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Reducing HIV infection among new injecting drug users in the ChinaVietnam Cross Border Project

Des Jarlais, Don Ca; Kling, Ryanb; Hammett, Theodore Mb; Ngu, Doanc; Liu, Weid; Chen, Yid; Binh, Kieu Thanhc; Friedmann, Patriciaa

doi: 10.1097/01.aids.0000304705.79541.34
Original papers

Objectives: To assess an HIV prevention programme for injecting drug users (IDU) in the crossborder area between China and Vietnam.

Design: Serial cross-sectional surveys (0, 6, 12, 18, 24 and 36 months) of community-recruited current IDU.

Methods: The project included peer educator outreach and the large-scale distribution of sterile injection equipment. Serial cross-sectional surveys with HIV testing of community recruited IDU were conducted at baseline (before implementation) and 6, 12, 18, 24 and 36 months post-baseline. HIV prevalence and estimated HIV incidence among new injectors (individuals injecting drugs for < 3 years) in each survey wave were the primary outcome measures.

Results: The percentages of new injectors among all subjects declined across each survey waves in both Ning Ming and Lang Son. HIV prevalence and estimated incidence fell by approximately half at the 24-month survey and by approximately three quarters at the 36-month survey in both areas (all P < 0.01).

Conclusion: The implementation of large-scale outreach and syringe access programmes was followed by substantial reductions in HIV infection among new injectors, with no evidence of any increase in individuals beginning to inject drugs. This project may serve as a model for large-scale HIV prevention programming for IDU in China, Vietnam, and other developing/transitional countries.

From the aBeth Israel Medical Center, New York, New York, USA

bAbt Associates Inc., Cambridge, Massachusetts, USA

cLang Son Health Department, Lang Son Province, Vietnam, China

dGuangxi Center for HIV/AIDS Prevention and Control, Guangxi, China.

Correspondence to Don C. Des Jarlais, Beth Israel Medical Center/CDI, 160 Water Street, 24th Floor, New York, NY 10038, USA. Tel: +1 212 256 2548; fax: +1 212 256 2570; e-mail: dcdesjarla@aol.com

© 2007 Lippincott Williams & Wilkins, Inc.