Low Awareness of HIV Status Among Men Who Have Sex with Men in Vietnam Despite Significant Improvements in the HIV Treatment Cascade.

Vietnam has committed to ending the AIDS epidemic by 2030 through the 95-95-95 targets. Men who have sex with men (MSM) remain a key population driving new infections. This study assessed progress toward national HIV targets among MSM and identified factors associated with HIV status awareness. Data were obtained from the HIV Sentinel Surveillance Plus Behavioral Surveys (HSS+) conducted from 2015 to 2020 in six provinces. Proportions of HIV-positive MSM who knew their HIV status, received antiretroviral therapy (ART), and achieved viral suppression were estimated. Temporal trends were analyzed using the Cochran-Armitage trend test, and correlates of HIV status awareness were examined using multivariable logistic regression. Among 4712 MSM, 471 (10.0%) tested HIV-positive. Awareness of HIV status increased from 16.7% in 2015 to 47.8% in 2020 (p-trend < 0.001). ART uptake among those aware of their status rose from 63.6 to 97.7% (p-trend < 0.001). Viral suppression among those on ART remained high (97.0% in 2018 to 98.8% in 2020). MSM who knew an HIV testing site (AOR = 6.0, 95% CI 2.7-13.1) had health insurance (AOR = 2.2, 95% CI 1.0-4.9), or had ever engaged in group sex (AOR = 2.3, 95% CI 1.1-5.0) were more likely to know their HIV status. Substantial improvements were observed in ART coverage and viral suppression among MSM with HIV in Vietnam from 2015 to 2020. However, more than half remained undiagnosed, underscoring the need to expand HIV testing improve insurance access, and strengthen community-based services to accelerate progress toward the 95-95-95 goals.