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In the last decade, the use of methamphetamine – also referred to as ‘meth’ or ‘ice’ – has increased significantly throughout Southeast Asia. And Vietnam is not an exception.
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Although we know that ice is a widely popular drug in Vietnam, most of the evidence is anecdotal or relatively outdated.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:
Our partners in Vietnam
Vietnam in context
News from Vietnam
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.
Burkina Faso, Burundi, Egypt, Kenya, Marocco, Mozambique, Nigeria, South Africa, Uganda, Zimbabwe
Mainline is a partner in the Love Alliance programme. The Love Alliance brings together organisations led by communities most affected by HIV and AIDS.
United Kingdom, Finland, Greece, Estonia, Serbia, Portugal, the Netherlands
Harm reduction approaches are rarely applied in a recreational sports setting. And why would we - sport equals health, right? Not always. Research shows that the use of performance and image-enhancing drugs (PIEDs) is quite common in various recreational sport scenes. And for those people who use frequently and in high doses, harm reduction can make a big difference.
Kenya, South Africa
Young people use drugs - including minors. It's an inconvenient truth: societies usually seek to prevent young people from damaging their health and there is a big taboo on drug use among young kids. But are stigma, legislation or moral judgement keeping young people away from harm reduction services? This project aims to find out and to improve access to services.
Global
The use of drugs during sex is a growing worldwide phenomenon among men who have sex with men (MSM). Mainline has built a unique track record while working in the frontline of the Dutch 'chemsex' scene. Now, we also apply this expertise in an international context. The best place to start? Our chemsex e-learning.
Iran
Iran is renowned for its harm reduction programme. It was one of the first countries in this geographical region to adopt a harm reduction approach. Government supports and funds the programme. But the drug scene in Iran has changed over the years: more people are using stimulants and there are more and more homeless people who use drugs due to economic circumstances. Mainline sets out to see whether the current programmes in Tehran still fit the needs of the local people who use drugs.
Indonesia
Prisons in Indonesia are often overcrowded and health services are limited. Is quality prison health too expensive? Not according to findings from Atma Jaya University, who applied the method of 'economic modelling' to prison health services, including drug treatment. The findings feed important advocacy messages to improve the prison system in 2021.
Vietnam
October 2019 marked the start of a cutting edge new initiative. With the support of Open Society Foundation, Mainline and SCDI in Vietnam are building expertise to support people who use stimulant drugs. The core motivation to do so is the sharp rise in the use of crystal meth in the South Asian region and the lack of a coordinated harm reduction response.
Kenya
Women who use drugs in Kenya face violence every day. At home. On the streets. By the police. In their communities. A unique study - conducted in Mombasa, Kenya - sheds light on the raw realities these women encounter. Urgent action is needed.
South Africa
Women Who Use Drugs face additional problems in comparison to their male counterparts. The harm reduction field far too often neglects the needs of women. To some extend, the same is true for peer workers: incredibly valuable staff in any impactful service. How can local services make sure that peer workers are valued, supported and living up to their full potential?
South Africa
Together with activists and peer- and outreach workers in South Africa, Mainline worked on a practical guide about involving peers in harm reduction work.
A MAINLINE-GIZ STUDY
With the support of the Global Partnership on Drug Policies and Development (GPDPD), a project implemented by Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH, a team of three Mainline researchers conducted a study into effective harm reduction interventions for stimulant users. The study includes a review of the evidence for different harm reduction strategies for stimulants and a detailed description of seven good practices in different world regions.
Indonesia, Kenya, Nepal, Pakistan, South Africa, Tanzania and Vietnam
The Bridging the Gaps programme started its second phase in January 2016 and continued until the end of 2020. The shared goal of the Bridging the Gaps alliance: to improve the health and rights of people who use drugs, sex workers and lesbian, gay, bisexual and transgender (LGBT) people.
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