial

Opioid injection and HIV infection are major public health problems in Vietnam. Injection drug users (IDUs) have a high burden of HIV infection (20% HIV prevalence, nationally; 6% mortality per year) and the high rate of HIV transmission continues (HIV incidence, 5% per year). The investigators propose an intervention that employs the seek, test, and treat strategies for the IDU population and their network members, by ensuring that high risk individuals are sought for HIV testing, promptly referred to and maintained on ART, while HIV prevention interventions provided to the many who test HIV-negative, as well as those who test HIV-positive. The intervention will seek and test IDUs and their network members in the community, particularly those who are recently released from drug treatment centers. HIV-positive IDUs will be referred to HIV care through a two arm randomized controlled trial to compare the effects of different levels of engagement in care on ART uptake, antiretroviral adherence, and treatment outcome.

Inclusion criteria

• Age 18 years or older;
• Recently released from drug treatment centers;
• Positive HIV serology;
• Male;
• Meet criteria for ART initiation according to Vietnam's national guidelines;
• Provide informed consent for the study; and
• Reside in study area and do not plan to move away in the next 18 months.

Exclusion criteria

• Currently on ART;
• Co-enrollment in other HIV interventional research study;
• Unwilling to provide locator information.