Familial support in integrated treatment with antiretroviral therapy and medications for opioid use disorder in Vietnam: A qualitative study

Abstract

Background: Patients report that familial support can facilitate initiation and maintenance of antiretroviral therapy (ART) and medications for opioid use disorder (MOUD). However, providing such support can create pressure and additional burdens for families of people with opioid use disorder (OUD) and HIV. We examined perspectives of people with HIV receiving treatment for OUD in Vietnam and their family members. Methods: Between 2015 and 2018, we conducted face-to-face qualitative interviews with 44 patients and 30 of their family members in Hanoi, Vietnam. Participants were people living with HIV and OUD enrolled in the BRAVO study comparing HIV clinic-based buprenorphine with referral to methadone treatment at 4 HIV clinics and their immediate family members (spouses or parents). Interviews were professionally transcribed, coded in Vietnamese, and analyzed using a semantic, inductive approach to qualitative thematic analysis. Results: Family members of people with OUD and HIV in Vietnam reported financially and emotionally supporting MOUD initiation and maintenance as well as actively participating in treatment. Family members described the burdens of supporting patients during opioid use, including financial costs and secondary stigma. Conclusions: Describing the role of family support in the lives of people living with OUD and HIV in the context of Vietnam enriches our understanding of their experiences and will support future treatment efforts targeting the family unit.

Keywords:

• Vietnam
• HIV
• opioid use disorder
• qualitative

Author contributions

PB performed the final thematic analysis and wrote the initial draft of the analysis. DT designed the qualitative data collection. NH and PM performed the qualitative interviews. DT, AE, NH, PM, and KH performed the initial qualitative analysis, consisting of data coding and synthesis in code summaries. TK, GB, and LG designed and oversaw the BRAVO trial, including the qualitative data collection. All authors edited the manuscript critically for content and agreed with the final manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This material is based upon work supported by the National Institute on Drug Abuse (R01DA037441), which had no further role in the study design, in the collection, analysis, and interpretation of data, in the writing of the report, or in the decision to submit the paper for publication.