Des Jarlais Don C, Kling Ryan, Hammett Theodore M, Ngu Doan, Liu Wei, Chen Yi, Binh Kieu Thanh, Friedmann Patricia
Beth Israel Medical Center, New York, New York 10038, USA.
AIDS. 2007 Dec;21 Suppl 8:S109-14. doi: 10.1097/01.aids.0000304705.79541.34.
To assess an HIV prevention programme for injecting drug users (IDU) in the crossborder area between China and Vietnam.
Serial cross-sectional surveys (0, 6, 12, 18, 24 and 36 months) of community-recruited current IDU.
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.
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).
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.
评估在中国和越南边境地区针对注射吸毒者开展的一项艾滋病预防项目。
对社区招募的现职注射吸毒者进行系列横断面调查(第0、6、12、18、24和36个月)。
该项目包括同伴教育者外展服务以及大规模分发无菌注射设备。在基线期(实施前)以及基线期后第6、12、18、24和36个月,对社区招募的注射吸毒者进行系列横断面调查并检测HIV。每次调查中新注射吸毒者(注射毒品<3年的个体)的HIV流行率和估计HIV发病率是主要结局指标。
在宁明和谅山,各次调查中所有对象中新注射吸毒者的比例均有所下降。在24个月调查时,两个地区的HIV流行率和估计发病率下降了约一半,在36个月调查时下降了约四分之三(所有P<0.01)。
大规模外展服务和注射器获取项目实施后,新注射吸毒者中的HIV感染大幅减少,且没有证据表明开始注射毒品的人数增加。该项目可作为中国、越南及其他发展中/转型国家针对注射吸毒者开展大规模艾滋病预防规划的一个范例。