TY - JOUR
T1 - HIV prevention for injection drug users in China and Vietnam
T2 - Policy and research considerations
AU - Hammett, T. M.
AU - des Jarlais, D.
AU - Johnston, P.
AU - Kling, R.
AU - Ngu, D.
AU - Liu, W.
AU - Chen, Y.
AU - Van, L. K.
AU - Donghua, M.
N1 - Funding Information:
The cross-border interventions in China and Vietnam are supported by the Ford Foundation offices in Beijing and Hanoi, with additional support for the interventions in China from the Global Fund and national and provincial budgets. The evaluation research was supported by grant number 1 R01 DA-14703 from the National Institute on Drug Abuse, US National Institutes of Health, with continuing support from a generous anonymous donor in New York City.
PY - 2007/4
Y1 - 2007/4
N2 - A pattern of serious injection drug user (IDU) driven HIV epidemics in Asia, with emerging evidence of generalization through heterosexual transmission, indicates the need for interventions focusing on both drug- and sex-related risk reduction. In a cross-border HIV prevention project for IDUs in northern Vietnam and southern China, peer educators disseminated risk reduction information to IDUs in the community and provided 20,000-25,000 sterile needles/syringes and 4,000-6,000 condoms per month. Since implementation of these interventions, the frequency of both injecting and sexual risk behaviours fell significantly, HIV prevalence among IDUs declined or stabilized, and HIV incidence dropped. There is official support for harm reduction interventions in both countries but this appears precarious in view of persistently powerful political and financial support for a law enforcement approach. Moreover, the simultaneous pursuit of inconsistent policies can have negative effects on the implementation of interventions. A harmonized and consistent policy environment is needed. Most of the evidence for efficacy of community-based HIV prevention comes from the developed world, but well-designed evaluations of such interventions in Asia and elsewhere in the developing world would have a better chance to influence policy decisions there. A synergistic approach to research, policy development, and service delivery is best calculated to achieve positive results in the struggle against HIV/AIDS in developing countries.
AB - A pattern of serious injection drug user (IDU) driven HIV epidemics in Asia, with emerging evidence of generalization through heterosexual transmission, indicates the need for interventions focusing on both drug- and sex-related risk reduction. In a cross-border HIV prevention project for IDUs in northern Vietnam and southern China, peer educators disseminated risk reduction information to IDUs in the community and provided 20,000-25,000 sterile needles/syringes and 4,000-6,000 condoms per month. Since implementation of these interventions, the frequency of both injecting and sexual risk behaviours fell significantly, HIV prevalence among IDUs declined or stabilized, and HIV incidence dropped. There is official support for harm reduction interventions in both countries but this appears precarious in view of persistently powerful political and financial support for a law enforcement approach. Moreover, the simultaneous pursuit of inconsistent policies can have negative effects on the implementation of interventions. A harmonized and consistent policy environment is needed. Most of the evidence for efficacy of community-based HIV prevention comes from the developed world, but well-designed evaluations of such interventions in Asia and elsewhere in the developing world would have a better chance to influence policy decisions there. A synergistic approach to research, policy development, and service delivery is best calculated to achieve positive results in the struggle against HIV/AIDS in developing countries.
KW - Asia
KW - China
KW - HIV/AIDS
KW - Injection drug users
KW - Prevention
KW - Vietnam
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U2 - 10.1080/17441690600981806
DO - 10.1080/17441690600981806
M3 - Article
C2 - 19280395
AN - SCOPUS:34248391764
SN - 1744-1692
VL - 2
SP - 125
EP - 139
JO - Global Public Health
JF - Global Public Health
IS - 2
ER -