Meth is a strong stimulant drug, which – depending on its form – is smoked, injected or ingested. This ‘upper’ increases wakefulness, focus and confidence. It can elevate someone’s mood and provide feelings of power. It can also decrease fatigue and appetite. And, among many groups, meth is associated with an increased sex drive and delayed and/or more intense orgasms. These effects make the drug popular among groups who work long hours or night shifts. Sex workers in Southeast Asia also commonly use meth: 50.6% of the sex workers in this region have used methamphetamine (UNODC, 2012).

However, like every drug, meth has clear downsides. It can produce nervousness or anxiety and, in some cases, psychosis and suicidal thoughts (e.g. Holman, 1994; EMCDDA, 2007; Hildrey et al., 2009; Pates and Riley, 2009). Research shows that meth use is associated with an increased risk of contracting HIV in a range of populations. These include people who inject drugs, but also non-injecting drug users. A recent study by Mainline’s partner Atma Jaya Catholic University confirmed these risks for meth users in Indonesia. The same risks exist for sex workers and for men-who-have-sex-with-men (MSM) under the influence of meth. 

Ice in Vietnam

Although we know that ice is a widely popular drug in Vietnam, most of the evidence is anecdotal or relatively outdated. We are not sure how big the meth-using population is in Vietnam, or which groups are at the most risk of damaging their health. Nor do we know how many people encounter legal, social or economic problems as a consequence of their meth use. In a country like Vietnam, where punishment for drug-related crimes is severe, people naturally prefer to hide their use of substances. However, without knowledge about the people who use meth and how they can best be reached, it is hard to provide services to reduce the possible preventable (health) harms. We need information to inform harm reduction programmes.

For this reason, Mainline, SOA AIDS the Netherlands and SCDI initiated a pilot study to estimate the size of the group of meth users and to get a better understanding of the potential risky behaviours. This assessment is being implemented in Ho Chi Minh City between February and July 2018 and is part of the Bridging the Gaps programme. The study is primarily meant to inform future harm reduction programming and consists of:

1. Desk study: to investigate current research available on meth use in Vietnam
2. Size estimation mapping: to estimate the number of meth users in Ho Chi Minh City
3. Mixed method study: collecting (qualitative and quantitative) socio-demographic and bio-behaviour data via semi-structured interviews.

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The study is implemented by the local networks for people who use drugs and sex workers – who function under the SCDI network. We found that the outreach workers from these networks are best equipped to talk to people about drugs and sexual risk behaviour. Mainline trained a group of ten outreach workers in the research methodology and they will now set out to interview their peers. Their efforts will result in a recommendation for a harm reduction programme aimed at meth users in Ho Chi Minh City and possibly for other cities in Vietnam.