This four-year project will be carried out by Abt Associates, the Guangxi Center for HIV/AIDS Prevention and Control, the National AIDS Standing Bureau of Vietnam, and Beth Israel Medical Center in New York City. This will be the first ever intervention designed to prevent cross-border HIV transmission. It will target Ning Ming County, Guangxi Province, China and Langson Province, Vietnam, a border area seriously affected by large-scale drug trafficking and cross-border movement related to small-scale drug purchase and use, an HIV epidemic that appears poised to enter a take-off stage, and very limited HIV prevention activities to date. The intervention will be a comprehensive, peer education model embracing elements of social marketing, risk reduction for drug users, public health infection control, and community education. It will be evaluated through repeat cross-sectional behavioral surveys and measurement of cross-sectional HIV seroprevalence, with a """"""""capture-recapture"""""""" component allowing analysis of longitudinal behavior change and estimation of HIV incidence. Community KAP surveys and peer educators' process data will be employed as well. The project also seeks to improve cross-border collaboration on and in-country capacity for prevention interventions, positive policy development, and behavioral and epidemiologic research. This intervention is considered as a """"""""structural"""""""" intervention with assessment at the community level.
The specific aims are as follows: 1) Show control of HIV transmission on both sides of the border through stable HIV prevalence rates among IDUs (currently -10 percent); 2) Show control of HIV transmission on both sides of the border by low HIV incidence (targeting 1/100 person-years at hisk) among IDUs; 3) Show very large reductions in HIV injection risk behavior, from the currently estimated 60 percent of IDUs engaging in receptive sharing of needles and syringes to a stable level of 30 percent; 4) Show large reductions in HIV transmission behavior, from the currently estimated 60 percent of IDUs engaging in distributive sharing to a stable level of 30 percent; 5) Show statistically significant reductions in unsafe sexual behavior among IDUs; 6) Demonstrate very-large scale safe disposal of used injection equipment, with a target safe disposal of 150,000 used syringes per year; 7) achieve significant increases in HIV knowledge and in expressed support for the project interventions among samples of residents in the target communities.
|Hammett, Theodore M; Des Jarlais, Don C; Kling, Ryan et al. (2012) Controlling HIV epidemics among injection drug users: eight years of Cross-Border HIV prevention interventions in Vietnam and China. PLoS One 7:e43141|
|Hammett, T M; Des Jarlais, D; Johnston, P et al. (2007) HIV prevention for injection drug users in China and Vietnam: policy and research considerations. Glob Public Health 2:125-39|
|Des Jarlais, Don C; Kling, Ryan; Hammett, Theodore M et al. (2007) Reducing HIV infection among new injecting drug users in the China-Vietnam Cross Border Project. AIDS 21 Suppl 8:S109-14|
|Hammett, Theodore M; Johnston, Patrick; Kling, Ryan et al. (2005) Correlates of HIV status among injection drug users in a border region of southern China and northern Vietnam. J Acquir Immune Defic Syndr 38:228-35|
|Des Jarlais, Don C; Johnston, Patrick; Friedmann, Patricia et al. (2005) Patterns of HIV prevalence among injecting drug users in the cross-border area of Lang Son Province, Vietnam, and Ning Ming County, Guangxi Province, China. BMC Public Health 5:89|
|Hammett, Theodore M; Norton, Giulia D; Kling, Ryan et al. (2005) Community attitudes toward HIV prevention for injection drug users: findings from a cross-border project in southern China and northern Vietnam. J Urban Health 82:iv34-42|