Linkage between HIV diagnosis and care: Understanding the role of gender in a Northern Province in Vietnam.

Early linkage to HIV care is associated significantly with improved patient outcomes and reduced the risk of HIV transmission. However, delays between HIV diagnosis and registering for care have prevailed in Vietnam. The aim of researchers in this study is to examine linkages to care for individuals newly diagnosed with HIV in 2014, especially to highlight the impact of gender upon these linkages in a Northern Province of Ninh Binh. We collected secondary data of all 125 eligible HIV positive people diagnosed in 2014 and conducted a gender-based descriptive analysis of their registration to care within 6 months. Nineteen in-depth interviews and two focus group discussions were completed. We found that women accounted for one-third of newly diagnosed cases (42/125), but initiated HIV treatment at an earlier stage of HIV disease than men (65% women at stage 1, 2 versus 31% in men). Stigma and discrimination was greater among women while inadequate awareness of treatment was greater for men. Dissatisfaction with HIV testing and counseling and no or passive referral to treatment were other barriers for both the genders for enrolling in care services after diagnosis.