Joint Circular No. 02/2015/TTLT-BCA-BQP-BYT guiding the management, care, counseling, and treatment for people living with HIV and prevention of HIV transmission in prisons, temporary detention centers, holding houses, compulsory education facilities, and reformatory schools.

JOINT CIRCULAR

Guidelines for the management, care, counseling, and treatment of people living with HIV and prevention of HIV transmission in prisons, detention centers, temporary holding facilities, compulsory educational facilities, and correctional schoolsg

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Based on the Criminal Enforcement Law 2010;

Pursuant to the Law on Prevention and Control of Infection with Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS);

Pursuant to Decree No. 02/2014/NĐ-CP dated January 10, 2014 of the Government detailing the regime of applying and implementing administrative measures for educational facilities and compulsory rehabilitation centers;

Pursuant to Decree No. 106/2014/NĐ-CP dated November 17, 2014 of the Government stipulating the functions, tasks, powers, and organizational structure of the Ministry of Public Security;

Pursuant to Decree No. 35/2013/NĐ-CP dated April 22, 2013, of the Government, stipulating the functions, tasks, powers, and organizational structure of the Ministry of National Defense;

This Circular prescribes procedures for receiving, providing health care for domestic violence victims and statistical reports on domestic violence victims at medical facilities.

Pursuant to Decision No. 96/2007/QĐ-TTg dated June 28, 2007 of the Prime Minister on the management, care, counseling, and treatment of people living with HIV and prevention of HIV transmission at educational facilities, correctional schools, medical institutions, social welfare institutions, prisons, and detention centers;

The Ministers of Public Security, National Defense, and Health hereby issue these joint circulars to guide the management, care, counseling, and treatment of people living with HIV and prevention of HIV transmission in prisons, detention centers, temporary holding facilities, compulsory educational facilities, and correctional schools.

PART I

GENERAL PROVISIONS

Article 1. Scope of Regulation

These joint circulars provide guidance on the management, care, counseling, and antiretroviral therapy treatment, opioid substitution therapy (referred to as substitution therapy) for prisoners, detainees, persons under temporary custody, compulsory educational facility inmates, and correctional school students (referred to as managed subjects) and prevention of HIV transmission in prisons, detention centers, temporary holding facilities, compulsory educational facilities, and correctional schools (referred to as management facilities).

Article 2. Applicability

These joint circulars apply to management facilities; HIV/AIDS Prevention and Control Centers of provinces and centrally administered cities (referred to as provincial HIV/AIDS Prevention and Control Centers); antiretroviral therapy treatment facilities, and substitution therapy facilities (referred to as treatment facilities).

Article 3. Principles for the management, care, counseling, and treatment of people living with HIV and prevention of HIV transmission in management facilities

1. Managed subjects infected with HIV shall not be organized into separate teams or groups for study, labor, daily life, and medical treatment, except in cases where they must undergo isolation treatment according to the provisions of the law due to certain diseases.

2. Work and labor assignments shall be made suitable to the health conditions of managed subjects infected with HIV; managed subjects infected with HIV shall not be assigned work that easily leads to infection, skin abrasions, or has the potential to transmit HIV to others.

3. Focus on counseling and HIV testing for subjects who fall under the categories specified in Clauses 1, 2, 4, 5, and 6 of Article 5 of Decree No. 108/2007/NĐ-CP dated June 26, 2007 of the Government detailing the implementation of certain provisions of the Law on Prevention and Control of HIV/AIDS (referred to as the HIV/AIDS Prevention Law).

4. The notification of positive HIV test results for managed subjects shall be carried out in accordance with Circular No. 01/2010/TT-BYT dated January 6, 2010 of the Minister of Health stipulating responsibilities, procedures for notifying positive HIV test results.

Article 4. Implementation funds

The funding for implementing, contents, and expenditure levels, budget preparation, allocation, accounting, and settlement of funds for the management, care, counseling, and antiretroviral therapy treatment, and substitution therapy for managed subjects and prevention of HIV transmission in management facilities shall be implemented in accordance with the regulations of the Ministry of Finance as set forth in Circular No. 125/2007/TT-BTC dated October 29, 2007 guiding the management and use of funds for the implementation of management, care, counseling, and treatment for people living with HIV and prevention of HIV transmission in compulsory educational facilities, correctional schools, medical institutions, social welfare institutions, prisons, and detention centers, and other lawful sources of funding as provided by law.

Chapter II

SPECIFIC PROVISIONS

Article 5. Medical Examination and Health Classification

1. After receiving the managed subject, the management facility shall conduct a health examination in accordance with the following contents:

a) Collecting the medical history and drug use history of the managed subject, paying particular attention to collecting information on HIV infection status and antiretroviral therapy history, as well as substitution treatment history;

b) Conducting an assessment and classification of the health status of the managed subject;

c) After classifying the health status of the managed subject, the management facility shall implement HIV/AIDS prevention and control activities for the managed subjects according to the following contents:

- In cases where the managed subject has been treated for HIV/AIDS or substitution treatment outside the community: Implement in accordance with the provisions of Clause 2 of this Article;

- In cases where the managed subject knows their HIV infection status but has not yet received HIV/AIDS treatment: Implement in accordance with the provisions of Clause 3 of this Article;

- In cases where the managed subject engages in high-risk behavior without knowing their HIV infection status: Implement in accordance with the provisions of Clause 4 of this Article.

2. In cases where the managed subject is currently undergoing HIV/AIDS treatment or substitution treatment outside the community, the treatment for the managed subject shall be carried out as follows:

a) The management facility shall send a letter accompanied by a list of managed subjects who have undergone HIV/AIDS treatment or substitution treatment outside the community to the treatment facility where the managed subject is currently being treated, requesting to stop providing antiretroviral drugs and substitution treatment drugs, and sending the transfer treatment form and transfer letter (referred to as the transfer treatment form) of the managed subject to the management facility;

b) Within three working days from the date of receipt of the management facility's letter (the receipt date is calculated based on the stamp of the treatment facility upon receipt of the letter) (referred to as from the date of receipt of the letter), the treatment facility shall be responsible for sending the transfer treatment form of the managed subject to the management facility according to the model prescribed in Appendix 3 of Circular No. 32/2013/TT-BYT dated October 17, 2013 issued by the Minister of Health guiding the management and monitoring of HIV-infected persons and those exposed to HIV (referred to as Circular No. 32/2013/TT-BYT), and the transfer letter of the managed subject according to the model prescribed in Appendix 10 of Circular No. 12/2013/TT-BYT dated April 12, 2013 issued by the Minister of Health detailing the implementation of certain provisions of Government Decree No. 96/2012/NĐ-CP dated November 15, 2012 on substitution treatment for opiate addiction (referred to as Circular No. 12/2013/TT-BYT);

c) Within three working days from the date of receipt of the transfer treatment form from the treatment facility, the management facility shall be responsible for:

- Establishing an HIV/AIDS treatment file for the managed subject in accordance with Clause 2 of Article 8 and treating the managed subject for HIV/AIDS in accordance with Article 9 of this Joint Circular;

- Establishing a substitution treatment file for the managed subject in accordance with Clause 3 of Article 8 and treating the managed subject for substitution treatment in accordance with Article 10 of this Joint Circular.

3. In cases where the managed subject reports having been infected with HIV but has not yet received HIV/AIDS treatment:

a) The management facility shall send a letter to the provincial HIV/AIDS Prevention and Control Center where the managed subject is registered to request confirmation of the managed subject's HIV infection status;

b) Within five working days from the date of receipt of the management facility's letter, the provincial HIV/AIDS Prevention and Control Center shall be responsible for sending a letter confirming the managed subject's HIV infection status to the management facility;

c) Within five working days from the date of receipt of the reply letter from the provincial HIV/AIDS Prevention and Control Center, the management facility shall be responsible for:

- Establishing an HIV/AIDS treatment file for the managed subject in accordance with Clause 2 of Article 8 and treating the managed subject for HIV/AIDS in accordance with Article 9 of this Joint Circular if they meet the treatment criteria;

- Managing the treatment of HIV-infected managed subjects who do not meet the treatment criteria in accordance with Article 8 of Circular No. 32/2013/TT-BYT;

- Providing counseling and HIV testing for the managed subject in accordance with Article 7 of this Joint Circular in cases where the provincial HIV/AIDS Prevention and Control Center cannot determine the managed subject's HIV infection status.

4. In cases where the managed subject engages in high-risk behavior without knowing their HIV infection status, the management facility shall be responsible for providing counseling and HIV testing for the managed subject in accordance with Article 7 of this Joint Circular. Upon receiving the HIV test results of the managed subject, the management facility shall be responsible for:

a) Implementing management, care, and treatment for the managed subject in accordance with the first and second paragraphs of Point c of Clause 3 of this Article in cases where the managed subject's HIV test result is positive;

b) Repeating the counseling and HIV testing for the managed subject in accordance with Article 7 of this Joint Circular in cases where the managed subject's HIV test result is negative three months after the initial test when entering the management facility.

Article 6. Propaganda, education, and preventive counseling for HIV infection

1. Communication measures:

a) Conduct group communication on prevention and control of HIV/AIDS twice a year for subjects under management by the managing entity. In cases where the managing entity has multiple sub-camps or sub-zones, each sub-camp or sub-zone must organize communication on prevention and control of HIV/AIDS at least once a year;

b) Broadcast information on prevention and control of HIV/AIDS through the managing entity's radio system every two weeks;

c) Incorporate basic knowledge about HIV/AIDS and preventive measures against HIV/AIDS into the regular education program of the managing entity;

d) The managing entity may establish peer educators' groups in accordance with Clause 2, Article 2 of Decree No. 108/2007/NĐ-CP dated June 26, 2007, of the Government detailing implementation of certain provisions of the Law on Prevention and Control of HIV/AIDS, with core members being selected and trained to participate in propaganda and education for other managed subjects regarding preventive measures against HIV infection, sexually transmitted infections, and other related HIV/AIDS prevention and control contents;

đ) Other appropriate communication measures based on the situation and characteristics of the managing entity.

2. Content of communication: Implemented according to Article 8 of the Law on Prevention and Control of HIV/AIDS.

3. Organization of preventive counseling activities for HIV infection:

a) Annually, the managing entity collaborates with the provincial HIV/AIDS Prevention and Control Center located at the managing entity's headquarters to provide group counseling for managed subjects (excluding those temporarily detained or imprisoned in detention centers or temporary holding facilities). In cases where the managing entity has multiple sub-camps or sub-zones, each sub-camp or sub-zone must organize separate group counseling sessions;

b) During the management process, healthcare staff of the managing entity have the responsibility to organize preventive counseling activities for managed subjects in accordance with the situation and characteristics of the managing entity.

4. Counseling content: Implemented according to Articles 5 and 6 of Circular No. 06/2012/TT-BYT dated April 20, 2012, of the Minister of Health on conditions for establishment and content of activities for organizations providing counseling on HIV/AIDS prevention and control.

Article 7. Counseling and HIV Testing

1. In cases where the managing entity meets the conditions for voluntary counseling and testing for HIV as stipulated in Articles 9 and 10 of Decision No. 647/QĐ-BYT dated February 22, 2007, of the Minister of Health on guidelines for voluntary counseling and testing for HIV (referred to as Decision No. 647/QĐ-BYT), counseling and HIV testing for managed subjects shall be carried out in accordance with Articles 7 and 8 of Decision No. 647/QĐ-BYT.

2. In cases where the managing entity meets the conditions stipulated in Article 9 but not all conditions stipulated in Article 10 of Decision No. 647/QĐ-BYT, HIV testing for managed subjects shall be conducted as follows:

a) Send a letter along with a list of managed subjects requiring HIV testing to the provincial HIV/AIDS Prevention and Control Center located at the managing entity's headquarters requesting cooperation in conducting HIV testing for managed subjects;

b) Within seven working days from the date of receipt of the request from the managing entity, the provincial HIV/AIDS Prevention and Control Center shall be responsible for cooperating with the managing entity in planning sample collection and conducting HIV testing for managed subjects.

3. In cases where the managing entity does not meet the conditions for voluntary counseling and testing for HIV as stipulated in Articles 9 and 10 of Decision No. 647/QĐ-BYT, counseling and HIV testing for subjects shall be conducted as follows:

a) Send a letter along with a list of managed subjects requiring counseling and HIV testing to the provincial HIV/AIDS Prevention and Control Center located at the managing entity's headquarters requesting cooperation in conducting counseling and HIV testing for managed subjects;

b) Within ten working days from the date of receipt of the request from the managing entity, the provincial HIV/AIDS Prevention and Control Center shall be responsible for cooperating with the managing entity in planning counseling, sample collection, and conducting HIV testing for managed subjects.

Article 8. Establishing Treatment Files

1. Health management files for new subjects entering management facilities shall be established in accordance with the provisions of laws on medical examination and treatment.

2. Treatment files for HIV-positive subjects treated with antiretroviral drugs shall be established in accordance with Clause 3, Article 4 of Circular No. 32/2013/TT-BYT. The authority to establish treatment files is as follows:

a) In cases where the management facility does not have the conditions to implement antiretroviral therapy as prescribed by the Ministry of Health in Circular No. 09/2011/TT-BYT dated January 26, 2011 guiding the conditions and scope of specialized activities of healthcare facilities providing antiretroviral therapy (referred to as Circular No. 09/2011/TT-BYT):

- The designated treatment facility, designated by the Provincial Department of Health or the Military Medical Service - Ministry of National Defense (hereinafter referred to as the designated treatment facility), shall be responsible for establishing medical records and prescribing treatment for the subject at the management facility;

- The management facility shall be responsible for managing the treatment file and overseeing the use of medication by the subject.

b) In cases where the management facility has the conditions to implement antiretroviral therapy as prescribed in Circular No. 09/2011/TT-BYT, the management facility shall establish the treatment file, manage the treatment file, and oversee the use of medication by the subject.

3. Treatment files for subjects managed through opioid substitution therapy shall be established in accordance with the professional guidelines on opioid substitution therapy issued by the Minister of Health, specifically as follows:

a) In cases where the management facility does not have the conditions to be a treatment facility but meets the conditions to be a dispensing facility as prescribed in Circular No. 12/2013/TT-BYT, it shall be implemented as follows:

- The designated treatment facility, designated by the Provincial Department of Health or the Military Medical Service - Ministry of National Defense, shall be responsible for establishing medical records and treating the subject at the management facility in accordance with Clause 1, Article 10;

- The management facility shall be responsible for managing the treatment file and overseeing the use of substitute medication by the subject.

b) In cases where the management facility meets the conditions to be a treatment facility as prescribed in Circular No. 12/2013/TT-BYT, the management facility shall establish the treatment file, manage the treatment file, and oversee the use of substitute treatment medication by the subject in accordance with the regulations.

Article 9. Treatment with Antiretroviral Drugs

1. Treatment with antiretroviral drugs for HIV-positive subjects in management facilities that do not meet the conditions as prescribed in Circular No. 09/2011/TT-BYT:

a) In cases where the subject has not received prophylactic treatment for opportunistic infections or antiretroviral therapy, the following actions shall be taken:

- The management facility shall cooperate with the designated treatment facility to conduct health assessments of the subject and handle post-assessment procedures in accordance with Articles 5 and 6 of Circular No. 32/2013/TT-BYT;

- In cases where the subject does not meet the criteria for treatment, the management and monitoring of the subject shall be carried out in accordance with Article 8 of Circular No. 32/2013/TT-BYT;

- In cases where the subject meets the criteria for treatment, the management and monitoring of the subject shall be carried out in accordance with Article 9 of Circular No. 32/2013/TT-BYT.

b) In cases where the subject is currently receiving antiretroviral therapy outside the community and is transferred to a management facility or is being transferred from another management facility, the following actions shall be taken:

- The management facility shall prepare a list of subjects and send it to the designated treatment facility along with a copy of the transfer form for the subject's antiretroviral therapy provided by the external treatment facility or the management facility from which the subject was transferred, to request antiretroviral drugs;

- Management and monitoring of antiretroviral therapy shall be conducted in accordance with Article 11 and Clause 2, Article 12 of Circular No. 32/2013/TT-BYT.

2. In cases where antiretroviral therapy is provided in management facilities that meet the conditions as prescribed in Circular No. 09/2011/TT-BYT, it shall be carried out in accordance with Circular No. 32/2013/TT-BYT.

3. In cases where the subject is transferred to another management facility or returned to the community, the health assessment of the subject and post-assessment handling shall be carried out in accordance with Article 12 of this Joint Circular.

4. The management facility shall contact the provincial AIDS Prevention and Control Center located in the province where the management facility is situated to receive guidance and support for conducting CD4 cell testing.

Article 10. Treatment with substitute medication

1. The treatment with substitute medication at management facilities that do not meet the conditions for treatment facilities but meet the conditions for dispensing medication as stipulated in Circular No. 12/2013/TT-BYT shall be carried out as follows:

a) Management facilities shall prepare a list of individuals under management and send it to designated substitute treatment facilities along with a copy of the transfer form for treatment of individuals under management issued by the designated treatment facility or the management facility where the individual under management transferred from, sent to the management facility where the individual transferred to, to request the issuance of substitute treatment medication.

In cases where individuals under management have discontinued treatment for six days or more or have weak health conditions, a health assessment must be conducted again for these individuals under management and post-assessment handling shall be carried out according to Decision No. 3140/QĐ-BYT dated August 30, 2010 on the substitution treatment for opiate addiction using methadone (hereinafter referred to as Decision No. 3140/QĐ-BYT).

b) Management facilities shall carry out the dispensing of substitute treatment medication and monitor the use of substitute treatment medication by individuals under management.

2. The treatment with substitute medication at management facilities that meet the conditions for treatment facilities as stipulated in Circular No. 12/2013/TT-BYT shall be carried out according to the provisions of Decision No. 3140/QĐ-BYT.

3. In cases where individuals under management are transferred to other management facilities or individuals are returned to the community: Implementation shall be carried out according to the provisions of Article 19 of Circular No. 12/2013/TT-BYT.

Article 11. Forecasting, distribution, management, and dispensing of free antiretroviral drugs and free substitute treatment drugs at management facilities

1. Approval of forecasts for the use of free antiretroviral drugs and free substitute treatment drugs at management facilities:

a) The Ministry of Health (Prevention and Control Center for HIV/AIDS) shall approve forecasts for the use of free antiretroviral drugs and free substitute treatment drugs at management facilities from the source of drugs under the management authority of the Ministry of Health. The forecasting, approval, distribution, management, and dispensing process of free drugs shall be implemented according to Clause 2, 3, and 4 of this Article;

b) Provincial Health Departments (Prevention and Control Centers for HIV/AIDS) shall approve forecasts for the use of free antiretroviral drugs and free substitute treatment drugs at management facilities from the source of drugs under the management authority of the provincial health departments. The forecasting and approval process for the use of free drugs under the management authority of the provincial health departments shall be implemented according to current regulations;

c) Military Medical Department - Ministry of National Defense, Health Department - Ministry of Public Security shall approve forecasts for the use of free antiretroviral drugs and free substitute treatment drugs at management facilities from the source of drugs under the management authority of their respective ministries and sectors. The forecasting and approval process for the use of free drugs under the management authority of the ministries and sectors shall be implemented according to current regulations.

2. Process for forecasting, distribution, management, and dispensing of free antiretroviral drugs at management facilities from the source of drugs under the management authority of the Ministry of Health:

a) In cases where management facilities meet the conditions for implementing antiretroviral drug treatment as stipulated in Circular No. 09/2011/TT-BYT, the forecasting, distribution, management, and use of free antiretroviral drugs shall be carried out as follows:

- Annually, management facilities shall prepare forecasts for antiretroviral drugs for individuals under management at the management facilities and submit them to the Provincial Prevention and Control Center for HIV/AIDS. The Provincial Prevention and Control Center for HIV/AIDS shall issue a letter to the National Prevention and Control Center for HIV/AIDS - Ministry of Health to approve the annual forecast for antiretroviral drugs;

- The distribution of antiretroviral drugs to management facilities shall be carried out as follows:

+ Management facilities shall issue a letter to the Provincial Prevention and Control Center for HIV/AIDS;

+ The Provincial Prevention and Control Center for HIV/AIDS shall compile the demand for antiretroviral drugs and issue a letter to the National Prevention and Control Center for HIV/AIDS - Ministry of Health requesting the supply of antiretroviral drugs;

+ The National Prevention and Control Center for HIV/AIDS - Ministry of Health shall issue a letter to the distribution unit to transfer antiretroviral drugs to management facilities.

- Management facilities shall be responsible for dispensing antiretroviral drugs daily according to the treatment regimen and time suitable for the management facility, while reporting monthly on the use of antiretroviral drugs to the Provincial Prevention and Control Center for HIV/AIDS;

- Management facilities shall provide two months' worth of antiretroviral treatment drugs to individuals under management during the transfer period from one management facility to another or from a management facility to the community.

b) In cases where management facilities do not meet the conditions for implementing antiretroviral drug treatment as stipulated in Circular No. 09/2011/TT-BYT, the forecasting, distribution, management, and use of free antiretroviral drugs shall be carried out as follows:

- Annually, designated treatment facilities shall prepare forecasts for antiretroviral drugs for individuals under management at management facilities and submit them to the Provincial Prevention and Control Center for HIV/AIDS. The Provincial Prevention and Control Center for HIV/AIDS shall issue a letter to the National Prevention and Control Center for HIV/AIDS - Ministry of Health to approve the annual forecast for antiretroviral drugs;

- The distribution of antiretroviral drugs to management facilities shall be carried out as follows:

+ Designated treatment facilities shall issue a letter to the Provincial Prevention and Control Center for HIV/AIDS requesting the supply of drugs;

+ The Provincial Prevention and Control Center for HIV/AIDS shall compile the demand for antiretroviral drugs and issue a letter to the National Prevention and Control Center for HIV/AIDS - Ministry of Health requesting the supply of antiretroviral drugs;

+ The National Prevention and Control Center for HIV/AIDS - Ministry of Health shall issue a letter to the distribution unit to transfer antiretroviral drugs to designated treatment facilities;

+ Designated treatment facilities shall receive antiretroviral drugs supplied by the National Prevention and Control Center for HIV/AIDS - Ministry of Health and transfer antiretroviral drugs to management facilities.

- Management facilities shall be responsible for dispensing antiretroviral drugs daily according to the treatment regimen and time suitable for the management facility, while reporting on the use of antiretroviral drugs to the designated treatment facility.

- Management facilities shall provide two months' worth of antiretroviral treatment drugs to individuals under management during the transfer period from one management facility to another or from a management facility to the community.

c) The coordination of the demand for free antiretroviral drugs of management facilities approved in the forecast for the year shall be carried out by the Provincial Prevention and Control Center for HIV/AIDS where the management facility is located or the National Prevention and Control Center for HIV/AIDS - Ministry of Health in collaboration with the management facility or the designated treatment facility.

3. Process for forecasting, distribution, management, and use of free substitute treatment drugs from the source of drugs under the management authority of the Ministry of Health:

a) Annually, the management facility prepares a budget for substitute treatment drugs for individuals under management at the facility and sends it to the Provincial Center for HIV/AIDS Prevention and Control where the management facility is located or the designated substitute treatment facility pursuant to Clause 1, Article 10 of this Circular for consolidation and submission to the Provincial Center for HIV/AIDS Prevention and Control. The Provincial Center for HIV/AIDS Prevention and Control consolidates the province's demand for substitute treatment drugs and submits it to the Department of Health to request approval from the National Center for HIV/AIDS Prevention and Control - Ministry of Health.

b) The distribution of substitute treatment drugs to the management facilities shall be carried out as follows:

- The Provincial Center for HIV/AIDS Prevention and Control issues a letter to the National Center for HIV/AIDS Prevention and Control - Ministry of Health requesting drug allocation;

- The National Center for HIV/AIDS Prevention and Control - Ministry of Health issues a letter to the distributing unit to transfer substitute treatment drugs to the management facility.

c) The management and use of substitute treatment drugs at the management facility shall be conducted in accordance with current laws;

d) The coordination of the demand for substitute treatment drugs of the management facility approved in the annual budget shall be implemented uniformly by the management facility and the distributing unit.

4. Procedure for budgeting, distribution, management, and use of free antiretroviral drugs and substitute treatment drugs from the stockpile under the management of the Ministry of Health for management facilities under the Ministry of National Defense:

a) Budgeting, distribution, management, and use of free antiretroviral drugs

- Annually, military hospitals according to the classification of the Ministry of National Defense (referred to as hospitals) prepare a budget for antiretroviral drugs for individuals under management at the management facility and submit it to the General Department of Health - Ministry of National Defense. The General Department of Health - Ministry of National Defense compiles the demand for antiretroviral drugs and issues a letter to the National Center for HIV/AIDS Prevention and Control - Ministry of Health to approve the annual antiretroviral drug budget;

- The distribution of antiretroviral drugs to management facilities shall be carried out as follows:

+ The hospital issues a letter to the National Center for HIV/AIDS Prevention and Control - Ministry of Health requesting antiretroviral drugs;

+ The National Center for HIV/AIDS Prevention and Control - Ministry of Health issues a letter to the distributing unit to transfer antiretroviral drugs to the hospital;

+ The hospital receives antiretroviral drugs provided by the National Center for HIV/AIDS Prevention and Control - Ministry of Health and transfers them to the management facility;

- The management facility is responsible for daily distribution of antiretroviral drugs according to the treatment regimen and time suitable for the management facility, while reporting on the use of antiretroviral drugs to the hospital. The hospital is responsible for monitoring, compiling, and submitting reports to the National Center for HIV/AIDS Prevention and Control - Ministry of Health as stipulated;

- When individuals under management are transferred, the management facility provides two months' supply of antiretroviral treatment drugs for the individual during the transfer from one management facility to another or from the management facility to the community;

- The coordination of the demand for free antiretroviral drugs of the hospital approved in the annual budget shall be implemented uniformly by the National Center for HIV/AIDS Prevention and Control - Ministry of Health, the hospital, and the distributing unit.

b) Budgeting, distribution, management, and use of free substitute treatment drugs:

- Annually, the hospital prepares a budget for substitute treatment drugs for individuals under management at the management facility and submits it to the General Department of Health - Ministry of National Defense. The General Department of Health - Ministry of National Defense compiles the demand for substitute treatment drugs and issues a letter to the National Center for HIV/AIDS Prevention and Control - Ministry of Health to approve the annual substitute treatment drug budget;

- The distribution of substitute treatment drugs to the management facility shall be carried out as follows:

+ The hospital issues a letter to the National Center for HIV/AIDS Prevention and Control - Ministry of Health requesting drug allocation;

+ The National Center for HIV/AIDS Prevention and Control - Ministry of Health issues a letter to the distributing unit to transfer substitute treatment drugs to the hospital;

+ The hospital receives substitute treatment drugs provided by the National Center for HIV/AIDS Prevention and Control - Ministry of Health and transfers them to the management facility;

- The management and use of substitute treatment drugs at the management facility shall be conducted in accordance with current laws;

- The coordination of the demand for substitute treatment drugs of the hospital approved in the annual budget shall be implemented uniformly by the National Center for HIV/AIDS Prevention and Control - Ministry of Health, the hospital, and the distributing unit.

Article 12. Procedures for transferring treatment for managed subjects

1. Procedures for transferring treatment for managed subjects from one management facility to another management facility:

a) Within fifteen working days before the managed subject transfers to another management facility, the management facility where the managed subject is transferred from shall be responsible for:

- Sending a letter requesting the designated treatment facility, as stipulated in Point a, Clause 2, Point a, Clause 3, Article 8 of this Joint Circular, to establish a treatment transfer form for the managed subject. The process of establishing the treatment transfer form for the managed subject shall be carried out in accordance with the provisions of Points b and c of this Clause;

- Establishing a treatment transfer form for the managed subject in cases where the management facility has the conditions to provide antiretroviral therapy;

b) Within two working days from the date of receipt of the letter from the management facility, the designated treatment facility shall be responsible for establishing a treatment transfer form for the managed subject and sending it to the management facility;

c) Within two working days from the date of receipt of the letter accompanied by the treatment transfer form of the managed subject, the management facility where the managed subject is transferred from shall be responsible for:

- Sending a letter accompanied by the treatment transfer form of the managed subject to request the management facility where the managed subject is transferred to continue providing treatment for the managed subject;

- Sending a letter notifying the Provincial Center for HIV/AIDS Prevention and Control where the management facility is located to request the cessation of antiretroviral therapy provision for the managed subject;

d) The management facility where the managed subject is transferred to shall be responsible for:

- Establishing a file for antiretroviral therapy and substitution therapy for the managed subject in accordance with the provisions of Clause 2, Clause 3, Article 8 of this Joint Circular;

- Implementing antiretroviral therapy and substitution therapy for the managed subject in accordance with the provisions of Articles 9 and 10 of this Joint Circular;

2. Procedures for transferring treatment for managed subjects who have been temporarily suspended, exempted, or completed their term of imprisonment, execution of decisions on compulsory educational facilities, placement in juvenile rehabilitation centers, or granted amnesty:

a) Within ten working days before the managed subject is temporarily suspended, exempted, or completes their term of imprisonment, execution of decisions on compulsory educational facilities, placement in juvenile rehabilitation centers, or granted amnesty, the management facility shall be responsible for:

- Sending a letter requesting the designated treatment facility, as stipulated in Point a, Clause 2, Point a, Clause 3, Article 8 of this Joint Circular, to establish a treatment transfer form for the managed subject. The process of establishing the treatment transfer form for the managed subject shall be carried out in accordance with the provisions of Points b and c of this Clause;

- Establishing a treatment transfer form for the managed subject in cases where the management facility has the conditions to provide antiretroviral therapy;

b) Within five working days from the date of receipt of the letter from the management facility, the designated treatment facility shall be responsible for establishing a treatment transfer form for the managed subject and sending it to the management facility;

c) Within fifteen working days before the managed subject is temporarily suspended, exempted, or completes their term of imprisonment, execution of decisions on compulsory educational facilities, placement in juvenile rehabilitation centers, or granted amnesty, the management facility shall be responsible for:

- Sending a letter notifying the Provincial Center for HIV/AIDS Prevention and Control where the management facility is located to request the cessation of antiretroviral therapy provision for the managed subject;

- Sending a letter accompanied by the treatment transfer form of the managed subject to request the Provincial Center for HIV/AIDS Prevention and Control where the managed subject registers to continue treatment after returning to the community to connect and introduce the managed subject to appropriate treatment facilities.

Article 13. Infection control at management facilities

1. Staff and employees of management facilities and subjects must comply with handwashing instructions and techniques as specified by the Ministry of Health.

2. Implement sterile technique regulations as stipulated in Article 2 of Circular No. 18/2009/TT-BYT dated October 14, 2009, issued by the Minister of Health, guiding the organization and implementation of infection control work in medical examination and treatment facilities (referred to as Circular No. 18/2009/TT-BYT).

3. Clean, disinfect, and sterilize care and treatment equipment and tools according to the provisions set out in Article 3 of Circular No. 18/2009/TT-BYT.

4. Staff and employees of management facilities must apply standard precautions when coming into contact with blood and biological fluids during care and treatment for all patients regardless of diagnosis, and apply additional preventive measures based on the mode of transmission.

5. Subjects infected with multi-drug resistant bacteria must be subject to appropriate isolation prevention measures consistent with the mode of disease transmission.

6. Management facilities shall organize, supervise, detect, and report suspected cases of highly dangerous infectious diseases in accordance with laws on prevention and control of infectious diseases.

7. There shall be regulations and implementation of terminal cleaning and decontamination of patient rooms and related care equipment immediately after the transfer or death of subjects with infectious diseases that have the potential to cause epidemics.

8. Infected fabric items, fabrics stained with blood and biological fluids must be collected, transported, and processed separately to ensure safety.

Article 14. Handling specimens and burial of HIV-infected managed subjects who have died

1. The handling of specimens from deceased HIV-infected managed subjects shall be carried out in accordance with the provisions of Circular No. 43/2011/TT-BYT dated December 5, 2011, issued by the Minister of Health regarding the management regime for infectious disease specimen samples.

2. The preservation, refrigeration, burial, and transportation of the remains of deceased HIV/AIDS-infected subjects shall be carried out in accordance with the provisions of Circular No. 02/2009/TT-BYT dated May 26, 2009, issued by the Minister of Health on hygiene guidance in funeral and cremation activities.

Chapter III

IMPLEMENTATION

Article 15. Effective Date

1. This joint circular takes effect from March 7, 2015, and replaces the following documents:

a) Decision No. 511/1999/QĐ-BCA(V26) of the Minister of Public Security dated September 3, 1999, on the issuance of regulations on HIV/AIDS prevention and control in detention centers, educational institutions, and juvenile correctional schools;

b) Joint Circular No. 05/2003/TTLT-BCA-BTC-BYT dated February 24, 2003, of the Ministry of Public Security - Ministry of Finance - Ministry of Health, guiding the management, care, treatment, and counseling of temporarily detained persons, prisoners, inmates, and students infected with HIV/AIDS in temporary detention centers, detention centers, prisons, educational institutions, and juvenile correctional schools under the management of the Ministry of Public Security;

c) Joint Circular No. 100/2003/TTLT-BQP-BTC-BYT dated August 22, 2003, of the Ministry of National Defense - Ministry of Finance - Ministry of Health, guiding the management, care, treatment, and counseling of temporarily detained persons and prisoners infected with HIV/AIDS in temporary detention centers, detention centers, and prisons under the management of the Ministry of National Defense;

2. In case the referenced documents in this document are replaced or amended, they shall be implemented according to the replacing or amending documents.

Article 16. Responsibility for Implementation

1. Departments and units under the Ministry of Public Security, Ministry of National Defense, and Ministry of Health are responsible for organizing the implementation and providing guidance and supervision of the implementation of this joint circular.

2. Public Security, Health Departments, HIV/AIDS Prevention and Control Centers of provinces and centrally administered cities; state-run medical facilities; detention centers, temporary detention centers, temporary holding centers, educational institutions, and juvenile correctional schools are responsible for implementing this joint circular. During the implementation process, if there are difficulties, relevant agencies, units, and localities shall reflect them to the Ministry of Public Security, Ministry of National Defense, and Ministry of Health for timely guidance.

During the implementation process, if there are difficulties, relevant agencies, units, and localities shall reflect them to the Ministry of Public Security, Ministry of National Defense, and Ministry of Health for timely guidance./.