TY - JOUR
T1 - Working With Persons Who Inject Drugs and Live in Rural Areas
T2 - Implications From China/Vietnam for the USA
AU - Des Jarlais, Don C.
AU - Hammett, Theodore M.
AU - Kieu, Binh
AU - Chen, Yi
AU - Feelemyer, Jonathan
N1 - Funding Information:
In Lang Son Province, in 2017, there were a total of 1321 patients on methadone maintenance in six clinics, and a total of 653 persons receiving ART in six clinics. Funding has been provided by the Global Fund for AIDS, Tuberculosis and Malaria, the World Bank, and the US Centers for Disease Control. HIV prevalence among PWID is currently 10% (Dr. Binh Kieu, unpublished data).
Funding Information:
The service activities of the project were initially funded jointly by the Ford Foundation and the National Institute on Drug Abuse, NIH, with later funding by the United Kingdom Department for International Development (DfID), the Global Fund for AIDS, Malaria and Tuberculosis, and an anonymous donor. The interventions were implemented by the health departments in Lang Son Province, Vietnam, and Ning Ming County and Guangxi Province, China. At the time, there were no community-based organizations working on HIV/AIDS in the area.
Funding Information:
Acknowledgements We would like to acknowledge the invaluable contributions of the Guangxi Province, Ning Ming County, and Lang Son Province Health Departments, the peer outreach workers, the research participants and the evaluation funding provided by the National Institute on Drug Abuse, Ford Foundation, and an anonymous donor.
Publisher Copyright:
© 2018, Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2018/8/1
Y1 - 2018/8/1
N2 - Purpose of Review: To describe a small city/rural area HIV prevention project (the Cross Border Project) implemented in Ning Ming County, Guangxi Province, China, and Lang Son province, Vietnam, and consider its implications for addressing the opioid/heroin epidemic in small cities/rural areas in the USA. The description and the outcomes of the Cross Border project were taken from published reports, project records, and recent data provided by local public health authorities. Evaluation included serial cross-sectional surveys of people who inject drugs to assess trends in risk behaviors and HIV prevalence. HIV incidence was estimated from prevalence among new injectors and through BED testing. Recent Findings: The Cross Border project operated from 2002 to 2010. Key components of the project 2 included the use of peer outreach workers for HIV/AIDS education, distribution of sterile injection equipment and condoms, and collection of used injection equipment. The project had the strong support of local authorities, including law enforcement, and the general community. Significant reductions in risk behavior, HIV prevalence, and estimated HIV incidence were observed. Community support for the project was maintained. Activities have been continued and expanded since the project formally ended. Summary: The Cross Border project faced challenges similar to those occurring in the current opioid crisis in US small cities/rural areas: poor transportation, limited resources (particularly trained staff), poverty, and potential community opposition to helping people who use drugs. It should be possible to adapt the strategies used in the Cross Border project to small cities/rural areas in the US opioid epidemic.
AB - Purpose of Review: To describe a small city/rural area HIV prevention project (the Cross Border Project) implemented in Ning Ming County, Guangxi Province, China, and Lang Son province, Vietnam, and consider its implications for addressing the opioid/heroin epidemic in small cities/rural areas in the USA. The description and the outcomes of the Cross Border project were taken from published reports, project records, and recent data provided by local public health authorities. Evaluation included serial cross-sectional surveys of people who inject drugs to assess trends in risk behaviors and HIV prevalence. HIV incidence was estimated from prevalence among new injectors and through BED testing. Recent Findings: The Cross Border project operated from 2002 to 2010. Key components of the project 2 included the use of peer outreach workers for HIV/AIDS education, distribution of sterile injection equipment and condoms, and collection of used injection equipment. The project had the strong support of local authorities, including law enforcement, and the general community. Significant reductions in risk behavior, HIV prevalence, and estimated HIV incidence were observed. Community support for the project was maintained. Activities have been continued and expanded since the project formally ended. Summary: The Cross Border project faced challenges similar to those occurring in the current opioid crisis in US small cities/rural areas: poor transportation, limited resources (particularly trained staff), poverty, and potential community opposition to helping people who use drugs. It should be possible to adapt the strategies used in the Cross Border project to small cities/rural areas in the US opioid epidemic.
KW - China
KW - Cross border
KW - HIV
KW - Persons who inject drugs
KW - Vietnam
KW - Prevalence
KW - Cross-Sectional Studies
KW - Humans
KW - Substance Abuse, Intravenous/complications
KW - Male
KW - Vietnam/epidemiology
KW - Incidence
KW - United States/epidemiology
KW - Rural Population
KW - Risk-Taking
KW - Adult
KW - Female
KW - HIV Infections/epidemiology
KW - China/epidemiology
KW - Health Education
UR - http://www.scopus.com/inward/record.url?scp=85048365435&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85048365435&partnerID=8YFLogxK
U2 - 10.1007/s11904-018-0405-0
DO - 10.1007/s11904-018-0405-0
M3 - Review article
C2 - 29948610
AN - SCOPUS:85048365435
VL - 15
SP - 302
EP - 307
JO - Current HIV/AIDS Reports
JF - Current HIV/AIDS Reports
SN - 1548-3568
IS - 4
ER -