Measuring HIV Discriminatory Attitudes in Vietnam: Insights from the 2020–2021 MICS Data

Abstract Background HIV/AIDS continues to be a major public health concern in Vietnam, where stigma and discrimination against people living with HIV (PLHIV) are still widespread across all segments of the population. This study aimed to assess discriminatory attitudes (DA) and associated factors among the Vietnamese population toward PLHIV. Methods A cross-sectional analysis was conducted using data from the Multiple Indicator Cluster Surveys (MICS) for 2020-2021, involving 15,693 Vietnamese individuals aged 15-49. Generalized structural equation modeling (GSEM) was applied to identify factors associated with discriminatory attitudes, with the final model selected based on the statistical significance of path coefficients. Results DA toward PLHIV remain widespread in Vietnam. Among respondents, 44.8% reported at least one DA. Comprehensive HIV knowledge was relatively high, with 82.3% of respondents classified as having good knowledge, but misconceptions persisted. GSEM revealed that more accepting attitudes were significantly associated with higher HIV knowledge (Coef = -0.511, 95% CI: -0.550, -0.471), higher education (Coef = -0.436, 95% CI: -0.618, -0.254), female gender (Coef = -0.166, 95% CI: -0.252, -0.081), older age (Coef = -0.011, 95% CI: -0.017, -0.005), and ever having been tested for HIV (Coef = -0.160, 95% CI: -0.259, -0.061). In contrast, being married under 18 years (Coef = 0.418, 95% CI: 0.262, 0.573) and belonging to an ethnic minority (Coef = 0.126, 95% CI: 0.006, 0.246) had a significantly positive effect on the odds of holding DA. Conclusions This study emphasizes the need for targeted public health actions, such as improving HIV education and expanding testing programs, to reduce discriminatory attitudes in Vietnam. Future efforts should focus on developing policies that address cultural factors and building community support networks to monitor progress in public attitudes and health outcomes. Key messages • Nearly half of the Vietnamese population holds discriminatory attitudes toward PLHIV, despite high HIV knowledge. • Targeted education and community actions are key to promoting inclusion and reducing discriminatory attitudes.