دورية أكاديمية
أعرض في EDS

Controlling HIV epidemics among injection drug users: eight years of Cross-Border HIV prevention interventions in Vietnam and China.

التفاصيل البيبلوغرافية
العنوان: Controlling HIV epidemics among injection drug users: eight years of Cross-Border HIV prevention interventions in Vietnam and China.
المؤلفون: Hammett TM; Abt Associates Inc., Cambridge, Massachusetts, United States of America. ted_hammett@abtassoc.com, Des Jarlais DC, Kling R, Kieu BT, McNicholl JM, Wasinrapee P, McDougal JS, Liu W, Chen Y, Meng D, Doan N, Tho HN, Quyen NH, Tren VH
المصدر: PloS one [PLoS One] 2012; Vol. 7 (8), pp. e43141. Date of Electronic Publication: 2012 Aug 27.
نوع المنشور: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE
أسماء مطبوعة: Original Publication: San Francisco, CA : Public Library of Science
مواضيع طبية MeSH: Communicable Disease Control/*methods , HIV Infections/*prevention & control , HIV Seropositivity/*epidemiology , Substance Abuse, Intravenous/*complications, Adult ; China ; Cross-Sectional Studies ; Female ; HIV Infections/epidemiology ; Humans ; Incidence ; Infectious Disease Medicine/methods ; International Cooperation ; Male ; Patient Education as Topic/methods ; Peer Group ; Prevalence ; Risk-Taking ; Surveys and Questionnaires ; Vietnam
مستخلص: Introduction: HIV in Vietnam and Southern China is driven by injection drug use. We have implemented HIV prevention interventions for IDUs since 2002-2003 in Lang Son and Ha Giang Provinces, Vietnam and Ning Ming County (Guangxi), China.
Methods: Interventions provide peer education and needle/syringe distribution. Evaluation employed serial cross-sectional surveys of IDUs 26 waves from 2002 to 2011, including interviews and HIV testing. Outcomes were HIV risk behaviors, HIV prevalence and incidence. HIV incidence estimation used two methods: 1) among new injectors from prevalence data; and 2) a capture enzyme immunoassay (BED testing) on all HIV+ samples.
Results: We found significant declines in drug-related risk behaviors and sharp reductions in HIV prevalence among IDUs (Lang Son from 46% to 23% [p<0.001], Ning Ming: from 17% to 11% [p = 0.003], and Ha Giang: from 51% to 18% [p<0.001]), reductions not experienced in other provinces without such interventions. There were significant declines in HIV incidence to low levels among new injectors through 36-48 months, then some rebound, particularly in Ning Ming, but BED-based estimates revealed significant reductions in incidence through 96 months.
Discussion: This is one of the longest studies of HIV prevention among IDUs in Asia. The rebound in incidence among new injectors may reflect sexual transmission. BED-based estimates may overstate incidence (because of false-recent results in patients with long-term infection or on ARV treatment) but adjustment for false-recent results and survey responses on duration of infection generally confirm BED-based incidence trends. Combined trends from the two estimation methods show sharp declines in incidence to low levels. The significant downward trends in all primary outcome measures indicate that the Cross-Border interventions played an important role in bringing HIV epidemics among IDUs under control. The Cross-Border project offers a model of HIV prevention for IDUs that should be considered for large-scale replication.
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معلومات مُعتمدة: R01 DA014703 United States DA NIDA NIH HHS; 1 R01 DA-14703 United States DA NIDA NIH HHS
تواريخ الأحداث: Date Created: 20120907 Date Completed: 20130219 Latest Revision: 20231105
رمز التحديث: 20231105
مُعرف محوري في PubMed: PMC3428343
DOI: 10.1371/journal.pone.0043141
PMID: 22952640
قاعدة البيانات: MEDLINE
الوصف
تدمد:1932-6203
DOI:10.1371/journal.pone.0043141