Patterns of HIV prevalence among injecting drug users in the cross-border area of Lang Son Province, Vietnam, and Ning Ming County, Guangxi Province, China

Don C Des Jarlais,Ryan Kling,Kieu T Binh,Ly K Van,Tran V Hoang,Patricia Friedmann,Wei Liu,Theodore M Hammett,Patrick Johnston,Meng Donghua,Yi Chen,Doan Ngu,Nguyen D Tung

doi:10.1186/1471-2458-5-89

Abstract

BackgroundTo assess patterns of injecting drug use and HIV prevalence among injecting drug users (IDUs) in an international border area along a major heroin trans-shipment route.MethodsCross-sectional surveys of IDUs in 5 sites in Lang Son Province, Vietnam (n = 348) and 3 sites in Ning Ming County, Guangxi Province, China (n = 308). Respondents were recruited through peer referral ("snowball") methods in both countries, and also from officially recorded lists of IDUs in Vietnam. A risk behavior questionnaire was administered and HIV counseling and testing conducted.ResultsParticipants in both countries were largely male, in their 20s, and unmarried. A majority of subjects in both countries were members of ethnic minority groups. There were strong geographic gradients for length of drug injecting and for HIV seroprevalence. Both mean years injecting and HIV seroprevalence declined from the Vietnamese site farthest from the border to the Chinese site farthest from the border. 10.6% of participants in China and 24.5% of participants in Vietnam reported crossing the international border in the 6 months prior to interview. Crossing the border by IDUs was associated with (1) distance from the border, (2) being a member of an ethnic minority group, and (3) being HIV seropositive among Chinese participants.ConclusionReducing the international spread of HIV among IDUs will require programs at the global, regional, national, and "local cross border" levels. At the local cross border level, the programs should be coordinated on both sides of the border and on a sufficient scale that IDUs will be able to readily obtain clean injection equipment on the other side of the border as well as in their country of residence.

Highlights

To assess patterns of injecting drug use and HIV prevalence among injecting drug users (IDUs) in an international border area along a major heroin trans-shipment route
Over twothirds of the subjects in China and one-half in Vietnam belonged to ethnic minority groups
We present data on injecting drug use and HIV infection among IDUs in Lang Son province, Vietnam and Ning Ming County, Guangxi Province, China from a

Summary

Introduction

To assess patterns of injecting drug use and HIV prevalence among injecting drug users (IDUs) in an international border area along a major heroin trans-shipment route. Both injecting drug use and HIV among injecting drug users (IDUs) have become major international public health problems. Travel by IDUs, along drug distribution routes, appears to be a major mechanism for the spread of both injecting drug use and HIV among IDUs. HIV spread north [2] and south [3] from New York City along the East Coast in the U.S Stimson [4], and Beyrer and colleagues [5] have reconstructed the spread of HIV among IDUs in South East Asia. A recent study by Kato and colleagues (2001) found patterns of HIV genetic subtyping consistent with cross-border transmission either from Vietnam to China or from China to Vietnam

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