title: "In their perception we are addicts": social vulnerabilities and sources of support for men released from drug treatment centers in Vietnam.
abstract: BACKGROUND
  Amid the global transition to treat opioid addiction as an illness, many people who inject drugs (PWID) face heterogeneous legal environments that include both punitive and harm reduction measures. In Vietnam, many PWID, who have a high burden of HIV, are sent to drug treatment centers, or "06 centers", for compulsory detoxification, vocational training, and labor for up to four years. This study investigates the challenges and facilitators of reentry into community and family life among men who are released from "06 centers" and provides insights and recommendations for developing policies and interventions that address special needs of this vulnerable population.
  
  
  METHODS
  In-depth interviews were conducted in 2011 by trained interviewers among a sample of 43 male PWID released within the past 2 years from "06 centers" in Hanoi, Vietnam to investigate the above issues and to recommend potential interventions. Participants were recruited from outpatient HIV clinics that serve PWID (n=22) and through peer referral from self-help groups for PWID (n=21). Interviews were audiotaped, transcribed, translated, entered into Atlas.TI qualitative data analysis software and analyzed for key themes.
  
  
  RESULTS
  The interviews revealed persistent drug-related stigmatization, frequently paired with HIV-related stigmatization and discrimination, which hindered employment, increased participants' social isolation and exacerbated their struggles with addiction. Families were participants' primary source of financial, employment, and emotional support, but addiction-related family tensions also had negative psychological effects. Participants identified methadone maintenance treatment as an effective means of overcoming addiction, yet few could fully benefit from this treatment due to its limited availability.
  
  
  CONCLUSIONS
  Our study suggests that PWID released from "06 centers" would greatly benefit from the scale-up of community-based harm reduction measures that include addiction and HIV treatment, coupled with employment-support and family centered mental health services.
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, 615 N. Wolfe Street, Baltimore, MD 21205, USA. Electronic address: ctomori1@jhu.edu.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Tomori
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
authors.forename: Vivian F
authors.initials: VF
authors.lastname: Go
authors.affiliation: Hanoi Center for HIV/AIDS Prevention and Control, 86 Tho Nhuom Street, Hanoi, Viet Nam.
authors.forename: Le Nhan
authors.initials: le N
authors.lastname: Tuan
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
authors.forename: Nguyen Mai
authors.initials: NM
authors.lastname: Huong
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
authors.forename: Nguyen Thanh
authors.initials: NT
authors.lastname: Binh
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
authors.forename: Carla E
authors.initials: CE
authors.lastname: Zelaya
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
authors.forename: David D
authors.initials: DD
authors.lastname: Celentano
authors.affiliation: National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam.
authors.forename: Do Tuan
authors.initials: do T
authors.lastname: Dat
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
authors.forename: Vu Minh
authors.initials: VM
authors.lastname: Quan
mesh_terms: D000328:Adult; D055030:Drug Users / Q000523:psychology*; D015658:HIV Infections / Q000453:epidemiology / Q000628:therapy; D040261:Harm Reduction; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D037141:Mandatory Programs / Q000458:organization & administration; D008691:Methadone / Q000008:administration & dosage; D008875:Middle Aged; D058850:Opiate Substitution Treatment / Q000379:methods; D009293:Opioid-Related Disorders / Q000534:rehabilitation; D012944:Social Support; D013240:Stereotyping; D016320:Substance Abuse Treatment Centers; D015819:Substance Abuse, Intravenous / Q000534:rehabilitation*; D014744:Vietnam / Q000453:epidemiology; D055815:Young Adult
chemical_list: D008691:Methadone
keywords: Compulsory detoxification; HIV; Injection drug use; Social reintegration; Social vulnerabilities; Vietnam