Circular No. 10/BYT-GD provides guidance on implementing Resolution No. 20/CP of the Government regarding the acceleration of HIV/AIDS prevention and control work.

CIRCULAR

OF THE MINISTER OF HEALTH

Guidelines for implementing Resolution No. 20/CP of the Government on intensifying HIV/AIDS prevention and control work
On May 5, 1993, the Government issued Resolution No. 20/CP on intensifying HIV/AIDS prevention and control work. Now, the Ministry of Health - National Committee for AIDS Prevention and Control provides guidance on implementing specific contents as follows:

On May 5, 1993, the Government issued Resolution No. 20/CP on intensifying HIV/AIDS prevention and control work. Now, the Ministry of Health - National Committee for AIDS Prevention and Control provides guidance on implementing specific contents as follows:

1. Current situation of HIV/AIDS infection and some existing issues:

The current situation of HIV/AIDS infection in Vietnam is very serious and urgent. HIV/AIDS has developed rapidly in the first months of 1993, becoming an epidemic in Ho Chi Minh City and 16 other southern provinces and cities (Tien Giang, Tay Ninh, Soc Trang, Dong Thap, Dong Nai, Kien Giang, Can Tho, Song Be, Tra Vinh, An Giang, and Lam Dong), central provinces (Khanh Hoa, Quang Nam - Da Nang, Thua Thien Hue, Phan Rang), and the Red River Delta region (Nam Ha).

As of May 31, 1993, the total number of people infected with HIV discovered in Vietnam was 455, including 380 Vietnamese and 75 foreigners, with nine deaths.

Most cases of HIV/AIDS infection belong to groups involved in social evils such as drug users and prostitutes, who have a high risk of infection. Among the 380 Vietnamese infected with HIV, there were 348 drug users (91.5%) and five prostitutes (1.3%).

The above reality shows that the situation of HIV/AIDS infection in Vietnam has entered a new, more severe phase, while resource investment (human resources, means, and budget) has not yet met the urgent needs. The organization of preventive measures against AIDS in recent times at various ministries, sectors, mass organizations, and localities has revealed several shortcomings as follows:

Local authorities at all levels have not directly directed and invested appropriate funds for AIDS prevention activities.

Information, education, and communication activities have not been widely普及，内容深入到必要内容和需要优先关注的对象中，因此效果仍然有限。

确保输血安全仍存在困难，一些血液中心尚未具备在输血前检测HIV的条件。

在大多数有HIV/AIDS感染者的地方，组织和开展对感染者的管理、咨询和帮助工作做得不够细致。

缺乏紧密配合艾滋病、毒品和卖淫三个预防项目的活动，因此效果仍然有限。

2. Specific Measures:

2.1. Information, Education, and Communication Activities:

Provincial and municipal AIDS prevention committees need to adjust their action plans, especially the education and communication programs, to be consistent with the actual situation of each locality. In the short term, it is necessary to plan to strengthen educational and communication activities from now until the end of 1993.

Prioritize focusing on southern provinces, directing educational and communication activities towards drug users, prostitutes, and young people in urban areas. Mobilize the participation of mass organizations such as youth and women's organizations.

AIDS prevention education in schools is a very necessary activity. Provincial and municipal AIDS prevention committees should direct according to the education sector's plan to implement the inclusion of HIV/AIDS prevention education and sex education into the school system (secondary schools, teacher training colleges, universities) in their respective localities.

Various forms and media of mass communication should be utilized, suitable for the conditions of each unit and locality. Brochures and small books with different contents should be widely distributed to different types of recipients, particularly targeting young people and high-risk groups (drug users, prostitutes) to educate them and help change their risky lifestyles.

At detoxification centers and social centers, medical staff need to combine treatment with educational and promotional activities, providing counseling on HIV/AIDS to drug users and prostitutes according to the guidelines of the provincial and municipal AIDS prevention committees.

2.2. Organization of Surveillance, Care, and Treatment for People Infected with HIV and AIDS Patients:

a) Epidemiological Surveillance:

Continue to focus on monitoring key groups such as drug users, prostitutes, and blood donors to ensure the quality of surveillance, save costs, and diagnostic reagents. If possible, blood tests should be conducted for spouses of HIV-infected individuals.

Provincial and municipal preventive health centers should cooperate with the labor, invalids, and social affairs department and local police to conduct serological testing and epidemiological investigations of drug users and prostitutes through collection campaigns or regular, systematic inspections at detoxification centers and social centers.

Good counseling on HIV/AIDS must be provided to these groups before and after testing, organizing epidemiological investigations and management for each HIV-infected individual to enable them to voluntarily prevent transmission to their families and society, while also providing a basis for accurate analysis and assessment of the situation.

For confirmed HIV cases, the provincial or municipal Department of Health must report to the Ministry of Health and the National Committee for AIDS Prevention and Control within 24 hours via telephone or telegraph, followed by a formal written report.

b) Sterilization and Aseptic Practices in Healthcare Systems and Primary Health Care:

Medical examination and treatment facilities and maternity homes must strictly adhere to sterilization and aseptic regulations to prevent infections through medical equipment during examinations and treatments; responsible persons for these facilities must ensure the means and conditions to properly implement the regulations and regularly inspect compliance within their facilities.

Sterilization and disinfection of equipment used for treating HIV/AIDS patients must be carried out in accordance with the specialized regulations on handling HIV/AIDS infections issued in Decision No. 265-BYT/QD dated March 5, 1993.

At primary healthcare service facilities (expanded immunization, rabies vaccine injection, tetanus vaccine injection, blood collection for testing, etc.) in localities where HIV/AIDS patients have been detected, disposable syringes and needles must be used; in other localities, disposable syringes and needles may be used or syringes and needles may be sterilized by boiling for 20 minutes. The Department of Health, provincial and municipal preventive health centers under the central government must regularly inspect the implementation of this regulation.

c) Ensuring safety in blood transfusion:

Healthcare facilities must strictly implement the Blood Transfusion Directive issued pursuant to Decision No. 937-BYT/QĐ dated September 4, 1992.

Strengthening the blood transfusion network from central to local levels, strictly implementing aseptic and sterilization regulations during blood transfusions to prevent HIV/AIDS transmission through blood transfusion equipment.

Blood collection and storage facilities must test for HIV in blood donors and shall not accept blood from drug users and sex workers.

Encourage family members of patients who are healthy and lead a clean lifestyle to donate blood for use in surgical and emergency cases.

d) Organizing care and treatment for patients:

In the short term, organize three main centers for patient care and treatment at the Ho Chi Minh City Tropical Disease Center, the Hanoi Institute of Clinical Tropical Medicine, and the Da Nang General Hospital. Simultaneously, expand patient admission for HIV/AIDS patients in infectious disease departments of provincial and municipal hospitals and provide counseling and mental support for them.

In provinces and cities with a large number of patients, patients can be discharged from hospitals but must be provided with good counseling services, combined with family and community organizations continuing to monitor and assist patients at home.

2.3. Operating funds:

Funds for HIV/AIDS prevention activities need to be mobilized from multiple sources: partial funding support from the central government, regular funding from localities, and international organization aid.

While waiting for central government funding support, it is recommended that the Departments of Health and units develop action programs, prepare budget estimates to submit to the People's Committees for local government budget allocation to implement urgent tasks.

3. Implementation:

Each medical staff member in preventive medicine and treatment specialties must be responsible for implementing aseptic and sterilization regulations to limit HIV transmission within the healthcare system.

Assign the Hygiene and Environment Department to direct, inspect, and urge the implementation of aseptic regulations in the hygiene and epidemic prevention system.

Assign the Health Management Department to direct, inspect, and urge the implementation of aseptic regulations in healthcare services (including both public and private healthcare), the Health Management Department together with the Hematology and Blood Transfusion Institute to direct and inspect blood collection facilities to comply with the Blood Transfusion Directive of the Ministry.

Assign regional Hygiene and Epidemiology Institutes and leading hospitals to guide and direct professional technical skills in sterilization and asepsis, supplement necessary equipment related to each system, ensuring that Centers and hospitals can perform aseptic work and avoid HIV spread to the community.

Regional Hygiene and Epidemiology Institutes and leading hospitals organize training to enhance knowledge on asepsis for medical staff within their jurisdiction, with plans to inspect and urge implementation.

Provincial and municipal Departments of Health have the responsibility to inspect the implementation of this Circular and report the results to the Ministry periodically.

Under limited budget conditions, it is recommended that localities and units focus on directing weak areas such as asepsis in surgery, dentistry, and blood transfusion, with specific calculations to avoid unnecessary waste.

Regularly every month, organize exchanges and reviews of completed tasks and remaining issues.

By the end of June 1993, regional Hygiene and Epidemiology Institutes and leading specialized hospitals must report to the Ministry of Health (Hygiene and Epidemic Prevention Department for the Hygiene and Epidemic Prevention System; Health Management Department for the Treatment System) on the implementation results of sterilization and disinfection work in each system, as well as reflect remaining issues and recommendations to the Ministry.

This Circular takes effect from the date of signature. During implementation, if there are any difficulties, localities and units are requested to report to the Ministry of Health and the National Committee for HIV/AIDS Prevention for study and supplementation./.