Development and implementation of a cross-border HIV prevention intervention for injection drug users in Ning Ming County (Guangxi Province), China and Lang Son Province, Vietnam
Section snippets
Background
The intertwined epidemics of injection drug use and HIV/AIDS are well known and have been documented in more than 100 countries on every continent (Ball, Rana, & Dehne, 1998). However, the problems posed by injection drug use and HIV infection are particularly challenging in border regions where geopolitical sensitivities may exacerbate already difficult issues.
One such region is the border between northern Vietnam and southern China. Fig. 1 shows the location of the cross-border project
Development of the project
This is the first-ever cross-border HIV prevention project targeting IDUs in which the same interventions are being implemented in both countries. The project is opportune in that HIV prevalence has reached a possible “takeoff” point in Ning Ming County, China and risen even higher in Lang Son Province, Vietnam during the time the project was under development.
Despite the need for the project, its development proved extremely challenging and ultimately required 4 years from the germination of
Implementation and evaluation of the interventions
The intervention aims to reduce HIV risk behaviours among IDUs and thereby stabilise HIV prevalence and reduce HIV incidence on both sides of the border, as well as prevent additional cross-border HIV transmission. The project also seeks to benefit the larger public health by collecting and safely disposing of large numbers of discarded needles and syringes that might otherwise put others at risk. The project involves intensive community education and regular meetings with relevant agencies,
Implementation challenges and strategies
Challenges have arisen for all of the key actors and stakeholders in the project: health departments, police, peer educators, pharmacists, IDUs and the community at large.
Conclusions
The development and implementation of cross-border HIV prevention interventions for IDUs pose substantial challenges. These challenges increase in complexity and intensity the more agencies and levels of government are involved. They also increase in relation to the history of police harassment and repression of drug users and to government policies stressing arrest and incarceration of drug users over treatment and support for drug use cessation.
The early implementation experience in this
Acknowledgements
Funding Support was provided by National Institute on Drug Abuse, Grant No. 1 R01 DA-14703, and the Ford Foundation (Beijing and Hanoi offices). The authors gratefully acknowledge all of the health department and clinic staff, other public officials, peer educators, and pharmacists in Ning Ming County and Lang Son Province who are participating in and supporting this project. We would also like to acknowledge the support and encouragement of Joan Kaufman and Eve Lee of the Ford Foundation’s
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