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Working With Persons Who Inject Drugs and Live in Rural Areas: Implications From China/Vietnam for the USA
Don C Des Jarlais1, Theodore M Hammett2,3, Binh Kieu4
1The Baron Edmond de Rothschild Chemical Dependency Institute, Icahn School of Medicine at Mount Sinai, 39 Broadway 5th Floor Suite 530, New York, NY, 10006, USA. don.desjarlais@mountsinai.org.
Current HIV/AIDS Reports
|June 28, 2018
Summary
The Cross Border Project reduced HIV risk behaviors and prevalence in rural China and Vietnam. Its strategies, including peer outreach and sterile equipment, can inform US rural opioid epidemic responses.
Area of Science:
- Public Health
- Infectious Disease Prevention
- Rural Health Initiatives
Background:
- The Cross Border Project addressed HIV prevention in rural China and Vietnam from 2002-2010.
- It targeted populations at risk, including people who inject drugs.
- Rural areas face unique challenges in public health interventions.
Purpose of the Study:
- To describe the Cross Border Project's implementation and outcomes.
- To evaluate its effectiveness in reducing HIV risk behaviors and prevalence.
- To consider its applicability to the US rural opioid/heroin epidemic.
Main Methods:
- Utilized published reports, project records, and public health data.
- Conducted serial cross-sectional surveys of people who inject drugs.
- Estimated HIV incidence using prevalence among new injectors and BED testing.
Main Results:
- Observed significant reductions in risk behavior, HIV prevalence, and estimated HIV incidence.
- Maintained strong community and local authority support throughout the project.
- Project activities continued and expanded post-formal termination.
Conclusions:
- The Cross Border Project demonstrated success in HIV prevention in a rural, cross-border setting.
- Identified challenges like limited resources and community opposition, mirroring those in the US opioid crisis.
- Strategies are adaptable for addressing the opioid epidemic in US small cities and rural areas.
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