Reducing HIV Infection among Injecting Drug Users in the China-Vietnam Cross Border Project

Objective: Assess an HIV prevention program for injecting drug users (IDUs) in the cross border area of Ning Ming County, Guangxi Province, China and Lang Son Province, Vietnam. Methods: The project included peer educator outreach and large-scale distribution of sterile injection equipment. Serial cross-sectional surveys with HIV testing of community recruited injecting drug users were conducted at baseline (prior to implementation), and 6, 12, 18, 24 and 36 months post-baseline. HIV prevalence and estimated HIV incidence among new injectors (persons injecting drugs for < 3 years) in each survey wave were the primary outcome measures. Results: HIV prevalence among all IDUs stabilized in Ning Ming and declined substantially in Lang Son over survey waves. The percentages of new injectors declined across survey waves in both Ning Ming and Lang Son. Prevalence and estimated incidence among new injectors declined by more than half in both study areas. Conclusions: Implementation of public health scale outreach and syringe access programs was followed by substantial reductions in HIV infection among new injectors. There was no evidence that the project led to an increase in persons beginning to inject drugs. This project may serve as a model for large-scale HIV prevention programming for injecting drug users in developing/transitional countries.