AIDS 2002
      News & Abstracts: Abstract


            Code :MoPeF4017

            Title :Community Cafe approach to accessing CSWs and IDUs in Ho Chi 
            Minh City (HCMC), Vietnam 

            Authors :L T L Thao1, L T Giang1, V Thanh1, C P Lindan2
            1Ho Chi Minh City AIDS Committee, Ho Chi Minh City , Vietnam; 
            2University of California San Francisco, San Francisco, 
            Abstract:

            Issues IDU and CSW are primary risk groups for HIV in HCMC (80% & 
            23% HIV+). Controlling HIV infection in these groups is crucial, but 
            access is difficult. Many IDU are young (<24 yo); sex work is 
            widespread and not brothel-based. We describe the approach to 
            targeting IDU & CSW in HCMC and evaluate its effectiveness. 
            Description Peer outreach for IDU & CSW was established in 1993 and 
            succeeded in raising awareness but not in changing behavior. 
            Community counseling centers (cafes) were established in 1996 to 
            provide comprehensive prevention services. The goals were to provide 
            a safe and comfortable environment for IDU & CSW and a site for 
            education and harm reduction. Information, education, counseling, 
            condoms, needle & syringe exchange, free STD care, showers & laundry 
            facilities were provided. 
            Lessons learned Cafe's were accepted by target groups. The variety 
            of services and activities suited their needs and encouraged 
            participation. Outreach services must earn the trust of CSW & IDU by 
            providing social services and a safe environment. However, because 
            of the sensitivity of drug use and sex work local authorities and 
            the community sometimes did not agree with cafe activities. The 
            program also had difficulty addressing rapid changes in the 
            epidemic, particularly the rise of opiate use among youth and CSW. 
            Recommendations Consistent support from the community is critical 
            for the success of the cafe model, because targeting high-risk 
            groups involves sensitive social & legal issues. Programs must raise 
            awareness, implement programs focused on the new generation of 
            high-risk groups, and implement harm reduction campaigns. Cafe's 
            should also coordinate better with outreach activities. The cafe 
            model can be an effective means of providing prevention services 
            that are acceptable to high-risk communities, but it requires 
            multi-sectoral support and cooperation. We recommend expanding the 
            program to better control the HIV epidemic in HCMC.





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