Patterns of HIV prevalence and HIV risk behaviors among injection drug users prior to and 24 months following implementation of cross-border HIV prevention interventions in Northern Vietnam and Southern China

Theodore M. Hammett, Ryan Kling, Patrick Johnston, Wei Liu, Doan Ngu, Patricia Friedmann, Thanh Binh Kieu, Viet Dong Ha, Kieu Van Ly, Meng Donghua, Yi Chen, Don Des Jarlais

Research output: Contribution to journalArticle

Abstract

In 2002, we implemented a 4-year HIV prevention intervention for injection drug users (IDUs) in Lang Son Province, Vietnam, and Ning Ming County, Guangxi Province, China, a cross-border region seriously affected by inter-twined epidemics of heroin injection and HIV infection. The interventions involve peer education on HIV risk reduction and provision of new needles/syringes through direct distribution and pharmacy vouchers. We consider this to be a structural intervention in which risk reduction information and sterile injection equipment are diffused through the IDU populations and not limited to those who actually interact with peer educators. The evaluation of structural interventions poses complex methodological challenges. The evaluation of our interventions relies primarily on cross-sectional surveys (interviews and HIV testing) of samples of IDUs selected using a combination of targeted cluster and snowball methods. We consider this to be an appropriate, albeit imperfect, design given the study context. This paper presents analyses of data from the IDU surveys conducted just prior to implementation of the interventions and 24 months thereafter. The cross-border interventions have reached large proportions of the IDUs in the project sites, drug-related HIV risk behaviors have declined in frequency, and HIV prevalence among IDUs has been stable in China and declined in Vietnam over the 24 months since the interventions were implemented. Attribution of these positive trends to the interventions must be qualified in light of possible sampling biases and the absence of control groups. However, we believe that the structural interventions implemented by the cross-border project have played a role in stabilizing HIV prevalence among IDUs two years after they were initiated. Evidence of further diffusion of the interventions among IDUs and continued stability or decline of HIV prevalence would strengthen this case.

Original languageEnglish (US)
Pages (from-to)97-115
Number of pages19
JournalAIDS Education and Prevention
Volume18
Issue number2
DOIs
StatePublished - Apr 1 2006

Fingerprint

Vietnam
Risk-Taking
Drug Users
risk behavior
China
HIV
drug
Injections
Risk Reduction Behavior
Selection Bias
Pharmacies
Heroin
Syringes
border region
Nuclear Family
trend
evaluation
HIV Infections
Needles
attribution

ASJC Scopus subject areas

  • Health(social science)
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Cite this

Patterns of HIV prevalence and HIV risk behaviors among injection drug users prior to and 24 months following implementation of cross-border HIV prevention interventions in Northern Vietnam and Southern China. / Hammett, Theodore M.; Kling, Ryan; Johnston, Patrick; Liu, Wei; Ngu, Doan; Friedmann, Patricia; Kieu, Thanh Binh; Ha, Viet Dong; Ly, Kieu Van; Donghua, Meng; Chen, Yi; Des Jarlais, Don.

In: AIDS Education and Prevention, Vol. 18, No. 2, 01.04.2006, p. 97-115.

Research output: Contribution to journalArticle

Hammett, Theodore M. ; Kling, Ryan ; Johnston, Patrick ; Liu, Wei ; Ngu, Doan ; Friedmann, Patricia ; Kieu, Thanh Binh ; Ha, Viet Dong ; Ly, Kieu Van ; Donghua, Meng ; Chen, Yi ; Des Jarlais, Don. / Patterns of HIV prevalence and HIV risk behaviors among injection drug users prior to and 24 months following implementation of cross-border HIV prevention interventions in Northern Vietnam and Southern China. In: AIDS Education and Prevention. 2006 ; Vol. 18, No. 2. pp. 97-115.
@article{c54a00398461422ebe8ed709bb3b06fe,
title = "Patterns of HIV prevalence and HIV risk behaviors among injection drug users prior to and 24 months following implementation of cross-border HIV prevention interventions in Northern Vietnam and Southern China",
abstract = "In 2002, we implemented a 4-year HIV prevention intervention for injection drug users (IDUs) in Lang Son Province, Vietnam, and Ning Ming County, Guangxi Province, China, a cross-border region seriously affected by inter-twined epidemics of heroin injection and HIV infection. The interventions involve peer education on HIV risk reduction and provision of new needles/syringes through direct distribution and pharmacy vouchers. We consider this to be a structural intervention in which risk reduction information and sterile injection equipment are diffused through the IDU populations and not limited to those who actually interact with peer educators. The evaluation of structural interventions poses complex methodological challenges. The evaluation of our interventions relies primarily on cross-sectional surveys (interviews and HIV testing) of samples of IDUs selected using a combination of targeted cluster and snowball methods. We consider this to be an appropriate, albeit imperfect, design given the study context. This paper presents analyses of data from the IDU surveys conducted just prior to implementation of the interventions and 24 months thereafter. The cross-border interventions have reached large proportions of the IDUs in the project sites, drug-related HIV risk behaviors have declined in frequency, and HIV prevalence among IDUs has been stable in China and declined in Vietnam over the 24 months since the interventions were implemented. Attribution of these positive trends to the interventions must be qualified in light of possible sampling biases and the absence of control groups. However, we believe that the structural interventions implemented by the cross-border project have played a role in stabilizing HIV prevalence among IDUs two years after they were initiated. Evidence of further diffusion of the interventions among IDUs and continued stability or decline of HIV prevalence would strengthen this case.",
author = "Hammett, {Theodore M.} and Ryan Kling and Patrick Johnston and Wei Liu and Doan Ngu and Patricia Friedmann and Kieu, {Thanh Binh} and Ha, {Viet Dong} and Ly, {Kieu Van} and Meng Donghua and Yi Chen and {Des Jarlais}, Don",
year = "2006",
month = "4",
day = "1",
doi = "10.1521/aeap.2006.18.2.97",
language = "English (US)",
volume = "18",
pages = "97--115",
journal = "AIDS Education and Prevention",
issn = "0899-9546",
publisher = "Guilford Publications",
number = "2",

}

TY - JOUR

T1 - Patterns of HIV prevalence and HIV risk behaviors among injection drug users prior to and 24 months following implementation of cross-border HIV prevention interventions in Northern Vietnam and Southern China

AU - Hammett, Theodore M.

AU - Kling, Ryan

AU - Johnston, Patrick

AU - Liu, Wei

AU - Ngu, Doan

AU - Friedmann, Patricia

AU - Kieu, Thanh Binh

AU - Ha, Viet Dong

AU - Ly, Kieu Van

AU - Donghua, Meng

AU - Chen, Yi

AU - Des Jarlais, Don

PY - 2006/4/1

Y1 - 2006/4/1

N2 - In 2002, we implemented a 4-year HIV prevention intervention for injection drug users (IDUs) in Lang Son Province, Vietnam, and Ning Ming County, Guangxi Province, China, a cross-border region seriously affected by inter-twined epidemics of heroin injection and HIV infection. The interventions involve peer education on HIV risk reduction and provision of new needles/syringes through direct distribution and pharmacy vouchers. We consider this to be a structural intervention in which risk reduction information and sterile injection equipment are diffused through the IDU populations and not limited to those who actually interact with peer educators. The evaluation of structural interventions poses complex methodological challenges. The evaluation of our interventions relies primarily on cross-sectional surveys (interviews and HIV testing) of samples of IDUs selected using a combination of targeted cluster and snowball methods. We consider this to be an appropriate, albeit imperfect, design given the study context. This paper presents analyses of data from the IDU surveys conducted just prior to implementation of the interventions and 24 months thereafter. The cross-border interventions have reached large proportions of the IDUs in the project sites, drug-related HIV risk behaviors have declined in frequency, and HIV prevalence among IDUs has been stable in China and declined in Vietnam over the 24 months since the interventions were implemented. Attribution of these positive trends to the interventions must be qualified in light of possible sampling biases and the absence of control groups. However, we believe that the structural interventions implemented by the cross-border project have played a role in stabilizing HIV prevalence among IDUs two years after they were initiated. Evidence of further diffusion of the interventions among IDUs and continued stability or decline of HIV prevalence would strengthen this case.

AB - In 2002, we implemented a 4-year HIV prevention intervention for injection drug users (IDUs) in Lang Son Province, Vietnam, and Ning Ming County, Guangxi Province, China, a cross-border region seriously affected by inter-twined epidemics of heroin injection and HIV infection. The interventions involve peer education on HIV risk reduction and provision of new needles/syringes through direct distribution and pharmacy vouchers. We consider this to be a structural intervention in which risk reduction information and sterile injection equipment are diffused through the IDU populations and not limited to those who actually interact with peer educators. The evaluation of structural interventions poses complex methodological challenges. The evaluation of our interventions relies primarily on cross-sectional surveys (interviews and HIV testing) of samples of IDUs selected using a combination of targeted cluster and snowball methods. We consider this to be an appropriate, albeit imperfect, design given the study context. This paper presents analyses of data from the IDU surveys conducted just prior to implementation of the interventions and 24 months thereafter. The cross-border interventions have reached large proportions of the IDUs in the project sites, drug-related HIV risk behaviors have declined in frequency, and HIV prevalence among IDUs has been stable in China and declined in Vietnam over the 24 months since the interventions were implemented. Attribution of these positive trends to the interventions must be qualified in light of possible sampling biases and the absence of control groups. However, we believe that the structural interventions implemented by the cross-border project have played a role in stabilizing HIV prevalence among IDUs two years after they were initiated. Evidence of further diffusion of the interventions among IDUs and continued stability or decline of HIV prevalence would strengthen this case.

UR - http://www.scopus.com/inward/record.url?scp=33646698864&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33646698864&partnerID=8YFLogxK

U2 - 10.1521/aeap.2006.18.2.97

DO - 10.1521/aeap.2006.18.2.97

M3 - Article

VL - 18

SP - 97

EP - 115

JO - AIDS Education and Prevention

JF - AIDS Education and Prevention

SN - 0899-9546

IS - 2

ER -