General Articles

PEPFAR in Vietnam: Prevention Needs of Youth Not Being Met

Recently, President Bush called for doubling funding for the President’s Emergency Plan for AIDS Relief (PEPFAR) when it comes up for reauthorization in the current Congress.  While PEPFAR is providing unprecedented resources for combating HIV/AIDS, it is nonetheless failing to meet its promise in very significant ways, particularly when it comes to prevention.  A new report released today by the Sexuality Information and Education Council of the United States (SIECUS) highlights the shortcomings of PEPFAR in combating the growth of the HIV/AIDS epidemic in Vietnam.

Vietnam is the only Asian country to be included among the 15 focus countries of PEPFAR; it received $17 million in HIV/AIDS-prevention funds from the United States in 2004 and $25 million in 2005.  While this money can do good, its focus on the stigmatization of injecting drug users and sex workers, and on promoting abstinence-until-marriage programs greatly hinders its effectiveness.  Our in-country research found that these restrictive, blanket policies fail to take into account the unique nature of the epidemic in Vietnam.

More than 50% of Vietnam’s population is under the age of 24, and the HIV infection rate among this age group is high and growing.  Recent surveys have found that Vietnamese in this age group are woefully uniformed about condoms and HIV prevention, while, at the same time, they are more likely than ever to engage in pre-marital sex.  These youth are placed at further risk by the fact that the Vietnamese government classifies drug use and sex work as “social evils,” stigmatizing young people who fall into those categories and sending some of the most at risk youth to mandatory rehabilitation centers, called “05/06 centers,” where HIV infection can run rampant. This forced isolation makes gaining access to services even more difficult for those who need it most.

PEPFAR does not provide support to young people in Vietnam’s 05/06 centers, and requires all grantees receiving funds to sign an “anti-prostitution pledge,” an action which further marginalizes sex workers. PEPFAR also does not adequately support programs that address injecting drug use.   Instead, the focus of PEPFAR remains on abstinence-until-marriage programs, which fail to serve the needs of the growing percentage of youth who are sexually active. 

SIECUS strongly recommends that PEPFAR prevention efforts should abandon the disproportionate emphasis on abstinence-until marriage programs in Vietnam. PEPFAR should instead work with local groups to adapt its programs to fit the unique needs of Vietnam, including reaching out specifically to drug users, sex workers, and young people, instead of reinforcing the systems that have marginalized them by continuing with a rigid, predetermined approach to HIV/AIDS prevention.

To view the full SIECUS Special Report on Vietnam, visit or e-mail a request to