Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #115931

Theodore M. Hammett, PhD¹, Don Des Jarlais, PhD², Patrick Johnston, MMath¹, Ryan N. Kling, MA³, Wei Liu, MD⁴, Yi Chen, MD⁴, Doan Ngu, MD, MSc⁵, Nguyen Son, MD⁵, Ly Kieu Van, MD⁶, and Meng Donghua, MD⁷. (1) Abt Associates Inc., 55 Wheeler Street, Cambridge, MA 02138-1168, 617-349-2734, ted_hammett@abtassoc.com, (2) Chemical Dependency Institute, Beth Israel Medical Center, New York, New York, 160 Water Street, 24th Floor, New York, NY 10038, (3) Law and Public Policy, Abt Associates Inc., 55 Wheeler St., Cambridge, MA 02138, (4) Guangxi Center for HIV/AIDS Prevention and Control, 80 Taoyuan Road, Nanning, 530021, China, (5) Consultant, 20 Quan Tram, Dong Da, Hanoi, Vietnam, (6) Lang Son Provincial Health Services, 50 Dinh Tien Hoang, Lang Son City, Vietnam, (7) Ning Ming CDC, Headquarters, Ning Ming City, China

Background: The HIV epidemic in Vietnam remains largely concentrated among IDUs but there is evidence of increasing sexual transmission and HIV prevalence among sex workers and sexual partners of IDUs. To control a cross-border HIV epidemic among IDUs, we implemented peer-based interventions in Lang Son Province, Vietnam and Ning Ming County, China. Peer educators provide risk reduction information and distribute new needles/syringes, condoms, and pharmacy vouchers. The next phase of the project targets women at risk for acquiring or transmitting HIV sexually. Methods: Evaluation employs cross-sectional surveys of IDUs (behavioral interviews and HIV testing) at baseline and 6-month intervals thereafter. Unique ID numbers allow linkage of participants in multiple surveys. To strengthen inferences regarding intervention effects, we compare epidemic scenarios in project sites (with v. without interventions) and between sites and other places in China and Vietnam without interventions. Results: Interventions are reaching ~70% of IDUs and providing ~25,000 needles/syringes per month. Drug-related risk behaviors declined significantly. HIV prevalence among IDUs stabilized and incidence declined while prevalences in comparison localities increased. A south-north gradient of HIV prevalence from Vietnam to China has held, indicating control of cross-border transmission. Conclusions: The interventions have been supported by political leaders, police, pharmacies, community members, and IDUs. Coverage suggests public health scale implementation. Results though 24 months indicate control of HIV transmission among IDUs. In the next phase of the project we seek to prevent transition to a more generalized HIV epidemic in this cross-border area.

Learning Objectives: At the conclusion of this session, the participant will be able to

• Describe the course of the HIV epidemic in Vietnam;
• List the key elements of a harm reduction intervention for IDUs and women at risk (sex workers and sexual partners of IDUs);
• Identify methods for evaluating harm reduction interventions at the community/population level.

Keywords: HIV Interventions, Vietnam

Awards: Excellence in Abstract Submission on an International Topic--Award Winner - Recipient

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.