Tackling Stigma Champion #5

Ahead of World AIDS day, we spoke with Tung Doan, Executive Director of Lighthouse Vietnam, Senior Advisor at Y+ Global, and a member of the Southeast Asia Stigma Reduction QI Learning Network (QIS+D Network). Tung’s work sits at the intersection of lived experience, community leadership, and structural reform — pushing Vietnam’s HIV sector toward genuine partnership between communities, providers, and government.

From co-designing the country’s first national HIV-friendly service guidelines, to building key population–friendly clinics and integrating community-led monitoring into formal systems, Tung is dedicated to dismantling stigma at every level.

Tung’s tips at a glance

Involve communities from start to finish: design, delivery, monitoring, improvement
Pair community-led monitoring with quality improvement — one without the other falls flat
Build trust with policymakers through co-design of standards and guidelines
Create real avenues for feedback: dialogue sessions can change provider behaviour
Invest in HIV literacy and training early — from primary school to medical curricula
Normalise flexible, private, respectful services: small system tweaks can make big differences
Identify champions inside the health system, but be ready to build empathy where none exists
Tackle stigma as multilevel and intersectional: HIV, sexuality, gender, drug use, sex work etc
Remember young people: they face layered stigma and need tailored support
Treat stigma reduction as collective work — not something left to communities alone

Tell us a bit about yourself, your work, and how you became involved in stigma reduction

My work came from my experience as a queer person and a member of key populations in Vietnam, and from listening to the stories and experiences of my community — my brothers and sisters who suffer stigma in society, in the workplace, and in healthcare settings when accessing HIV services. I realised we cannot end HIV without ending stigma and discrimination. That is when I started focusing strongly on stigma reduction and quality improvement for HIV services.

That includes my work at Lighthouse, a community-led organisation working on education, stigma reduction, service delivery, and advocacy for better laws and policies across Vietnam. It is also how I got involved in The Southeast Asia Stigma Reduction QI Learning Network (QIS+D), as I realised there was a lot to learn about stigma reduction from different countries.

What types of stigma are you seeing in your work, and what approaches are you using to respond?

Stigma has various forms and appears in every aspect of life from schools, society, families, and healthcare settings.

For personal stigma or self-stigma, we run circle sharing groups, group support therapy, and one-on-one counselling. We listen to people’s stories and find ways to provide psychological support
For stigma in society, we focus on education. We run events in universities to deliver stories from people living with HIV and key populations to students, including medical students. We use role-play and drama so young people can understand how stigma feels and how to address it as future providers
For stigma in healthcare services, we’ve developed several innovations, including a key population–friendly service model now used across six provinces. It incorporates community-led monitoring, where community members collect feedback on client satisfaction and share it directly with facilities. This includes the Community and Provider Partnership for Quality Improvement — a co-designed toolkit that maps where stigma occurs, outlines community-expected standards, and helps both community and providers monitor and improve service quality
For systems level change, we’re working with the government to review policies and identify gaps where stigma occurs. This includes Vietnam’s first-ever national HIV-friendly service guidelines

Tell us more about the Key Population Friendly Service Model. How has this led to stigma reduction?

In all sites using the key population-friendly model, client satisfaction has improved, some even doubled. This has been a direct result of changes made due to the model and community led feedback and monitoring.

For example, many facilities now offer more flexible hours, including outside working hours or weekends. And at one healthcare facility in Hanoi, all services were delivered in one room. Clients said there was no privacy, they could hear doctors talking to others and this environment directly led to increased stigma.

After the feedback, the facility received permission to move downstairs and use three different rooms: one for counselling, one for doctors, and one for pharmacists. This was a big change, especially because infrastructure for HIV services in Vietnam is difficult to secure.

Some providers say they never had this kind of dialogue with community members before and didn’t know people suffered these experiences when accessing services. It helped them understand what the right thing to do is as providers.

You worked with the government to introduce Vietnam’s first-ever national HIV-friendly service guidelines. How did you secure government support?

Starting in 2020/2021, we worked with VAAC — the Vietnam Administration of HIV/AIDS Control under the Ministry of Health — to produce and issue the country’s first national guidelines on HIV-friendly services for key populations and people living with HIV. These guidelines act as a key reference for HIV facilities: a checklist to see what standards they meet, what is missing, and what they need to improve in order to provide truly friendly services.

It was a long process, around three years. From the beginning, we had strong support from the US CDC, who helped engage and convince government officers to join our efforts. The steps were quite clear. First, we helped them fully understand the purpose of the model — that it is not about pointing fingers at healthcare providers, but about collecting real feedback from the community and working together to improve service quality.

Once they were on board, we introduced the components of the model, how it works, and how it aligns with the existing health system. We then invited them into the co-design process. They could give feedback and input, but they also listened directly to the voices of community members, who were also core designers. This helped harmonise the needs and perspectives of all players.

We piloted the models and collected clear evidence showing they worked. We saw tangible changes — improvements in client satisfaction, increases in provider knowledge, and changes in how services were organised and made more flexible and comprehensive. Providers placed high value on these results.

With this pool of evidence, we introduced the idea of developing national guidelines. There was strong need not only from the community, but also from healthcare providers, and that helped move the process forward.

Across all your work, community-led monitoring keeps coming up. Why is it so essential, and how does it link to quality improvement?

Community-led monitoring is important, but it must always be coupled with quality improvement. Community members should not only collect data and feedback — we also play a core role in implementing improvements, supporting providers to strengthen their knowledge of key populations, and raising our voices with government to influence policies.

As part of this, we bring community members together with champions inside the healthcare system — doctors and nurses who already practice nonjudgmental care — to share their experiences. Providers often say they feel it is simply the right thing to do, and that they receive love and respect from their patients in return. For many, that is the highest ethic of healthcare.

What unique challenges do key populations face in Vietnam?

Young key populations and young people with HIV face multilevel stigma — self-stigma, healthcare stigma, stigma toward LGBTQ identities, sex work, drug use — in schools, families, and healthcare settings.

In concentrated epidemics like Vietnam, key populations face very targeted stigma from different identities they hold. To address this, we need to bring this reality to policymakers and donors, and embed stigma as a core component of healthcare services. We cannot tackle stigma in silo.

What message would you share with others working to strengthen stigma reduction?

This month marks 35 years of Vietnam’s HIV response since the first case. It’s important to emphasise that everyone has a role. Stigma reduction is not only the job of the community. It requires collective efforts — government officials producing good law and policy, healthcare providers equipping themselves with better knowledge, and donors and development partners investing in community work and centering communities in all work.

Tackling Stigma Champion #5: Tung Doan on tackling stigma in Vietnam’s HIV response