Decree 63/2021/ND-CP detailing Law on Prevention and Control of HIV/AIDS

DECREE

Detailing the Law Amending and Supplementing a Number of Articles of the Law on Prevention and Control of Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome (HIV/AIDS)^[1]

Pursuant to the June 19, 2015 Law on Organization of the Government; and the November 22, 2019 Law Amending and Supplementing a Number of Articles of the Law on Organization of the Government and the Law on Organization of Local Administration;

Pursuant to the June 29, 2006 Law on Prevention and Control of Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome (HIV/AIDS); and the November 16, 2020 Law Amending and Supplementing a Number of Articles of the Law on Prevention and Control of Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome (HIV/AIDS);

At the proposal of the Minister of Health;

The Government promulgates the Decree detailing the Law Amending and Supplementing a Number of Articles of the Law on Prevention and Control of Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome (HIV/AIDS).

Chapter I

GENERAL PROVISIONS

Article 1. Scope of regulation

This Decree details Clauses 5, 7 and 11, Article 1 of November 16, 2020 Law No. 71/2020/QH14  Amending and Supplementing a Number of Articles of the Law on Prevention and Control of Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome (HIV/AIDS) regarding:

1. Management of, propaganda among, and provision of counseling, testing, care and treatment for, HIV-infected people, and HIV transmission prevention at compulsory education institutions, reformatories, drug rehabilitation facilities, social protection establishments, prisons, detention camps, custody houses and other detention facilities (below collectively referred to as managing establishments).

2. Pre-exposure prophylaxis.

3. State budget funds for, and methods of, payment of HIV testing costs for uninsured pregnant women and HIV testing costs not covered by the Health Insurance Fund for insured pregnant women.

Article 2. Interpretation of terms

1. Social protection establishments are social relief establishments specified in the Government’s Decree No. 103/2017/ND-CP of September 12, 2017, on establishment, organization, operation, dissolution and management of social relief establishments and other social protection establishments in accordance with law.

2. Managed subjects are persons consigned to compulsory education institutions, reformatories, drug rehabilitation facilities, social protection establishments, prisons, detention camps, custody houses and other detention facilities in accordance with law.

3. Managed subjects whose HIV status has been identified are persons with HIV positive test results.

Chapter II

MANAGEMENT OF, PROPAGANDA AMONG, AND PROVISION OF COUNSELING, TESTING, CARE AND TREATMENT FOR, HIV-INFECTED PEOPLE, AND HIV TRANSMISSION PREVENTION AT MANAGING ESTABLISHMENTS

Article 3. Management of subjects

1. After admitting managed subjects, managing establishments shall carry out anamnesis to acquire information on these persons’ use of drugs, HIV status, and receipt of antiretroviral therapy and opiate substitution treatment so as to classify managed subjects.

2. Classification of managed subjects and implementation of HIV/AIDS prevention and control activities:

a/ Managing establishments shall provide antiretroviral therapy to managed subjects whose HIV status has been identified according to Article 6 of this Decree;

b/ Managing establishments shall provide counseling to and carry out HIV testing for managed subjects whose HIV status has not been identified under Article 5 of this Decree. For the managed subjects specified in Clauses 1, 2, 3 and 4, Article 9 of this Decree, managing establishments shall provide them with pre-exposure prophylaxis under Article 7 of this Decree.

3. Managing establishments shall:

a/ Arrange jobs suitable to the health status of managed subjects who are HIV-infected;

b/ Not organize groups or teams consisting of managed subjects who are HIV- infected for them to study, live, work or receive medical treatment together, except those who are infected with diseases requiring quarantine in accordance with law;

c/ Not assign managed subjects who are HIV-infected to perform jobs that make them become prone to infections or get scratches or transmit HIV to others.

4. Managing establishments shall manage HIV/AIDS treatment records and pre-exposure prophylaxis records of managed subjects.

Article 4. Propaganda about HIV/AIDS prevention and control at managing establishments

1. Contents of propaganda about HIV/AIDS prevention and control include:

a/ Causes and channels of HIV transmission, HIV transmission prevention measures and measures of care and treatment for HIV-infected people;

b/ Impacts of HIV/AIDS on human health and life and socio-economic development;

c/ Rights and obligations of individuals and HIV-infected people in HIV/AIDS prevention and control;

d/ Methods and services of HIV testing and care, support and treatment for HIV-infected people;

dd/ Harm reduction measures in HIV transmission prevention;

e/ Fight against stigma and discrimination against HIV-infected people;

g/ Sexually transmitted infections and other contents on healthcare;

h/ The Party’s lines and the State’s policies and laws on HIV/AIDS prevention and control.

2. Forms of propaganda about HIV/AIDS prevention and control include:

a/ Via means of public communication such as public-addressing systems, panels, posters, propaganda posters; propaganda films on HIV/AIDS prevention and control;

b/ Communications among groups of managed subjects on the basis of classification of managed subjects by managing establishments;

c/ Personal communications among managed subjects;

d/ Event-based communications: organizing contests on HIV/AIDS prevention and control; art performances and other events integrated with contents on HIV/AIDS prevention and control held on the occasion of events of managing establishments or the National Month of Action for HIV/AIDS Prevention and Control;

dd/ Integration of contents on HIV/AIDS prevention and control into continuing education programs carried out at managing establishments;

e/ Distribution of publications and communication materials to managed subjects;

g/ The propaganda of the State’s policies and laws on HIV/AIDS prevention and control must comply with Article 21 of the Law on Law Dissemination and Education.

3. Each managed subject shall receive propaganda information about HIV/AIDS prevention and control at least twice a year.      

Article 5. Counseling and HIV testing for managed subjects

1. Managing establishments shall provide counseling to managed subjects before and after HIV testing when the following conditions are fully met:

a/ Counselors have been trained in HIV/AIDS prevention and control counseling;

b/ Counseling venues ensure privacy;

c/ There are sufficient tables, chairs and materials serving the provision of counseling.

2. Managing establishments shall carry out HIV testing for managed subjects when fully meeting the conditions specified in the Government’s Decree No. 75/2016/ND-CP of July 1, 2016, providing conditions for carrying out HIV testing, Decree No. 109/2016/ND-CP of July 1, 2016, on grant of practice certificates to practitioners and grant of operation licenses to medical examination and treatment establishments (below referred to as Decree No. 109/2016/ND-CP), and Decree No. 155/2018/ND-CP of November 12, 2018, amending and supplementing a number of provisions related to business investment conditions within the scope of state management by the Ministry of Health (below referred to as Decree No. 155/2018/ND-CP).

3. Counseling contents and HIV testing techniques must comply with professional guidance on medical examination and treatment and HIV/AIDS.

4. In case a managing establishment does not fully meet the conditions specified in Clauses 1 and 2 of this Article, it shall send a request to the concerned provincial-level Department of Health or the Ministry of National Defense, proposing the latter to designate a qualified health establishment under its management (below referred to as designated establishment) to coordinate in providing counseling and carrying out HIV testing for managed subjects. 

Article 6. Care and HIV/AIDS treatment for managed subjects

1. Managing establishments shall provide HIV/AIDS treatment for managed subjects when fully meeting the conditions specified in Decree No. 109/2016/ND-CP and Decree No. 155/2018/ND-CP. If disqualified for providing HIV/AIDS treatment, managing establishments shall request in writing designated establishments to coordinate in providing HIV/AIDS treatment for managed subjects.

2. The provision of care and treatment for, and making of HIV/AIDS treatment records of, managed subjects must comply with professional guidance on medical examination and treatment and HIV/AIDS.

3. Managing establishments qualified for providing HIV/AIDS treatment shall make antiretroviral therapy records for managed subjects. If unqualified for providing HIV/AIDS treatment, managing establishments shall request in writing designated establishments to coordinate in making HIV/AIDS treatment records for managed subjects.

4. The transfer among establishments providing antiretroviral therapy for managed subjects shall be carried out as follows:

a/ For managing establishments qualified for providing HIV/AIDS treatment: The managing establishments from which managed subjects move shall make treatment transfer slips and distribute up-to-90-day supply of anti-HIV drugs to the managing establishments to which managed subjects move or to managed subjects, in case such subjects are released for integration into community;

b/ For managing establishments unqualified for providing HIV/AIDS treatment: They shall coordinate with health establishments currently providing treatment for managed subjects to make treatment transfer slips for and distribute anti-HIV drugs to managed subjects according to Point a of this Clause.

Article 7. Pre-exposure prophylaxis

1. Managing subjects shall provide pre-exposure prophylaxis to managed subjects when fully meeting the conditions specified in Article 10 of this Decree. If unqualified for providing pre-exposure prophylaxis, managing establishments shall request in writing designated establishments to coordinate in providing treatment for managed subjects.

2. The provision of treatment and making of pre-exposure prophylaxis records must comply with professional guidance on medical examination and treatment and HIV/AIDS.

3. Managing establishments qualified for providing pre-exposure prophylaxis shall make treatment records for managed subjects. If unqualified for providing pre-exposure prophylaxis, managing establishments shall request in writing designated establishments to coordinate in making treatment records for managed subjects.

Article 8. Infection control measures for HIV transmission prevention

1. To apply sterile methods and clean, disinfect and sterilize instruments and equipment used for provision of care and treatment under professional guidance on medical examination and treatment and HIV/AIDS.

2. To apply standard precautions when being exposed to blood and bio-fluids and providing care and treatment to patients, regardless of their diagnosed diseases, and apply additional precautions based on transmission channels of diseases.

3. Textiles and fabrics that are contaminated or contain blood or bio-fluids shall be collected, transported and disposed of separately.

4. Specimens of HIV-infected managed subjects who are dead shall be disposed of under professional guidance on medical examination and treatment and HIV/AIDS.

5. To apply other infection control measures under professional guidance on medical examination and treatment and HIV/AIDS.

Chapter III

PRE-EXPOSURE PROPHYLAXIS

Article 9. Subjects entitled to receive pre-exposure prophylaxis

1. People who have sex with same-sex partners.

2. Transgender people.

3. Drug users.

4. Prostitutes.

5. Spouses of HIV-infected people; spouses of the subjects specified in Clauses 1, 2, 3, and 4 of this Article.

6. People who have sex with HIV-infected people.

Article 10. Provision of pre-exposure prophylaxis

1. Establishments providing pre-exposure prophylaxis include:

a/ Medical examination and treatment establishments;

b/ Other health establishments.

2. Conditions for provision of pre-exposure prophylaxis applicable to the establishments specified at Point a, Clause 1 of this Article:

a/ Meeting the conditions specified in Decree No. 109/2016/ND-CP and Decree No. 155/2018/ND-CP;

b/ Physicians or health workers directly providing pre-exposure prophylaxis must possess medical examination and treatment practice certificates and certificates of training in pre-exposure prophylaxis issued by qualified training institutions.

3. Conditions for provision of pre-exposure prophylaxis applicable to the establishments specified at Point b, Clause 1 of this Article:

a/ Having sufficient physical foundations and appropriate equipment for treatment activities meeting the conditions specified in Decree No. 109/2016/ND-CP and Decree No. 155/2018/ND-CP;

b/ Having physicians or health workers who possess medical examination and treatment practice certificates and certificates of training in pre-exposure prophylaxis issued by qualified training institutions.

4. Pre-exposure prophylaxis must follow professional guidance on medical examination and treatment and HIV/AIDS.

Chapter IV

STATE BUDGET FUNDS FOR, AND METHODS OF, PAYMENT OF HIV TESTING COSTS FOR UNINSURED PREGNANT WOMEN AND AMOUNTS OF HIV TESTING COSTS NOT COVERED BY THE HEALTH INSURANCE FUND FOR INSURED PREGNANT WOMEN

Article 11. State budget funds

1. The state budget funds include:

a/ Domestic funds in accordance with the Law on the State Budget;

b/ Aid of foreign donors;

c/ Supports of agencies, organizations and individuals in accordance with law.

2. The state budget funds shall be allocated for HIV testing for pregnant women according to professional descriptions and current regulations on budget decentralization, covering:

a/ HIV testing costs for uninsured women at the charge rates of health insurance-covered medical examination and treatment services;

b/ Amounts not covered by the Health Insurance Fund for insured women according to the scope and level of benefits specified by the law on health insurance.

3. Ministries, ministerial-level agencies and provincial-level People’s Committees shall allocate funds for HIV testing for pregnant women at health establishments under their management according to Clause 2 of this Article within their annual current expenditure estimates as assigned.

Article 12. Methods of payment

1. For public health establishments

Annually, at the time of making state budget estimates, public health establishments carrying out HIV testing for pregnant women shall make reports on funds actually paid for HIV testing and include these figures in their state budget expenditure estimates according to the forms provided in Appendices I and II to this Decree for submission to competent authorities. The process of making and executing state budget estimates and finalizing state budget funds’ accounts must comply with the Law on the State Budget and the Accounting Law and guiding documents.

2. For non-public health establishments

a/ Annually, at the time of making state budget estimates, non-public health establishments carrying out HIV testing for pregnant women shall make reports on funds actually paid for HIV testing for pregnant women according to the form provided in Appendix I to this Decree and send such reports to provincial-level Departments of Health;

b/ Provincial-level Departments of Health shall appraise and make reports on funds actually paid for HIV testing for pregnant women as prescribed by non-public health establishments under their management according to the form provided in Appendix II to this Decree and include these figures in their state budget expenditure estimates for submission to competent authorities according to regulations. The process of making and executing state budget estimates and finalizing state budget funds’ accounts must comply with the Law on the State Budget and the Accounting Law and guiding documents.

Chapter V

IMPLEMENTATION PROVISIONS

Article 13. Organization of implementation

1. The Ministry of Health shall:

a/ Provide technical guidance on counseling, HIV testing, treatment and care, and HIV transmission prevention;

b/ Formulate plans on supply, distribution and management of use of anti-HIV drugs for managed subjects;

c/ Assume the prime responsibility for, and coordinate with related ministries and sectors in, organizing and examining the implementation of this Decree.

2. The Ministry of National Defense shall:

a/ Organize, guide, and examine the performance of tasks falling within the scope of its management;

b/ Formulate annual plans and plans on receipt of, and summarize information on the use and inventory of, anti-HIV drugs at managing establishments and send them to the Ministry of Health;

c/ Designate qualified health establishments under its management and designated establishments to coordinate with managing establishments in providing counseling, testing and treatment of HIV/AIDS and pre-exposure prophylaxis for managed subjects, for disqualified managing establishments;

d/ Coordinate with the Ministry of Health in organizing the implementation of this Decree.

3. The Ministry of Public Security shall:

a/ Organize, guide, and examine the performance of tasks falling within the scope of its management;

b/ Direct managing establishments to formulate annual plans and plans on receipt of, and summarize information on the use and inventory of, anti-HIV drugs at managing establishments and send them to the Ministry of Health;

c/ Coordinate with the Ministry of Health in directing provincial-level Departments of Health to designate treatment establishments qualified for providing antiretroviral therapy to coordinate with managing establishments in providing treatment to managed subjects;

d/ Coordinate with the Ministry of Health in organizing the implementation of this Decree.

4. The Ministry of Labor, Invalids and Social Affairs shall:

a/ Organize, guide and examine the performance of tasks falling within the scope of its management.

b/ Coordinate with the Ministry of Health in organizing the implementation of this Decree.

5. Ministries, ministerial-level agencies, and provincial-level People’s Committees shall formulate plans, arrange resources and budgets for, and organize HIV/AIDS prevention and control activities in accordance with this Decree.

6. Provincial-level Departments of Health shall designate health establishments to coordinate with managing establishments in organizing counseling, testing and treatment of HIV/AIDS and providing pre-exposure prophylaxis for managed subjects, for disqualified managing subjects, except those managed by the Ministry of National Defense.

7. Managing establishments shall:

a/ Ensure that all managed subjects are provided with counseling, HIV testing, care, antiretroviral therapy, treatment for opportunistic infections and other co-infections, and HIV transmission prevention treatment;

b/ Provide HIV/AIDS prevention and control services to managed subjects according to their competence and within the scope of their management;

c/ Formulate plans, receive, use, and report on the use of anti-HIV drugs according to guidance of the Ministry of Health.

8. Health establishments carrying out HIV testing for pregnant women shall ensure funds for HIV testing for pregnant women according to regulations.

Article 14. Effect

This Decree takes effect on July 1, 2021.

Article 15. Implementation responsibility

Ministers, heads of ministerial-level agencies, heads of government-attached agencies, chairpersons of provincial-level People’s Committees, and related organizations and individuals shall implement this Decree.-

On behalf of the Government
For the Prime Minister
Deputy Prime Minister
VU DUC DAM

* The appendices to this Decree are not translated.