title: Coalition building by drug user and sex worker community-based organizations in Vietnam can lead to improved interactions with government agencies: a qualitative study.
abstract: BACKGROUND
  Drug users and female sex workers are among the groups most vulnerable to HIV infection in Vietnam. To address the HIV epidemic within these communities, former drug users and sex workers established the first community-based organizations (CBOs) in 2009. The study provides a focused assessment of CBOs' expanding efforts to advocate for their members that identifies existing collaborations with Vietnamese government programs. This assessment explores the barriers to and facilitators of expansion in order to propose recommendations to improve the working relationship between CBOs and government programs.
  
  
  METHODS
  Thirty-two individuals from drug user and sex worker CBOs (n = 24) and relevant government programs (n = 8) participated in face-to-face interviews in Hanoi, Ho Chi Minh City, and Hai Phong. Coded interview transcripts were analyzed qualitatively concerning the purpose of CBOs, the interactions between CBOs and government programs, and the perceived barriers, facilitators, and feasibility of future CBO-government program collaborations.
  
  
  RESULTS
  Services provided by the CBOs were considered to improve members' quality of life. The formation of coalitions among CBOs increased efficiency in meeting members' specific service needs, in addition to internal capacity building. Government field staff interacted with CBOs by providing CBOs with technical and legal support. CBOs and methadone maintenance treatment (MMT) clinics collaborated to help the clinics meet patient enrollment quotas and facilitate entry into treatment for CBO members. Barriers to CBO-government program collaboration included perceived conflicting missions on how to address drug use and sex work in the community, limited CBO-government program communication, CBO mistrust of the MMT system, and lack of legal status for CBOs.
  
  
  CONCLUSIONS
  To reduce these barriers, we recommend (1) introduction of CBO consultative services at government healthcare centers, (2) enlistment of CBO outreach to ensure full access to the imminent scaled-up MMT program, and (3) establishment of standards by which CBOs can obtain legal status.
authors.affiliation: Yale School of Medicine, New Haven, CT, 06511, USA. leah.le@aya.yale.edu.
authors.forename: Leah T
authors.initials: LT
authors.lastname: Le
authors.affiliation: Yale School of Medicine, New Haven, CT, 06511, USA. lauretta.grau@yale.edu.|Yale School of Public Health, New Haven, CT, 06510, USA. lauretta.grau@yale.edu.
authors.forename: Lauretta E
authors.initials: LE
authors.lastname: Grau
authors.affiliation: Center for Supporting Community Development Initiatives (SCDI), 240 Mai Anh Tuan, Ba Dinh district, Hanoi, Vietnam. huongnguyen2@scdi.org.vn.
authors.forename: Huong H
authors.initials: HH
authors.lastname: Nguyen
authors.affiliation: Center for Supporting Community Development Initiatives (SCDI), 240 Mai Anh Tuan, Ba Dinh district, Hanoi, Vietnam. oanhkhuat@scdi.org.vn.
authors.forename: Oanh Hai T
authors.initials: OH
authors.lastname: Khuat
authors.affiliation: Yale School of Medicine, New Haven, CT, 06511, USA. robert.heimer@yale.edu.|Yale School of Public Health, New Haven, CT, 06510, USA. robert.heimer@yale.edu.
authors.forename: Robert
authors.initials: R
authors.lastname: Heimer
mesh_terms: D000328:Adult; D057191:Capacity Building; D018672:Community Health Planning; D003299:Cooperative Behavior; D055030:Drug Users; D005260:Female; D006077:Government Agencies; D015658:HIV Infections / Q000517:prevention & control; D040261:Harm Reduction; D006293:Health Promotion; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D015397:Program Evaluation; D036301:Qualitative Research; D060386:Sex Workers; D014744:Vietnam