Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2011

Open Access 01-12-2011 | Research article

Peer-based behavioral health program for drug users in China: a pilot study

Authors: Song-Ying Shen, Zhou-Bin Zhang, Joseph D Tucker, Helena Chang, Guan-Rong Zhang, Ai-Hua Lin

Published in: BMC Public Health | Issue 1/2011

Login to get access

Abstract

Background

Many injection drug users (IDUs) in China have high risk sexual behaviors that contribute to the spread of HIV infection. Although many IDUs in China move through drug rehabilitation centers, this opportunity for sexual health education has largely been overlooked.

Methods

A convenience sample of 667 drug users from two rehabilitation centers in South China was recruited in the study. Two hundred and forty seven drug users from a single Guangdong Province rehabilitation center received the peer-based education intervention, while 420 drug users from another rehabilitation center received routine HIV/STI education and was used as the control. One hundred and eighty nine (22.1%) individuals refused to participate in the study. HIV/STI behavioral and knowledge domains were assessed at 3 months in rehabilitation centers after the intervention (first follow-up) and at 2-23 months in the community after release (second follow-up).

Results

Drug users who completed the intervention reported more frequent condom use with casual sex partners (60.0% vs. 12.5% condom use every time, p = 0.011) and less frequent injection (56.7% vs. 26.4% no injection per day, p = 0.008) at the second follow-up compared to those in the routine education group. Loss to follow up was substantial in both control and intervention groups, and was associated with living far from the detention center and having poor HIV knowledge at baseline.

Conclusions

This study shows that rehabilitation centers may be a useful location for providing behavioral HIV/STI prevention services and referral of individuals to community-based programs upon release. More research is needed on behalf of detained drug users in China who have complex social, medical, and legal needs.
Appendix
Available only for authorised users
Literature
1.
State Council AIDS Working Committee Office C, UN Theme Group on HIV/AIDS in China: A joint assessment of HIV/AIDS prevention, treatment and care in China. 2003, Beijing: State Council AIDS Working Committee Office, China, UN Theme Group on HIV/AIDS in China
2.
State Council AIDS Working Committee Office C, UN Theme Group on HIV/AIDS in China: A joint assessment of HIV/AIDS prevention, treatment and care in China. 2007, Beijing: State Council AIDS Working Committee Office, China, UN Theme Group on HIV/AIDS in China
3.
Rou KSS, Liu P, Wu Z: Scaling up prevention programmes to reduce the sexual transmission of HIV in China. Int J Epidemiol. 2010, 39 (Suppl 2): ii38-ii46.PubMedPubMedCentral
4.
Dou ZCR, Xu J, Ma Y, Jiao JH, Durako S, Zhao Y, Zhao D, Fang H, Zhang F: Changing baseline characteristics among patients in the China National Free Antiretroviral Treatment Program, 2002-09. Int J Epidemiol. 2010, 39 (Suppl 2): ii56-ii64.PubMedPubMedCentral
5.
Qian HZ, Vermund SH, Wang N: Risk of HIV/AIDS in China: subpopulations of special importance. Sex Transm Infect. 2005, 81 (6): 442-447. 10.1136/sti.2004.014258.CrossRefPubMedPubMedCentral
6.
Zhang KL, Ma SJ: Epidemiology of HIV in China:Intravenous drug users, sex workers, and large mobile populations are high risk groups. British Medical Journal. 2002, 324 (7341): 803-804. 10.1136/bmj.324.7341.803.CrossRefPubMedCentral
7.
Liu JB, Zhang LL, Lai WH, Feng L, Zeng YL, Liu L, Hu Y, Li J, Zhang XL, Xiao Y, et al: Sharing of needles and paraphernalia injection in new and long-term injection drug users in Sichuan, China. Zhonghua Liu Xing Bing Xue Za Zhi. 2009, 30 (7): 656-662.PubMed
8.
Duan S, Guo HY, Pang L, Yuan JH, Jia MH, Xiang LF, Ye RH, Yang YC, Lu JY, Luo W, et al: Analysis of the epidemiologic patterns of HIV transmission in Dehong prefecture, Yunnan province. Zhonghua Yu Fang Yi Xue Za Zhi. 2008, 42 (12): 866-869.PubMed
9.
Gu J, Wang R, Chen H, Lau JT, Zhang L, Hu X, Lei Z, Li Z, Cai H, Wang T, et al: Prevalence of needle sharing, commercial sex behaviors and associated factors in Chinese male and female injecting drug user populations. AIDS Care. 2009, 21 (1): 31-41. 10.1080/09540120802068787.CrossRefPubMed
10.
Ruan Y, Chen K, Hong K, He Y, Liu S, Zhou F, Qin G, Chen J, Xing H, Shao Y: Community-based survey of HIV transmission modes among intravenous drug users in Sichuan, China. Sex Transm Dis. 2004, 31 (10): 623-627.CrossRefPubMed
11.
Jia Y, Lu F, Zeng G, Sun X, Xiao Y, Lu L, Liu W, Ni M, Qu S, Li C, et al: Predictors of HIV infection and prevalence for syphilis infection among injection drug users in China: Community-based surveys along major drug trafficking routes. Harm Reduct J. 2008, 5: 29-10.1186/1477-7517-5-29.CrossRefPubMedPubMedCentral
12.
Chen XS, Yin YP, Tucker JD, Gao X, Cheng F, Wang TF, Wang HC, Huang PY, Cohen MS: Detection of Acute and Established HIV Infections in Sexually Transmitted Disease Clinics in Guangxi, China: Implications for Screening and Prevention of HIV Infection. J Infect Dis. 2007, 196 (11): 1654-1661. 10.1086/522008.CrossRefPubMed
13.
Sullivan SG, Wu Z: Rapid scale up of harm reduction in China. Int J Drug Policy. 2007, 18 (2): 118-128. 10.1016/j.drugpo.2006.11.014.CrossRefPubMed
14.
Wu Z, Sullivan SG, Wang Y, Rotheram-Borus MJ, Detels R: Evolution of China's response to HIV/AIDS. Lancet. 2007, 369 (9562): 679-690. 10.1016/S0140-6736(07)60315-8.CrossRefPubMed
15.
Yin WHY, Sun X, Gong X, Li F, Li J, Rou K, Sullivan SG, Wang C, Cao X, Luo W, Wu Z: Scaling up the national methadone maintenance treatment program in China: achievements and challenges. Int J Epidemiol. 2010, 39 (suppl 2): ii29-ii37.PubMedPubMedCentral
16.
Latkin CAFV, Knowlton A, Sherman S: Norms, social networks, and HIV-related risk behaviors among urban disadvantaged drug users. Soc Sci Med. 2003, 56 (3): 465-476. 10.1016/S0277-9536(02)00047-3.CrossRefPubMed
17.
Li J, Luo J, Yang F: Evaluation on peer education program among injecting drug users. Zhonghua Liu Xing Bing Xue Za Zhi. 2001, 22 (5): 334-336.PubMed
18.
Lin P, Fan ZF, Yang F, Wu ZY, Wang Y, Liu YY, Ming ZQ, Li WJ, Luo W, Fu XB, et al: Evaluation of a pilot study on needle and syringe exchange program among injecting drug users in a community in Guangdong, China. Zhonghua Yu Fang Yi Xue Za Zhi. 2004, 38 (5): 305-308.PubMed
19.
Des Jarlais DC, Kling R, Hammett TM, Ngu D, Liu W, Chen Y, Binh KT, Friedmann P: Reducing HIV infection among new injecting drug users in the China-Vietnam Cross Border Project. Aids. 2007, 21 (Suppl 8): S109-114. 10.1097/01.aids.0000304705.79541.34.CrossRefPubMed
20.
Liu B, Sullivan SG, Wu Z: An evaluation of needle exchange programmes in China. Aids. 2007, 21 (Suppl 8): S123-128. 10.1097/01.aids.0000304707.56670.cf.CrossRefPubMed
21.
Andia JF, Deren S, Robles RR, Kang SY, Colon HM: Peer norms and sharing of injection paraphernalia among Puerto Rican injection drug users in New York and Puerto Rico. AIDS Educ Prev. 2008, 20 (3): 249-257. 10.1521/aeap.2008.20.3.249.CrossRefPubMed
22.
Broadhead RS, Heckathorn DD, Weakliem DL, Anthony DL, Madray H, Mills RJ, Hughes J: Harnessing peer networks as an instrument for AIDS prevention: results from a peer-driven intervention. Public Health Rep. 1998, 113 (Suppl 1): 42-57.PubMedPubMedCentral
23.
Purcell DW, Garfein RS, Latka MH, Thiede H, Hudson S, Bonner S, Golub ET, Ouellet LJ: Development, description, and acceptability of a small-group, behavioral intervention to prevent HIV and hepatitis C virus infections among young adult injection drug users. Drug Alcohol Depend. 2007, 91 (Suppl 1): S73-80.CrossRefPubMed
24.
Chen JQ, Dunne MP, Zhao DC: HIV/AIDS prevention: knowledge, attitudes and education practices of secondary school health personnel in 14 cities of China. Asia Pac J Public Health. 2004, 16 (1): 9-14. 10.1177/101053950401600103.CrossRefPubMed
25.
Cai Y, Hong H, Shi R, Ye X, Xu G, Li S, Shen L: Long-term follow-up study on peer-led school-based HIV/AIDS prevention among youths in Shanghai. Int J STD AIDS. 2008, 19 (12): 848-850. 10.1258/ijsa.2008.008129.CrossRefPubMed
26.
Huang H, Ye X, Cai Y, Shen L, Xu G, Shi R, Jin X: Study on peer-led school-based HIV/AIDS prevention among youths in a medium-sized city in China. Int J STD AIDS. 2008, 19 (5): 342-346. 10.1258/ijsa.2007.007208.CrossRefPubMed
27.
HIV Infection--Guangdong Province, China, 1997-2007. MMWR Morb Mortal Wkly Rep. 2009, 58 (15): 396-400.
28.
Yang LGTJ, Yang B, Shen SY, Sun XF, Chen YF, Chen XS: Primary syphilis cases in Guangdong Province 1995-2008: Opportunities for linking syphilis control and regional development. BMC Public Health. 2010, 10 (1): 793-10.1186/1471-2458-10-793.CrossRefPubMedPubMedCentral
29.
Huang XY, Zhu W, Hu XY, Zeng ZX, He QH, Wu ZH, Liang W: An analysis of the effects of training in the drug-abuser's peer education. Chinese Journal of Drug Abuse Prevention and Treatment. 2008, 14 (5): 260-262.
30.
Biddulph S: Legal reform and administrative detention powers in China. 2007, Cambridge; New York: Cambridge University PressCrossRef
31.
Wu ZYSX, Sullivan SG, Detels R: HIV Testing in China. Science. 2006, 312 (5779): 1475-1476. 10.1126/science.1120682.CrossRefPubMed
32.
Rou GMWZ: Comprehensive and integrated responses to HIV/AIDS among drug users. Chinese Journal of Drug Dependence. 2009, 18 (3): 172-174.
33.
Shen S: Effectiveness of a Peer Education-base Harm Reduction Program to Prevent HIV Infection Among Drug Users in Guangzhou, China. 2006, Sun Yat-Sen University, Department of Medical Statistics and Epidemiology, School of Public Health
34.
Zhang ZBLA, Zhao YT, Gao K, Li ZR, Xu HF: Investigation on 432 Drug uses' HIV knowledge and skills of risk reduction in Guangzhou, China. The Chin J AIDS STD. 2007, 13 (1): 62-63.
35.
36.
Devilly GJ, Sorbello L, Eccleston L: Prison-based peer-education schemes. Aggression and Violent Behavior. 2005, 10 (2): 219-240. 10.1016/j.avb.2003.12.001.CrossRef
37.
Zhang ZBXH, Zhao YT, Gao K, Li ZR, Lin AH: Effect evaluating of peer education on AIDS knowledge among withdrawal members after compulsory detoxification. Chinese Journal of Health Education. 2008, 24 (08): 578-580.
38.
Chaplinskas S, Trechiokas A: HIV infection and sexually transmitted infections in Lithuania. Int J STD AIDS. 1999, 10 (10): 677-679. 10.1258/0956462991913105.CrossRefPubMed
39.
Malow RM, Jager KB, Ireland SJ, Penedo F: Alcohol & drug abuse. HIV infection and risky sexual behaviors among women in treatment for noninjection drug dependence. Psychiatr Serv. 1996, 47 (11): 1197-1199.CrossRefPubMed
40.
Lau JT, Zhang L, Zhang Y, Wang N, Lau M, Tsui HY, Zhang J, Cheng F: Changes in the prevalence of HIV-related behaviors and perceptions among 1832 injecting drug users in Sichuan, China. Sex Transm Dis. 2008, 35 (4): 325-335. 10.1097/OLQ.0b013e3181614364.CrossRefPubMed
41.
Yao Y, Wang N, Chu J, Ding G, Jin X, Sun Y, Wang G, Xu J, Smith K: Sexual behavior and risks for HIV infection and transmission among male injecting drug users in Yunnan, China. Int J Infect Dis. 2009, 13 (2): 154-161. 10.1016/j.ijid.2008.05.1228.CrossRefPubMed
42.
Zhao M, Wang QY, Lu GH, Xu P, Xu H, McCoy CB: Risk behaviors and HIV/AIDS prevention education among IDUs in drug treatment in Shanghai. J Urban Health. 2005, 82 (3 Suppl 4): iv84-91.PubMed
43.
Medley A, Kennedy C, O'Reilly K, Sweat M: Effectiveness of peer education interventions for HIV prevention in developing countries: a systematic review and meta-analysis. AIDS Educ Prev. 2009, 21 (3): 181-206. 10.1521/aeap.2009.21.3.181.CrossRefPubMedPubMedCentral
44.
Walsh N, Gibbie TM, Higgs P: The development of peer educator-based harm reduction programmes in Northern Vietnam. Drug Alcohol Rev. 2008, 27 (2): 200-203. 10.1080/09595230701829348.CrossRefPubMed
45.
Harden AWR, Oakley A: A review of the eff ectiveness and appropriateness of peer-delivered health promotion interventions for young people. 1999, London: EPPI-Centre
46.
David N, Tang A: Sexually transmitted infections in a young offenders institution in the UK. Int J STD AIDS. 2003, 14 (8): 511-513. 10.1258/095646203767869084.CrossRefPubMed
47.
Rhodes T, Platt L, Maximova S, Koshkina E, Latishevskaya N, Hickman M, Renton A, Bobrova N, McDonald T, Parry JV: Prevalence of HIV, hepatitis C and syphilis among injecting drug users in Russia: a multi-city study. Addiction. 2006, 101 (2): 252-266. 10.1111/j.1360-0443.2006.01317.x.CrossRefPubMed
48.
Cohen J, Amon J: Health and Human Rights Concerns of Drug Users in Detention in Guangxi Province, China. PLoS Med. 2008, 5 (12): e234-10.1371/journal.pmed.0050234.CrossRefPubMedPubMedCentral
Metadata
Title
Peer-based behavioral health program for drug users in China: a pilot study
Authors
Song-Ying Shen
Zhou-Bin Zhang
Joseph D Tucker
Helena Chang
Guan-Rong Zhang
Ai-Hua Lin
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2011
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-11-693

Other articles of this Issue 1/2011

BMC Public Health 1/2011 Go to the issue

Research article

Evaluation of a pilot cooperative medical scheme in rural China: impact on gender patterns of health care utilization and prescription practices

Research article

Violence witnessing, perpetrating and victimization in medellin, Colombia: a random population survey

Research article

Explaining gender differences in non-fatal suicidal behaviour among adolescents: a population-based study

Research article

Preventing the next 'SARS' - European healthcare workers' attitudes towards monitoring their health for the surveillance of newly emerging infections: qualitative study

Research article

Reproductive health and access to healthcare facilities: risk factors for depression and anxiety in women with an earthquake experience

Research article

Snowbirds and infection--new phenomena in pneumonia and influenza hospitalizations from winter migration of older adults: A spatiotemporal analysis