In the case of HIV and PMTCT, additional reasons for the unsatisfying performance included inadequate knowledge and skills due to lack of training, medicines, protective equipment and practice guidelines. Health care workers had poor knowledge about HIV and about prevention of occupational exposure to HIV, especially at district or lower levels. Even in the expected sources of expertise, the medical schools around Vietnam, 70% of medical students and 48% of lecturers recapped used needles by hand, while two thirds always cleaned their hands with antiseptic after contact with blood. Sixty percent of medical students and 37% of lecturers had been exposed directly to blood or body fluids and were worried about HIV transmission. However, 15% of the respondents recommended antibiotics for post-exposure prophylaxis, while one third proposed ARV prophylaxis [23] . These results reveal a disturbing lack of knowledge and awareness about HIV, even among the medical profession. Lack of practical needs can become an excuse for health care workers to justify their fear of HIV infection and their reluctance to provide good services for HIV-infected people [7, 24] .