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

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

doi:10.1186/1471-2458-11-693

Abstract

BackgroundMany 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.MethodsA 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).ResultsDrug 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.ConclusionsThis 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.

Highlights

Many injection drug users (IDUs) in China have high risk sexual behaviors that contribute to the spread of HIV infection
IDUs in China have been shown to have a higher prevalence of sexually transmitted infections compared to non-drug using individuals [10,11] while patients at STI clinics have a higher prevalence of drug use compared to other individuals [12]
Comparability of characteristics between intervention and control groups at baseline Two hundred and eight participants in the intervention group and 227 in the control group were included in the baseline analysis

Summary

Introduction

Many injection drug users (IDUs) in China have high risk sexual behaviors that contribute to the spread of HIV infection. Many IDUs in China move through drug rehabilitation centers, this opportunity for sexual health education has largely been overlooked. China’s HIV epidemic has shifted from that of predominately injection drug users’ (IDUs) to one that is predominately sexually transmitted [1,2,3,4,5,6]. Many individuals in China have both unsafe sex and unsafe drug use [7,8,9], making sexual health services for drug users an important area for HIV/STI prevention services. Drug users’ lack of trust in public health authorities at rehabilitation centers complicates behavioral interventions in this context [15]

Methods

Results

Discussion

Conclusion