Evaluation of a needle social marketing strategy to control HIV among injecting drug users in China

AIDS. 2007 Dec:21 Suppl 8:S115-22. doi: 10.1097/01.aids.0000304706.79541.ef.

Abstract

Objective: To evaluate the effectiveness of a needle social marketing strategy to reduce needle sharing and hepatitis C Virus (HCV)/HIV transmission among injecting drug users (IDU) in China.

Design: Two-armed, prospective, community-randomized prevention trial.

Setting: Four counties/townships in Guangxi and Guangdong provinces; one randomized to intervention the other to control in each province.

Participants: Injecting drug users: 823 (443 intervention, 382 control) at baseline and 852 (415 intervention, 407 control) at the second cross-sectional survey 12 months later.

Intervention: A needle social marketing programme, including promotion of safe injection norms and increased access to clean needles over a 12 month period.

Main outcome measures: Cross sectional surveys at baseline and follow-up compared changes in drug using behaviours and HIV and HCV rates in the intervention and control communities.

Results: Needle sharing behaviours were similar in the two groups at baseline (68.4 vs. 67.8%), and dropped significantly to 35.3% in the intervention community and remained relatively stable in the control community (62.3%; P < 0.001). In a subset of cohort of new injectors, the incidence of HCV was significant lower in intervention than in control in both provinces (P < 0.001, P = 0.014) and overall (P < 0.001) but HIV was only significantly lower in intervention in Guangdong (P = 0.011).

Conclusion: Needle social marketing can reduce risky injecting behaviour and HIV/HCV transmission among injecting drug users in China and should be expanded.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Child
  • China / epidemiology
  • Cross-Sectional Studies
  • Disease Outbreaks
  • Female
  • Follow-Up Studies
  • Government Programs / organization & administration
  • Government Programs / statistics & numerical data*
  • HIV Infections / diagnosis
  • HIV Infections / epidemiology
  • HIV Infections / prevention & control*
  • HIV Infections / transmission
  • Hepatitis C / diagnosis
  • Hepatitis C / epidemiology
  • Hepatitis C / prevention & control*
  • Hepatitis C / transmission
  • Humans
  • Male
  • Middle Aged
  • Needle Sharing / statistics & numerical data
  • Needle-Exchange Programs / organization & administration
  • Needle-Exchange Programs / standards*
  • Prospective Studies
  • Risk-Taking
  • Sexual Behavior / statistics & numerical data
  • Social Marketing*
  • Socioeconomic Factors
  • Substance Abuse Treatment Centers / statistics & numerical data
  • Substance Abuse, Intravenous* / epidemiology
  • Substance Abuse, Intravenous* / psychology