{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T23:06:48Z","timestamp":1790118408567,"version":"4.0.1"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":83,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>People who inject drugs (PWID) are central to the HIV epidemic in Vietnam, many delay HIV testing and antiretroviral therapy (ART) until advanced disease. We assessed prevalence and correlates of ART use and low CD4 counts among PWID with HIV.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Analysis of the 2013 Integrated Behavioral and Biologic Survey in Vietnam.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Eligible participants were men aged\u2009\u2265\u200918 years who reported recent injecting, were HIV positive, and consented to future viral load (VL) and CD4 testing. Undetectable VL was defined as &lt;\u200950 copies\/ml. Percentages and prevalences were adjusted for sampling method.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 287 PWID, 55% knew their status. Among these, 88% were on ART, and 82% had undetectable VL. ART use was positively associated with older age (&gt;\u200940 vs.\u2009&lt;\u200930 years, OR 4.9, 95% CI 1.2\u201320.5) and opioid substitution therapy (OR 12.7, 95% CI 1.1\u2013141.7). It was negatively associated with living alone (OR 0.1, 95% CI 0.0\u20130.5), living with a partner versus relatives (OR 0.3, 95% CI 0.1\u20130.8), higher income (&gt;\u2009VND 4.5 vs.\u2009&lt;\u20092.5\u00a0million; OR 0.2, 95% CI 0.1\u20130.7), and recent rehabilitation (OR 0.2, 95% CI 0.1\u20130.8). Among those not on ART, 16% had CD4\u2009&lt;\u2009200 cells\/mm\u00b3; longer injecting duration was strongly associated (OR 6.3 for &gt;\u200910 vs.\u2009&lt;\u20095 years, 95% CI 1.5\u201327.3).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Suboptimal HIV status awareness, ART uptake, and advanced immunosuppression among untreated PWID highlight the need for strengthened case finding and earlier engagement. Linking treatment, social support, and HIV services in closed settings could improve outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12879-026-13180-2","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T07:14:42Z","timestamp":1782976482000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Antiretroviral therapy use and CD4 cell count among people who inject drugs living with HIV in southern Vietnam"],"prefix":"10.1186","volume":"26","author":[{"given":"Duong Cong","family":"Thanh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David Charles","family":"Boettiger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abu","family":"Abdul-Quader","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hoang Thi","family":"Thanh Ha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pham Hong","family":"Thang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,2]]},"reference":[{"key":"13180_CR1","unstructured":"UNAIDS. Country factsheet - Vietnam 2024 Available from: https:\/\/www.unaids.org\/en\/regionscountries\/countries\/vietnam"},{"key":"13180_CR2","unstructured":"Ministry of Health - National Institute of Hygiene and Epidemiology. HIV\/STI Integrated Biological and Behavioral Surveillance (IBBS) in Vietnam - Results from round III 2013 and trends across three rounds (2005-2009-2013) of surveys. Available from: https:\/\/www.researchgate.net\/publication\/305471855_HIVSTI_Integrated_Biologcial_and_Behavioral_Surveillance_IBBS_in_Vietnam_-_Results_from_Round_III_and_Trends_Across_Three_Rounds_2005_-_2009_-_2013_of_Surveys"},{"key":"13180_CR3","unstructured":"MOH. AIDS epidemic model analysis for mid-term review of the national strategy to end AIDS by 2030. Hanoi: Ministry of Health \u2013 Vietnam Administration of Disease Control; 2025."},{"key":"13180_CR4","doi-asserted-by":"publisher","first-page":"18804","DOI":"10.7448\/IAS.17.1.18804","volume":"17","author":"S Kiertiburanakul","year":"2014","unstructured":"Kiertiburanakul S, Boettiger D, Lee MP, Omar SF, Tanuma J, Ng OT, et al. Trends of CD4 cell count levels at the initiation of antiretroviral therapy over time and factors associated with late initiation of antiretroviral therapy among Asian HIV-positive patients. J Int AIDS Soc. 2014;17:18804.","journal-title":"J Int AIDS Soc"},{"key":"13180_CR5","unstructured":"Vietnam Administration for HIV\/AIDS Control. Prevalence of HIV, syphilis, and related risk behaviors among men who have sex with men, male people who inject drugs, female sex workers in Vietnam: findings from HIV Sentinel Surveillance Plus (HSS+). Hanoi: Vietnam Ministry of Health; 2025. p. 2012\u201322."},{"issue":"4","key":"13180_CR6","doi-asserted-by":"publisher","first-page":"744","DOI":"10.1007\/s11524-015-9966-z","volume":"92","author":"HV Tran","year":"2015","unstructured":"Tran HV, Le LV, Johnston LG, Nadol P, Van Do A, Tran HT, et al. Sampling males who inject drugs in Haiphong, Vietnam: comparison of time-location and respondent-driven sampling methods. J Urban Health. 2015;92(4):744\u201357.","journal-title":"J Urban Health"},{"key":"13180_CR7","unstructured":"Handcock M, Fellows I, Giles K. Deducer RDS Analyst: graphical user interface to the RDS package for respondent-driven sampling. Version 0.1. 2012. Available from: http:\/\/hpmrg.org"},{"key":"13180_CR8","unstructured":"Duong CT, Abdul-Quader A, Nguyen TA, editors. Knowledge of HIV status, enrolment in care, and CD4 count among HIV+ PWID in Vietnam. In: Australian HIV\/AIDS Conference; 6\u20138 November 2016; Adelaide, Australia."},{"key":"13180_CR9","unstructured":"UNAIDS. The Gap Report 2014. Available from: http:\/\/www.unaids.org\/sites\/default\/files\/media_asset\/UNAIDS_Gap_report_en.pdf"},{"issue":"Suppl 3","key":"13180_CR10","doi-asserted-by":"publisher","first-page":"S392","DOI":"10.1097\/QAI.0000000000001416","volume":"75","author":"BE Hoots","year":"2017","unstructured":"Hoots BE, Finlayson TJ, Broz D, Paz-Bailey G, Group NS. Antiretroviral therapy use among HIV-infected people who inject drugs-20 cities, United States, 2009\u20132015. J Acquir Immune Defic Syndr. 2017;75(Suppl 3):S392\u20136.","journal-title":"J Acquir Immune Defic Syndr"},{"issue":"8","key":"13180_CR11","doi-asserted-by":"publisher","first-page":"1094","DOI":"10.1093\/cid\/ciw416","volume":"63","author":"AJ Low","year":"2016","unstructured":"Low AJ, Mburu G, Welton NJ, May MT, Davies CF, French C, et al. Impact of opioid substitution therapy on antiretroviral therapy outcomes: a systematic review and meta-analysis. Clin Infect Dis. 2016;63(8):1094\u2013104.","journal-title":"Clin Infect Dis"},{"key":"13180_CR12","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1186\/1472-6963-13-57","volume":"13","author":"A Opsal","year":"2013","unstructured":"Opsal A, Kristensen O, Larsen TK, Syversen G, Rudshaug EB, Gerdner A, et al. Factors associated with involuntary admissions among patients with substance use disorders and comorbidity: a cross-sectional study. BMC Health Serv Res. 2013;13:57.","journal-title":"BMC Health Serv Res"},{"issue":"4","key":"13180_CR13","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1071\/SH06062","volume":"4","author":"T Gibbie","year":"2007","unstructured":"Gibbie T, Hay M, Hutchison CW, Mijch A. Depression, social support and adherence to highly active antiretroviral therapy in people living with HIV\/AIDS. Sex Health. 2007;4(4):227\u201332.","journal-title":"Sex Health"},{"issue":"3","key":"13180_CR14","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1007\/s10461-005-9042-x","volume":"10","author":"EN Waddell","year":"2006","unstructured":"Waddell EN, Messeri PA. Social support, disclosure, and use of antiretroviral therapy. AIDS Behav. 2006;10(3):263\u201372.","journal-title":"AIDS Behav"},{"key":"13180_CR15","unstructured":"Viet Nam Network of People Living with HIV (VNP+). Stigma Index Report 2014 2014. Available from: https:\/\/www.aidsdatahub.org\/sites\/default\/files\/resource\/plhiv-stigma-index-2014-viet-nam.pdf"},{"issue":"1","key":"13180_CR16","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1081\/JA-200030511","volume":"40","author":"MA Hacker","year":"2005","unstructured":"Hacker MA, Friedman SR, Telles PR, Teixeira SL, Bongertz V, Morgado MG, et al. The role of long-term and new injectors in a declining HIV\/AIDS epidemic in Rio de Janeiro, Brazil. Subst Use Misuse. 2005;40(1):99\u2013123.","journal-title":"Subst Use Misuse"},{"issue":"9","key":"13180_CR17","doi-asserted-by":"publisher","first-page":"795","DOI":"10.1056\/NEJMoa1506816","volume":"373","author":"ISS Group","year":"2015","unstructured":"Group ISS, Lundgren JD, Babiker AG, Gordin F, Emery S, Grund B, et al. Initiation of antiretroviral therapy in early asymptomatic HIV infection. N Engl J Med. 2015;373(9):795\u2013807.","journal-title":"N Engl J Med"},{"key":"13180_CR18","unstructured":"UNAIDS. Strengthening Viet Nam\u2019s national HIV response: key findings and policy recommendations. 2025. Contract No.: 15 Sep 2025."}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12879-026-13180-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-026-13180-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-026-13180-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T22:52:01Z","timestamp":1790117521000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12879-026-13180-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,2]]},"references-count":18,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["13180"],"URL":"https:\/\/doi.org\/10.1186\/s12879-026-13180-2","relation":{},"ISSN":["1471-2334"],"issn-type":[{"value":"1471-2334","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,2]]},"assertion":[{"value":"10 October 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 March 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The study was reviewed and approved by the institutional review boards of the National Institute of Hygiene and Epidemiology, Vietnam; Family Health International, Vietnam; and the U.S. Centers for Disease Control and Prevention, USA, and CDC investigators did not interact with human subjects or access identifiable data or specimens for research purposes. The study was conducted in accordance with the ethical principles of the Declaration of Helsinki. All participants provided written informed consent, including consent for storage of specimens and future unspecified laboratory analyses.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The findings and conclusions in this paper are those of the authors and do not necessarily represent the official position of the funding agencies.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"1703"}}