Objective: The aim of this study was to evaluate the impact of a multifaceted harm reduction program by comparing seroincidence rates of HIV, hepatitis C virus (HCV), hepatitis B virus (HBV), and syphilis before and after implementation of harm reduction strategies among intravenous drug users (IDUs) in a drug-trafficking city in Southwest China.
Design: This is a prospective cohort study with 24 months of follow-up.
Methods: Two prospective cohorts (cohort 2002–2004 and cohort 2006–2008) were followed up every 6 months for seroconversions of HIV, HCV, and syphilis antibodies and HBV surface antigen.
Results: After implementation of harm reduction strategies in Xichang city, Sichuan province, the HIV incidence rate among IDUs significantly dropped from 2.5 to 0.6 cases per 100 person-years. Subanalyses also indicated that the incidence rate of HBV significantly declined from 14.2 to 8.8 cases per 100 person-years. No significant changes in the seroincidence rates of HCV or syphilis were detected after implementation of IDU harm reduction strategies.
Conclusions: Harm reduction strategies may help reduce the high incidence of certain blood-borne infectious diseases and sexual transmitted diseases among high-risk IDUs in southwest China. Additional research is needed on the implementation and evaluation of harm reduction strategies in China.
From the *State Key Laboratory for Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China; †Sichuan Provincial Center for Disease Control and Prevention, Chengdu, Sichuan, China; ‡Tianjin Hangu Center for Disease Control and Prevention, Tianjin, China; §The School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada; ¶Xichang Center for STD and Leprosy Control, Xichang City, Sichuan, China; and ∥Liangshan Prefecture Center for Disease Control and Prevention, Xichang, Sichuan Province, China
Author’s contributions and approval of text: Study design: Yuhua Ruan and Yiming Shao. Data collection: Shu Liang, Junling Zhu, Xudong Li, Qianping liu, Benli Song, and Qixing Wang. Data analysis: Yuhua Ruan and Xudong Li. Data interpretation and writing: Yuhua Ruan, Stephen W. Pan, Hui Xing, and Yiming Shao. Principal investigator: Yiming Shao.
All authors have read and approved the text as submitted to the journal.
Supported by grants from the National Natural Science Foundation of China (81273188), the Ministry of Science and Technology of China (2012ZX10001-002), and Chinese State Key Laboratory for Infectious Disease Develop Grant (2012SKLID103).
Conflicts of interest: None.
Correspondence: Yiming Shao, MD, PhD, State Key Laboratory for Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China, 155 Changbai Rd, Changping District, Beijing 102206, PR China. E-mail: firstname.lastname@example.org.
Received for publication July 16, 2012, and accepted November 21, 2012.