This article was revised with updated data and information in July 2019.
When Anh (not his real name), a young man who has sex with men (MSM) living in Ho Chi Minh City, first decided to take the plunge and get tested for HIV, he carefully vetted his options online before landing on the MSM-led social enterprise Glink. Glink partners with PATH’s Healthy Markets project, funded by the United States Agency for International Development (USAID), to deliver community-based HIV testing: testing either conducted by Glink staff or the clients themselves, using an easy-to-use rapid diagnostic test.
Knowing Glink to be a strong voice and advocate for MSM in Vietnam, and a provider of confidential and friendly health services, Anh felt confident in trusting them with this most private sexual health matter. In between getting tested and receiving the test results, Anh’s mind was eased by Glink clinic’s professionalism and comprehensive counseling services. When the test results came back positive, Anh’s partner was his first concern.
“The Glink staff seemed to understand what was happening to me. At that moment, I really was not thinking about my own health. The first thing I thought of was my partner who has been with me for over four months now. The counselor at Glink encouraged me to inform him about my diagnosis, and I wholeheartedly agreed because it was so important to do so. ”
Taking action to prevent infection
One of the most effective ways to prevent new HIV infections is to reach those known to be at immediate risk—i.e., the partners of people with newly diagnosed HIV. This process is called index client testing.
Glink offered Anh several ways to help him inform his partner about his test results and the options available to them as a next step. All scenarios were thoroughly counseled by the staff, allowing Anh to feel well equipped to choose the best plan to disclose his HIV-positive status to his partner. Even so, Anh was not without trepidation.
“I was thinking that I may lose my relationship. But also, if I could do something to keep my partner safe, I would do it. After all, I also hoped that our love would keep us together and solve any problem. And with the supportive counseling and treatment from Glink, I knew what I should do.”
As it turned out, Anh’s worries were unfounded. His partner Minh (not his real name) was very understanding of the situation and grateful for the honesty in their relationship.
"I appreciate his courage and respect for me. Informing your partner about your HIV status is not wrong ... what would be wrong is to destroy your relationship just because of something you cannot change. The truth won’t always make us happy, but we have to accept it. I did not blame him or feel like I should leave him because of [the diagnosis]. It’s important to put yourself in the other person's position, to understand how difficult it is for them to struggle with this problem.”
Glink was there every step of the way to help Minh get tested himself (his result came back negative) and support the couple to move forward together—providing information about treatment for Anh and prevention options for them. Minh is now considering enrolling in pre-exposure prophylaxis (PrEP), and he is committed to supporting Anh to adhere to his treatment regime.
Being brave pays off
Now having been through the entire procedure of HIV testing and partner notification, Anh would encourage others who may be worried about telling their partners about their diagnosis.
“I know there are many barriers, but you will find peace of mind once you have told your partner about your HIV status. For myself, I would have felt guilty and not been able to work or study if I hadn’t told Minh. The bottom line is, we have a responsibility to tell our partners about this.”
Index client testing in Vietnam is highly effective in detecting new cases of HIV
At Glink and dozens of other Healthy Markets–supported clinics and organizations, clients may elect to notify partners of their HIV status on their own (with prior counseling from the clinic) or anonymously with assistance from the counselor, who can play a more active role in notifying partners and referring them to HIV testing services.
“ Between June 2017 and May 2019, 12,420 injecting and sexual partners of people living with HIV have been invited to test for HIV. Of those, 12,070 (97.2 percent) then accessed community-based HIV testing services, and 1,038 (8.6 percent of those tested and 8.4 percent of those contacted) were subsequently diagnosed with HIV and linked to treatment. ”— USAID/PATH Healthy Markets Project
In contrast, Vietnam’s Ministry of Health reports that 1.5 percent of people who are reached by conventional testing services are diagnosed with HIV.
Index partner testing is therefore a hugely important and effective strategy in detecting and preventing new HIV infections—as well as boosting people’s awareness and control over their own sexual health. Healthy Markets has successfully advocated for the inclusion of index partner testing in the National Guidelines for Community-based HIV testing, developed by the Vietnam Administration for HIV/AIDS Control. These guidelines provide a legal and technical foundation for the government of Vietnam and health care service providers to deliver innovative and high quality HIV services such as index partner testing.
For Anh and Minh, the support they received not only prevented the onward transmission of HIV, it also enabled them to reinforce the love and respect they had already built in their relationship, and look forward to the future.
Read more about index partner testing in this factsheet: Index partner testing in Vietnam