EFFECTS OF HIV PROPHYLAXIS FOR INJECTING DRUG USERS (IDU) IN QUANG NAM

THE 6TH
NATIONAL SCIENTIFIC CONFERENCE ON HIV/AIDS

EFFECTS OF HIV PROPHYLAXIS
FOR INJECTING DRUG USERS
(IDU) IN QUANG NAM
Tran Van Kiem
Quang Nam Provincial Center of
HIV/AIDS Control


Contents
1. Introduction
2. Research objectives
3. Research objects and methods
4. Results and discussion
5. Conclusions
6. Recommendations
Hội nghị Khoa học Quốc gia về Phòng, chống HIV/AIDS lần thứ VI


INTRODUCTION
 HIV/AIDS epidemic was detected in 1981, at the
moment it has become a disaster globally.
 Over the last 30 years, many efforts have been done
by countries and scientists, yet no drugs to cure the
disease and no vaccine to prevent it have been
invented.
 In Vietnam, HIV is transmitted mainly through drug
injection. In Quang Nam, among PLHIV detected
annually, over 65% are IDUs.

Hội nghị Khoa học Quốc gia về Phòng, chống HIV/AIDS lần thứ VI


RESEARCH OBJECTIVES
 In Quang Nam, there has been no research on IDUs
as well as prophylaxis to prevent HIV transmission in
this group.
This research is carried out to achieve 2 objectives:
1. To identify HIV prevalence rate and describe HIV
transmission risk behaviors of IDUs in Quang Nam in
2011;
2. To evaluate the effects of HIV prophylaxis for IDUs in
Quang Nam (2012-2013).
Hội nghị Khoa học Quốc gia về Phòng, chống HIV/AIDS lần thứ VI


RESEARCH OBJECTS AND
METHODS

Hội nghị Khoa học Quốc gia về Phòng, chống HIV/AIDS lần thứ VI


Research objects
Male IDUs, ≥ 18 years old, participating in the research
voluntarily.

Research site: 05 districts/city including Tam Ky, Thang
Binh, Phu Ninh, Que Sơn and Phuoc Son.
Research period: 03 stages
- Survey of the situation: Oct – Dec 2011

- Community intervention: 02 years, from Jan 2012 to
December 2013
- Post-intervention survey: Jan - Mar 2014
Hội nghị Khoa học Quốc gia về Phòng, chống HIV/AIDS lần thứ VI


Research design
Research design:
This is a community intervention study, comparing pre and
post-intervention without a control group.
Sample size

As a result of the calculation, n=416. In fact, the survey is done
with 430 IDUs.
Hội nghị Khoa học Quốc gia về Phòng, chống HIV/AIDS lần thứ VI


Research design
Sampling:
Purposive sampling in 5 districts/city
Mapping of gathering points: making a map of all gathering
points of IDUs in 5 districts. Sample is distributed to 5 districts.
Making a list of communes with IDUs in the districts and
calculating the average number of ICUs per commune.
Randomly select communes until the number of IDUs for one
district is reached; and continuing to do so until reaching the
required number of IDUs in 5 districts/city
Hội nghị Khoa học Quốc gia về Phòng, chống HIV/AIDS lần thứ VI

Contents of interventions
After the 1st survey:
- Conducting a consensus building conference and building the plan
-Building and strengthening the network of peers and collaborators
-Organizing technical training
After that, implementing interventions for 2 years
Education and communication: direct communication by peers and
collaborators, communication on mass media, distribution of
materials
Distribution of condoms free of charge
Exchange of syringes free of charge
Fixed and mobile VCT
Hội nghị Khoa học Quốc gia về Phòng, chống HIV/AIDS lần thứ VI


Data treatment and research ethics
Data treatment:
Data are entered into EpiData software and analyzed
by Stata, Excel
Research ethics:
Approved by the Medical Ethics Committee
Accepted by local governments
IDUs participate in the research voluntarily and their
information is kept confidential
Research findings are used to serve IDUs only, not for
any other purposes.
Hội nghị Khoa học Quốc gia về Phòng, chống HIV/AIDS lần thứ VI


RESEARCH FINDINGS AND

DISCUSSION

Hội nghị Khoa học Quốc gia về Phòng, chống HIV/AIDS lần thứ VI


Knowledge

Used to hear about HIV

Myths about HIV

The majority of IDUs used to hear about HIV (97.2%). They also
have certain understanding about HIV prevention. But some still
believe in myths such as HIV can be transmitted through
mosquito bites (29,1%), eating with PLHIV (20%),…..
Hội nghị Khoa học Quốc gia về Phòng, chống HIV/AIDS lần thứ VI


Drug injecting behaviors

Sharing of syringes over the past 6
months

Sharing of syringes in the previous
month

The time of practicing injecting behaviors is 6 months and 1 month before the
survey. The proportion of IDUs sharing syringes over the past 6 month is high
(33,5%). This proportion is lower than only Da Nang (37%) and Lao Cai (35%);
and higher than the other 10 provinces such as Ho Chi Minh city (24,6%), Dien

Bien (23,7%)…
Hội nghị Khoa học Quốc gia về Phòng, chống HIV/AIDS lần thứ VI


Drug injecting behaviors (continued)

Reasons for sharing syringes
The most common reason for sharing syringes is because there
are insufficient syringes (accounting for 41,7%) and do not have
enoughHội
money
for having separate syringes (36,1%).
nghị Khoa học Quốc gia về Phòng, chống HIV/AIDS lần thứ VI


Sexual behaviors

Using condoms when having sexual intercourse with female
sex workers (FSW) over the past 12 months
Only 65,5% often use condoms in sexual intercourse with FSW.
This proportion is similar to that of Nghe An (63,3%), Quang Ninh
(68,8%) and is higher than that of Da Nang (50,4%), Ho Chi Minh
city (39,3%)...
Hội nghị Khoa học Quốc gia về Phòng, chống HIV/AIDS lần thứ VI


Sexual behaviors (continued)

Using condoms when having sexual intercourse with casual
partners over the past 12 months

Only 29,2% often use condoms, 57,3% sometimes use them
and 13,5% never use them. This means the risk of HIV
transmission from IDUs to FSW or their casual partners is very
high due to unsafe sex.
Hội nghị Khoa học Quốc gia về Phòng, chống HIV/AIDS lần thứ VI


HIV infection among IDUs
The current prevalence rate is 6,3%, which is lower than that of
the country of 13,4% (survey in 2011)
This prevalence rate is lower than many Northern and Southern
provinces: Dien Bien (48%), Quang Ninh (43%), Ho Chi Minh city
(36%)...
However it is higher than Da Nang (1,0%) and Quang Tri (3,9%)
which are in the same region.
Hội nghị Khoa học Quốc gia về Phòng, chống HIV/AIDS lần thứ VI


EFFECTS
AFTER 2 YEARS OF
INTERVENTION

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Effects of voluntary counselling and testing
(VCT)

Forms of HIV counselling and testing

VCT has been increased from 74,2% before interventions
to 88,2% after interventions. VCT is an important factor in
HIV/AIDS care and treatment.
Hội nghị Khoa học Quốc gia về Phòng, chống HIV/AIDS lần thứ VI


Effects in terms of accessibility

After 2 years of intervention, IDUs have better access to
HIV prevention activities. There have been considerable
changes to accessibility to condoms, syringes and their
knowledge.


Changed behaviors of IDUs

Sharing of syringes 6 months before and after interventions
The proportion of IDUs sharing syringes over the past 6 months
has been reduced from 33,5% to 22,6% (KPI = 32,6%).
This result is consistent with the finding of a survey conducted by
NIHE in 2012.
Hội nghị Khoa học Quốc gia về Phòng, chống HIV/AIDS lần thứ VI


Changed behaviors of IDUs (continued)

Sharing syringes in the last
month

Sharing syringes in the last injection

The proportion of IDUs sharing syringes in the last month has
been reduced from 21,2% before interventions to 13,7%.
Similarly, the proportion of IDUs sharing syringes in the last
injection has been reduced from 5,6% to 3,3%.
Hội nghị Khoa học Quốc gia về Phòng, chống HIV/AIDS lần thứ VI


Using condoms in sexual intercourse in the past
12 months
The proportion of IUDs using condoms frequently with FSW
has been increased from 65,6% to 86,1% (KPI = 31,3%); with
casual partners: increased from 29,2% to 56,1% (KPI =
Hội nghị Khoa học Quốc gia về Phòng, chống HIV/AIDS lần thứ VI


Changed HIV prevalence

HIV prevalence rate before and after interventions
HIV prevalence rate has been reduced from 6,3% before
interventions to 4,4% after interventions (KPI = 29,6%). This
shows the effects of prophylaxis.
Hội nghị Khoa học Quốc gia về Phòng, chống HIV/AIDS lần thứ VI


CONCLUSIONS
1. Situation of HIV infection among IDUs in 2011
 The HIV prevalence rate among IDUs in Quang
Nam in 2011 is 6,3%.
 The proportion of IDUs sharing syringes over the

past 6 months is 33,5% and in the last month is
21,2%.
 The proportion of IDUs using condoms frequently
in the past 12 months with wife/girl-friend is
13,3%, with FSW is 65,6% and with casual
partners is 29,2%.
Hội nghị Khoa học Quốc gia về Phòng, chống HIV/AIDS lần thứ VI