‘Social evils’ and harm reduction: the evolving policy environment for human immunodeficiency virus prevention among injection drug users in China and Vietnam
Identifieur interne : 001145 ( Istex/Corpus ); précédent : 001144; suivant : 001146‘Social evils’ and harm reduction: the evolving policy environment for human immunodeficiency virus prevention among injection drug users in China and Vietnam
Auteurs : Theodore M. Hammett ; Zunyou Wu ; Tran Tien Duc ; David Stephens ; Sheena Sullivan ; Wei Liu ; Yi Chen ; Doan Ngu ; Don C. Des JarlaisSource :
- Addiction [ 0965-2140 ] ; 2008-01.
Abstract
Aims This paper reviews the evolution of government policies in China and Vietnam regarding harm reduction interventions for human immunodeficiency virus (HIV) prevention, such as needle/syringe provision and opioid substitution treatment. Methods The work is based upon the authors' experiences in and observations of these policy developments, as well as relevant government policy documents and legislation. Results Both countries are experiencing HIV epidemics driven by injection drug use and have maintained generally severe policies towards injection drug users (IDUs). In recent years, however, they have also officially endorsed harm reduction. We sought to understand how and why this apparently surprising policy evolution took place. Factors associated with growing support for harm reduction were similar but not identical in China and Vietnam. These included the emergence of effective ‘champions’ for such policies, an ethos of pragmatism and receptivity to evidence, growing collaboration across public health, police and other sectors, the influence of contingent events such as the severe acute respiratory syndrome (SARS) epidemic and pressure from donors and international organizations to adopt best practice in HIV prevention. Conclusions Ongoing challenges and lessons learned include the persistence of tensions between drug control and harm reduction that may have negative effects on programs until a fully harmonized policy environment is established. Excessive reliance on law enforcement and forced detoxification will not solve the problems of substance abuse or of HIV among drug users. Ongoing evaluation of harm reduction programs, as well as increased levels of multi‐sectoral training, collaboration and support are also needed.
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DOI: 10.1111/j.1360-0443.2007.02053.x
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Hammett</name><affiliation><mods:affiliation>Abt Associates Inc., Cambridge, MA, USA,</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: ted_hammett@abtassoc.com</mods:affiliation></affiliation></author><author><name sortKey="Wu, Zunyou" sort="Wu, Zunyou" uniqKey="Wu Z" first="Zunyou" last="Wu">Zunyou Wu</name><affiliation><mods:affiliation>National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China,</mods:affiliation></affiliation></author><author><name sortKey="Duc, Tran Tien" sort="Duc, Tran Tien" uniqKey="Duc T" first="Tran Tien" last="Duc">Tran Tien Duc</name><affiliation><mods:affiliation>Health Policy Initiative, Hanoi, Vietnam,</mods:affiliation></affiliation></author><author><name sortKey="Stephens, David" sort="Stephens, David" uniqKey="Stephens D" first="David" last="Stephens">David Stephens</name><affiliation><mods:affiliation>Health Policy Initiative, Hanoi, Vietnam,</mods:affiliation></affiliation></author><author><name sortKey="Sullivan, Sheena" sort="Sullivan, Sheena" uniqKey="Sullivan S" first="Sheena" last="Sullivan">Sheena Sullivan</name><affiliation><mods:affiliation>National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China,</mods:affiliation></affiliation></author><author><name sortKey="Liu, Wei" sort="Liu, Wei" uniqKey="Liu W" first="Wei" last="Liu">Wei Liu</name><affiliation><mods:affiliation>Guangxi Center for HIV/AIDS Prevention and Control, Nanning, China,</mods:affiliation></affiliation></author><author><name sortKey="Chen, Yi" sort="Chen, Yi" uniqKey="Chen Y" first="Yi" last="Chen">Yi Chen</name><affiliation><mods:affiliation>Guangxi Center for HIV/AIDS Prevention and Control, Nanning, China,</mods:affiliation></affiliation></author><author><name sortKey="Ngu, Doan" sort="Ngu, Doan" uniqKey="Ngu D" first="Doan" last="Ngu">Doan Ngu</name><affiliation><mods:affiliation>Consultant to Lang Son Provincial Health Service, Ho Chi Minh City, Vietnam and</mods:affiliation></affiliation></author><author><name sortKey="Des Jarlais, Don C" sort="Des Jarlais, Don C" uniqKey="Des Jarlais D" first="Don C." last="Des Jarlais">Don C. Des Jarlais</name><affiliation><mods:affiliation>Beth Israel Medical Center, New York, NY, USA</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:1BE9947E5FF430575D3F83A424EB043E63630CA4</idno><date when="2008" year="2008">2008</date><idno type="doi">10.1111/j.1360-0443.2007.02053.x</idno><idno type="url">https://api.istex.fr/ark:/67375/WNG-MQ3HC5SF-P/fulltext.pdf</idno><idno type="wicri:Area/Istex/Corpus">001145</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">001145</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main">‘Social evils’ and harm reduction: the evolving policy environment for human immunodeficiency virus prevention among injection drug users in China and Vietnam</title><author><name sortKey="Hammett, Theodore M" sort="Hammett, Theodore M" uniqKey="Hammett T" first="Theodore M." last="Hammett">Theodore M. Hammett</name><affiliation><mods:affiliation>Abt Associates Inc., Cambridge, MA, USA,</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: ted_hammett@abtassoc.com</mods:affiliation></affiliation></author><author><name sortKey="Wu, Zunyou" sort="Wu, Zunyou" uniqKey="Wu Z" first="Zunyou" last="Wu">Zunyou Wu</name><affiliation><mods:affiliation>National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China,</mods:affiliation></affiliation></author><author><name sortKey="Duc, Tran Tien" sort="Duc, Tran Tien" uniqKey="Duc T" first="Tran Tien" last="Duc">Tran Tien Duc</name><affiliation><mods:affiliation>Health Policy Initiative, Hanoi, Vietnam,</mods:affiliation></affiliation></author><author><name sortKey="Stephens, David" sort="Stephens, David" uniqKey="Stephens D" first="David" last="Stephens">David Stephens</name><affiliation><mods:affiliation>Health Policy Initiative, Hanoi, Vietnam,</mods:affiliation></affiliation></author><author><name sortKey="Sullivan, Sheena" sort="Sullivan, Sheena" uniqKey="Sullivan S" first="Sheena" last="Sullivan">Sheena Sullivan</name><affiliation><mods:affiliation>National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China,</mods:affiliation></affiliation></author><author><name sortKey="Liu, Wei" sort="Liu, Wei" uniqKey="Liu W" first="Wei" last="Liu">Wei Liu</name><affiliation><mods:affiliation>Guangxi Center for HIV/AIDS Prevention and Control, Nanning, China,</mods:affiliation></affiliation></author><author><name sortKey="Chen, Yi" sort="Chen, Yi" uniqKey="Chen Y" first="Yi" last="Chen">Yi Chen</name><affiliation><mods:affiliation>Guangxi Center for HIV/AIDS Prevention and Control, Nanning, China,</mods:affiliation></affiliation></author><author><name sortKey="Ngu, Doan" sort="Ngu, Doan" uniqKey="Ngu D" first="Doan" last="Ngu">Doan Ngu</name><affiliation><mods:affiliation>Consultant to Lang Son Provincial Health Service, Ho Chi Minh City, Vietnam and</mods:affiliation></affiliation></author><author><name sortKey="Des Jarlais, Don C" sort="Des Jarlais, Don C" uniqKey="Des Jarlais D" first="Don C." last="Des Jarlais">Don C. Des Jarlais</name><affiliation><mods:affiliation>Beth Israel Medical Center, New York, NY, USA</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">Addiction</title><title level="j" type="alt">ADDICTION</title><idno type="ISSN">0965-2140</idno><idno type="eISSN">1360-0443</idno><imprint><biblScope unit="vol">103</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="page" from="137">137</biblScope><biblScope unit="page" to="145">145</biblScope><biblScope unit="page-count">9</biblScope><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2008-01">2008-01</date></imprint><idno type="ISSN">0965-2140</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0965-2140</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Aims This paper reviews the evolution of government policies in China and Vietnam regarding harm reduction interventions for human immunodeficiency virus (HIV) prevention, such as needle/syringe provision and opioid substitution treatment. Methods The work is based upon the authors' experiences in and observations of these policy developments, as well as relevant government policy documents and legislation. Results Both countries are experiencing HIV epidemics driven by injection drug use and have maintained generally severe policies towards injection drug users (IDUs). In recent years, however, they have also officially endorsed harm reduction. We sought to understand how and why this apparently surprising policy evolution took place. Factors associated with growing support for harm reduction were similar but not identical in China and Vietnam. These included the emergence of effective ‘champions’ for such policies, an ethos of pragmatism and receptivity to evidence, growing collaboration across public health, police and other sectors, the influence of contingent events such as the severe acute respiratory syndrome (SARS) epidemic and pressure from donors and international organizations to adopt best practice in HIV prevention. Conclusions Ongoing challenges and lessons learned include the persistence of tensions between drug control and harm reduction that may have negative effects on programs until a fully harmonized policy environment is established. Excessive reliance on law enforcement and forced detoxification will not solve the problems of substance abuse or of HIV among drug users. Ongoing evaluation of harm reduction programs, as well as increased levels of multi‐sectoral training, collaboration and support are also needed.</div></front></TEI><istex><corpusName>wiley</corpusName><keywords><teeft><json:string>harm reduction</json:string><json:string>drug user</json:string><json:string>methadone</json:string><json:string>idus</json:string><json:string>detoxification</json:string><json:string>injection drug user</json:string><json:string>vietnam</json:string><json:string>journal compilation</json:string><json:string>beijing</json:string><json:string>methadone maintenance</json:string><json:string>hanoi</json:string><json:string>addiction addiction</json:string><json:string>xinjiang</json:string><json:string>harm reduction intervention</json:string><json:string>condom</json:string><json:string>harm reduction program</json:string><json:string>yunnan</json:string><json:string>injection drug</json:string><json:string>social evil</json:string><json:string>minh city</json:string><json:string>drug control</json:string><json:string>user</json:string><json:string>peer education</json:string><json:string>international organization</json:string><json:string>state council</json:string><json:string>sexual transmission</json:string><json:string>government support</json:string><json:string>action plan</json:string><json:string>international donor</json:string><json:string>public security</json:string><json:string>national assembly</json:string><json:string>pilot program</json:string><json:string>methadone program</json:string><json:string>aid prevention</json:string><json:string>addiction</json:string><json:string>minh</json:string><json:string>policy development</json:string><json:string>quang ninh</json:string><json:string>substance abuse</json:string><json:string>recent year</json:string><json:string>risk behavior</json:string><json:string>drug administration</json:string><json:string>detoxification center</json:string><json:string>drug rehabilitation center</json:string><json:string>nation programme</json:string><json:string>pilot project</json:string><json:string>such intervention</json:string><json:string>civil society</json:string><json:string>communist party</json:string><json:string>severe policy</json:string><json:string>national center</json:string><json:string>urban health</json:string><json:string>drug policy</json:string><json:string>acquir immune defic syndr</json:string><json:string>family health international</json:string><json:string>health policy initiative</json:string><json:string>peer outreach</json:string><json:string>prevention strategy</json:string><json:string>harm reduction china</json:string><json:string>methadone maintenance treatment</json:string><json:string>world health organization</json:string><json:string>condom promotion</json:string><json:string>beth israel medical center</json:string><json:string>condom distribution</json:string><json:string>national institute</json:string><json:string>drug injection</json:string><json:string>generalized epidemic</json:string><json:string>york time</json:string><json:string>harm reduction strategy</json:string><json:string>yunnan province</json:string><json:string>peer educator</json:string><json:string>substitution treatment</json:string><json:string>high dropout rate</json:string><json:string>public health</json:string><json:string>pepfar program</json:string><json:string>national policy</json:string><json:string>other hand</json:string><json:string>study tour</json:string><json:string>antenatal woman</json:string><json:string>economic growth</json:string><json:string>scientific evidence</json:string><json:string>international evidence</json:string><json:string>methadone pilot</json:string><json:string>harm reduction policy</json:string><json:string>more willing</json:string><json:string>syringe program</json:string><json:string>mass arrest</json:string><json:string>national strategy</json:string><json:string>open dialogue</json:string><json:string>labor camp</json:string><json:string>severe acute respiratory syndrome</json:string><json:string>social affair commission</json:string><json:string>social affair</json:string><json:string>opioid substitution treatment</json:string><json:string>prostitution prevention</json:string><json:string>prevention program</json:string><json:string>york city</json:string><json:string>policy environment</json:string><json:string>aid educ prev</json:string><json:string>chinese center</json:string><json:string>government official</json:string><json:string>chinese government</json:string><json:string>southern china</json:string><json:string>northern vietnam</json:string><json:string>disease control</json:string><json:string>needle exchange</json:string><json:string>xinjiang prevention</json:string><json:string>care project</json:string><json:string>opioid maintenance treatment</json:string></teeft></keywords><author><json:item><name>Theodore M. Hammett</name><affiliations><json:string>Abt Associates Inc., Cambridge, MA, USA,</json:string><json:string>E-mail: ted_hammett@abtassoc.com</json:string></affiliations></json:item><json:item><name>Zunyou Wu</name><affiliations><json:string>National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China,</json:string></affiliations></json:item><json:item><name>Tran Tien Duc</name><affiliations><json:string>Health Policy Initiative, Hanoi, Vietnam,</json:string></affiliations></json:item><json:item><name>David Stephens</name><affiliations><json:string>Health Policy Initiative, Hanoi, Vietnam,</json:string></affiliations></json:item><json:item><name>Sheena Sullivan</name><affiliations><json:string>National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China,</json:string></affiliations></json:item><json:item><name>Wei Liu</name><affiliations><json:string>Guangxi Center for HIV/AIDS Prevention and Control, Nanning, China,</json:string></affiliations></json:item><json:item><name>Yi Chen</name><affiliations><json:string>Guangxi Center for HIV/AIDS Prevention and Control, Nanning, China,</json:string></affiliations></json:item><json:item><name>Doan Ngu</name><affiliations><json:string>Consultant to Lang Son Provincial Health Service, Ho Chi Minh City, Vietnam and</json:string></affiliations></json:item><json:item><name>Don C. Des Jarlais</name><affiliations><json:string>Beth Israel Medical Center, New York, NY, USA</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>China</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>harm reduction</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>HIV prevention</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>injection drug users</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>policy</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Vietnam</value></json:item></subject><articleId><json:string>ADD2053</json:string></articleId><arkIstex>ark:/67375/WNG-MQ3HC5SF-P</arkIstex><language><json:string>eng</json:string></language><originalGenre><json:string>article</json:string></originalGenre><abstract>Aims This paper reviews the evolution of government policies in China and Vietnam regarding harm reduction interventions for human immunodeficiency virus (HIV) prevention, such as needle/syringe provision and opioid substitution treatment. Methods The work is based upon the authors' experiences in and observations of these policy developments, as well as relevant government policy documents and legislation. Results Both countries are experiencing HIV epidemics driven by injection drug use and have maintained generally severe policies towards injection drug users (IDUs). In recent years, however, they have also officially endorsed harm reduction. We sought to understand how and why this apparently surprising policy evolution took place. Factors associated with growing support for harm reduction were similar but not identical in China and Vietnam. These included the emergence of effective ‘champions’ for such policies, an ethos of pragmatism and receptivity to evidence, growing collaboration across public health, police and other sectors, the influence of contingent events such as the severe acute respiratory syndrome (SARS) epidemic and pressure from donors and international organizations to adopt best practice in HIV prevention. Conclusions Ongoing challenges and lessons learned include the persistence of tensions between drug control and harm reduction that may have negative effects on programs until a fully harmonized policy environment is established. Excessive reliance on law enforcement and forced detoxification will not solve the problems of substance abuse or of HIV among drug users. Ongoing evaluation of harm reduction programs, as well as increased levels of multi‐sectoral training, collaboration and support are also needed.</abstract><qualityIndicators><score>10</score><pdfWordCount>6026</pdfWordCount><pdfCharCount>38317</pdfCharCount><pdfVersion>1.2</pdfVersion><pdfPageCount>9</pdfPageCount><pdfPageSize>595.276 x 782.362 pts</pdfPageSize><pdfWordsPerPage>670</pdfWordsPerPage><pdfText>true</pdfText><refBibsNative>true</refBibsNative><abstractWordCount>250</abstractWordCount><abstractCharCount>1767</abstractCharCount><keywordCount>6</keywordCount></qualityIndicators><title>‘Social evils’ and harm reduction: the evolving policy environment for human immunodeficiency virus prevention among injection drug users in China and 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Des</json:string><json:string>Doan Ngu</json:string><json:string>China</json:string><json:string>Sheena Sullivan</json:string><json:string>Theodore M. Hammett</json:string><json:string>Quang Ninh</json:string><json:string>Ming County</json:string><json:string>An Giang</json:string></persName><placeName><json:string>Hanoi</json:string><json:string>Vietnam</json:string><json:string>Ho Chi Minh City</json:string><json:string>New York City</json:string><json:string>China</json:string><json:string>Haiphong</json:string><json:string>York</json:string><json:string>MA</json:string><json:string>Russia</json:string><json:string>Cambridge</json:string></placeName><ref_url></ref_url><ref_bibl><json:string>[4]</json:string><json:string>[45]</json:string><json:string>March 2006</json:string><json:string>[29]</json:string><json:string>[6]</json:string><json:string>[44]</json:string><json:string>Theodore M. 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sociales</json:string></inist></categories><publicationDate>2008</publicationDate><copyrightDate>2008</copyrightDate><doi><json:string>10.1111/j.1360-0443.2007.02053.x</json:string></doi><id>1BE9947E5FF430575D3F83A424EB043E63630CA4</id><score>1</score><fulltext><json:item><extension>pdf</extension><original>true</original><mimetype>application/pdf</mimetype><uri>https://api.istex.fr/ark:/67375/WNG-MQ3HC5SF-P/fulltext.pdf</uri></json:item><json:item><extension>zip</extension><original>false</original><mimetype>application/zip</mimetype><uri>https://api.istex.fr/ark:/67375/WNG-MQ3HC5SF-P/bundle.zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/ark:/67375/WNG-MQ3HC5SF-P/fulltext.tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main">‘Social evils’ and harm reduction: the evolving policy environment for human immunodeficiency virus prevention among injection drug users in China and Vietnam</title><title level="a" type="short">‘Social evils’ and harm reduction: China and Vietnam</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><availability><licence>© 2007 The Authors</licence></availability><date type="published" when="2008-01"></date></publicationStmt><notesStmt><note type="content-type" subtype="article" source="article" scheme="https://content-type.data.istex.fr/ark:/67375/XTP-6N5SZHKN-D">article</note><note type="publication-type" subtype="journal" scheme="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</note></notesStmt><sourceDesc><biblStruct type="article"><analytic><title level="a" type="main">‘Social evils’ and harm reduction: the evolving policy environment for human immunodeficiency virus prevention among injection drug users in China and Vietnam</title><title level="a" type="short">‘Social evils’ and harm reduction: China and Vietnam</title><author xml:id="author-0000" role="corresp"><persName><forename type="first">Theodore M.</forename><surname>Hammett</surname></persName><affiliation><address><addrLine>Abt Associates Inc.</addrLine><addrLine>Cambridge, MA, USA,</addrLine></address></affiliation></author><author xml:id="author-0001"><persName><forename type="first">Zunyou</forename><surname>Wu</surname></persName><affiliation><orgName type="institution">National Center for AIDS/STD Control and Prevention</orgName><orgName type="institution">Chinese Center for Disease Control and Prevention</orgName><address><addrLine>Beijing</addrLine><addrLine>China,</addrLine><country key="CN" xml:lang="en">CHINA</country></address></affiliation></author><author xml:id="author-0002"><persName><forename type="first">Tran Tien</forename><surname>Duc</surname></persName><affiliation><address><addrLine>Health Policy Initiative</addrLine><addrLine>Hanoi, Vietnam,</addrLine></address></affiliation></author><author xml:id="author-0003"><persName><forename type="first">David</forename><surname>Stephens</surname></persName><affiliation><address><addrLine>Health Policy Initiative</addrLine><addrLine>Hanoi, Vietnam,</addrLine></address></affiliation></author><author xml:id="author-0004"><persName><forename type="first">Sheena</forename><surname>Sullivan</surname></persName><affiliation><orgName type="institution">National Center for AIDS/STD Control and Prevention</orgName><orgName type="institution">Chinese Center for Disease Control and Prevention</orgName><address><addrLine>Beijing</addrLine><addrLine>China,</addrLine><country key="CN" xml:lang="en">CHINA</country></address></affiliation></author><author xml:id="author-0005"><persName><forename type="first">Wei</forename><surname>Liu</surname></persName><affiliation><orgName type="institution">Guangxi Center for HIV/AIDS Prevention and Control</orgName><address><addrLine>Nanning</addrLine><addrLine>China,</addrLine><country key="CN" xml:lang="en">CHINA</country></address></affiliation></author><author xml:id="author-0006"><persName><forename type="first">Yi</forename><surname>Chen</surname></persName><affiliation><orgName type="institution">Guangxi Center for HIV/AIDS Prevention and Control</orgName><address><addrLine>Nanning</addrLine><addrLine>China,</addrLine><country key="CN" xml:lang="en">CHINA</country></address></affiliation></author><author xml:id="author-0007"><persName><forename type="first">Doan</forename><surname>Ngu</surname></persName><affiliation><orgName type="laboratory">Consultant to Lang Son Provincial Health Service</orgName><address><addrLine>Ho Chi Minh City</addrLine><addrLine>Vietnam and</addrLine></address></affiliation></author><author xml:id="author-0008"><persName><forename type="first">Don C.</forename><surname>Des Jarlais</surname></persName><affiliation><orgName type="institution">Beth Israel Medical Center</orgName><address><addrLine>New York</addrLine><addrLine>NY, USA</addrLine><country key="US" xml:lang="en">UNITED STATES</country></address></affiliation></author><idno type="istex">1BE9947E5FF430575D3F83A424EB043E63630CA4</idno><idno type="ark">ark:/67375/WNG-MQ3HC5SF-P</idno><idno type="DOI">10.1111/j.1360-0443.2007.02053.x</idno><idno type="unit">ADD2053</idno><idno type="toTypesetVersion">file:ADD.ADD2053.pdf</idno></analytic><monogr><title level="j" type="main">Addiction</title><title level="j" type="alt">ADDICTION</title><idno type="pISSN">0965-2140</idno><idno type="eISSN">1360-0443</idno><idno type="book-DOI">10.1111/(ISSN)1360-0443</idno><idno type="book-part-DOI">10.1111/add.2007.103.issue-1</idno><idno type="product">ADD</idno><idno type="publisherDivision">ST</idno><imprint><biblScope unit="vol">103</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="page" from="137">137</biblScope><biblScope unit="page" to="145">145</biblScope><biblScope unit="page-count">9</biblScope><publisher>Blackwell Publishing 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<ref target="http://www.tei-c.org/">We use TEI</ref></desc></application></appInfo></encodingDesc><profileDesc><abstract xml:lang="en" style="main"><head>ABSTRACT</head><p><hi rend="bold">Aims </hi> This paper reviews the evolution of government policies in China and Vietnam regarding harm reduction interventions for human immunodeficiency virus (HIV) prevention, such as needle/syringe provision and opioid substitution treatment.</p><p><hi rend="bold">Methods </hi> The work is based upon the authors' experiences in and observations of these policy developments, as well as relevant government policy documents and legislation.</p><p><hi rend="bold">Results </hi> Both countries are experiencing HIV epidemics driven by injection drug use and have maintained generally severe policies towards injection drug users (IDUs). In recent years, however, they have also officially endorsed harm reduction. We sought to understand how and why this apparently surprising policy evolution took place. Factors associated with growing support for harm reduction were similar but not identical in China and Vietnam. These included the emergence of effective ‘champions’ for such policies, an ethos of pragmatism and receptivity to evidence, growing collaboration across public health, police and other sectors, the influence of contingent events such as the severe acute respiratory syndrome (SARS) epidemic and pressure from donors and international organizations to adopt best practice in HIV prevention.</p><p><hi rend="bold">Conclusions </hi> Ongoing challenges and lessons learned include the persistence of tensions between drug control and harm reduction that may have negative effects on programs until a fully harmonized policy environment is established. Excessive reliance on law enforcement and forced detoxification will not solve the problems of substance abuse or of HIV among drug users. Ongoing evaluation of harm reduction programs, as well as increased levels of multi‐sectoral training, collaboration and support are also needed.</p></abstract><textClass><keywords xml:lang="en"><term xml:id="k1">China</term><term xml:id="k2">harm reduction</term><term xml:id="k3">HIV prevention</term><term xml:id="k4">injection drug users</term><term xml:id="k5">policy</term><term xml:id="k6">Vietnam</term></keywords><keywords rend="tocHeading1"><term>RESEARCH REPORT</term></keywords></textClass><langUsage><language ident="en"></language></langUsage></profileDesc><revisionDesc><change when="2019-12-20" who="#istex" xml:id="pub2tei">formatting</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/ark:/67375/WNG-MQ3HC5SF-P/fulltext.txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Blackwell Publishing Ltd</publisherName><publisherLoc>Oxford, UK</publisherLoc></publisherInfo><doi origin="wiley" registered="yes">10.1111/(ISSN)1360-0443</doi><issn type="print">0965-2140</issn><issn type="electronic">1360-0443</issn><idGroup><id type="product" value="ADD"></id><id type="publisherDivision" value="ST"></id></idGroup><titleGroup><title type="main" sort="ADDICTION">Addiction</title></titleGroup></publicationMeta><publicationMeta level="part" position="01001"><doi origin="wiley">10.1111/add.2007.103.issue-1</doi><numberingGroup><numbering type="journalVolume" number="103">103</numbering><numbering type="journalIssue" number="1">1</numbering></numberingGroup><coverDate startDate="2008-01">January 2008</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="21" status="forIssue"><doi origin="wiley">10.1111/j.1360-0443.2007.02053.x</doi><idGroup><id type="unit" value="ADD2053"></id></idGroup><countGroup><count type="pageTotal" number="9"></count></countGroup><titleGroup><title type="tocHeading1">RESEARCH REPORT</title></titleGroup><copyright>© 2007 The Authors</copyright><eventGroup><event type="firstOnline" date="2007-11-20"></event><event type="publishedOnlineFinalForm" date="2007-12-07"></event><event type="xmlConverted" agent="Converter:BPG_TO_WML3G version:2.3.2 mode:FullText source:FullText result:FullText" date="2010-02-26"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:4.0.1" date="2014-03-14"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-10-14"></event></eventGroup><numberingGroup><numbering type="pageFirst" number="137">137</numbering><numbering type="pageLast" number="145">145</numbering></numberingGroup><correspondenceTo>Theodore M. Hammett, Abt Associates Inc., 55 Wheeler Street, Cambridge, MA 02138‐1168, USA. E‐mail: <email>ted_hammett@abtassoc.com</email></correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:ADD.ADD2053.pdf"></link></linkGroup></publicationMeta><contentMeta><unparsedEditorialHistory>Submitted 11 May 2007; initial review completed 29 June 2007; final version accepted 11 September 2007</unparsedEditorialHistory><countGroup><count type="figureTotal" number="0"></count><count type="tableTotal" number="0"></count><count type="formulaTotal" number="0"></count><count type="referenceTotal" number="45"></count><count type="wordTotal" number="6666"></count><count type="linksPubMed" number="0"></count><count type="linksCrossRef" number="0"></count></countGroup><titleGroup><title type="main">‘Social evils’ and harm reduction: the evolving policy environment for human immunodeficiency virus prevention among injection drug users in China and Vietnam</title><title type="shortAuthors">Theodore M. Hammett <i>et al.</i></title><title type="short">‘Social evils’ and harm reduction: China and Vietnam</title></titleGroup><creators><creator creatorRole="author" xml:id="cr1" affiliationRef="#a1" corresponding="yes"><personName><givenNames>Theodore M.</givenNames><familyName>Hammett</familyName></personName></creator><creator creatorRole="author" xml:id="cr2" affiliationRef="#a2"><personName><givenNames>Zunyou</givenNames><familyName>Wu</familyName></personName></creator><creator creatorRole="author" xml:id="cr3" affiliationRef="#a3"><personName><givenNames>Tran Tien</givenNames><familyName>Duc</familyName></personName></creator><creator creatorRole="author" xml:id="cr4" affiliationRef="#a3"><personName><givenNames>David</givenNames><familyName>Stephens</familyName></personName></creator><creator creatorRole="author" xml:id="cr5" affiliationRef="#a2"><personName><givenNames>Sheena</givenNames><familyName>Sullivan</familyName></personName></creator><creator creatorRole="author" xml:id="cr6" affiliationRef="#a4"><personName><givenNames>Wei</givenNames><familyName>Liu</familyName></personName></creator><creator creatorRole="author" xml:id="cr7" affiliationRef="#a4"><personName><givenNames>Yi</givenNames><familyName>Chen</familyName></personName></creator><creator creatorRole="author" xml:id="cr8" affiliationRef="#a5"><personName><givenNames>Doan</givenNames><familyName>Ngu</familyName></personName></creator><creator creatorRole="author" xml:id="cr9" affiliationRef="#a6"><personName><givenNames>Don C.</givenNames><familyName>Des Jarlais</familyName></personName></creator></creators><affiliationGroup><affiliation xml:id="a1"><unparsedAffiliation>Abt Associates Inc., Cambridge, MA, USA,</unparsedAffiliation></affiliation><affiliation xml:id="a2" countryCode="CN"><unparsedAffiliation>National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China,</unparsedAffiliation></affiliation><affiliation xml:id="a3"><unparsedAffiliation>Health Policy Initiative, Hanoi, Vietnam,</unparsedAffiliation></affiliation><affiliation xml:id="a4" countryCode="CN"><unparsedAffiliation>Guangxi Center for HIV/AIDS Prevention and Control, Nanning, China,</unparsedAffiliation></affiliation><affiliation xml:id="a5"><unparsedAffiliation>Consultant to Lang Son Provincial Health Service, Ho Chi Minh City, Vietnam and</unparsedAffiliation></affiliation><affiliation xml:id="a6" countryCode="US"><unparsedAffiliation>Beth Israel Medical Center, New York, NY, USA</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en"><keyword xml:id="k1">China</keyword><keyword xml:id="k2">harm reduction</keyword><keyword xml:id="k3">HIV prevention</keyword><keyword xml:id="k4">injection drug users</keyword><keyword xml:id="k5">policy</keyword><keyword xml:id="k6">Vietnam</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><title type="main">ABSTRACT</title><p><b>Aims </b> This paper reviews the evolution of government policies in China and Vietnam regarding harm reduction interventions for human immunodeficiency virus (HIV) prevention, such as needle/syringe provision and opioid substitution treatment.</p><p><b>Methods </b> The work is based upon the authors' experiences in and observations of these policy developments, as well as relevant government policy documents and legislation.</p><p><b>Results </b> Both countries are experiencing HIV epidemics driven by injection drug use and have maintained generally severe policies towards injection drug users (IDUs). In recent years, however, they have also officially endorsed harm reduction. We sought to understand how and why this apparently surprising policy evolution took place. Factors associated with growing support for harm reduction were similar but not identical in China and Vietnam. These included the emergence of effective ‘champions’ for such policies, an ethos of pragmatism and receptivity to evidence, growing collaboration across public health, police and other sectors, the influence of contingent events such as the severe acute respiratory syndrome (SARS) epidemic and pressure from donors and international organizations to adopt best practice in HIV prevention.</p><p><b>Conclusions </b> Ongoing challenges and lessons learned include the persistence of tensions between drug control and harm reduction that may have negative effects on programs until a fully harmonized policy environment is established. Excessive reliance on law enforcement and forced detoxification will not solve the problems of substance abuse or of HIV among drug users. Ongoing evaluation of harm reduction programs, as well as increased levels of multi‐sectoral training, collaboration and support are also needed.</p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>‘Social evils’ and harm reduction: the evolving policy environment for human immunodeficiency virus prevention among injection drug users in China and Vietnam</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>‘Social evils’ and harm reduction: China and Vietnam</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>‘Social evils’ and harm reduction: the evolving policy environment for human immunodeficiency virus prevention among injection drug users in China and Vietnam</title></titleInfo><name type="personal"><namePart type="given">Theodore M.</namePart><namePart type="family">Hammett</namePart><affiliation>Abt Associates Inc., Cambridge, MA, USA,</affiliation><affiliation>E-mail: ted_hammett@abtassoc.com</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Zunyou</namePart><namePart type="family">Wu</namePart><affiliation>National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China,</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Tran Tien</namePart><namePart type="family">Duc</namePart><affiliation>Health Policy Initiative, Hanoi, Vietnam,</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">David</namePart><namePart type="family">Stephens</namePart><affiliation>Health Policy Initiative, Hanoi, Vietnam,</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Sheena</namePart><namePart type="family">Sullivan</namePart><affiliation>National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China,</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Wei</namePart><namePart type="family">Liu</namePart><affiliation>Guangxi Center for HIV/AIDS Prevention and Control, Nanning, China,</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Yi</namePart><namePart type="family">Chen</namePart><affiliation>Guangxi Center for HIV/AIDS Prevention and Control, Nanning, China,</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Doan</namePart><namePart type="family">Ngu</namePart><affiliation>Consultant to Lang Son Provincial Health Service, Ho Chi Minh City, Vietnam and</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Don C.</namePart><namePart type="family">Des Jarlais</namePart><affiliation>Beth Israel Medical Center, New York, NY, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-6N5SZHKN-D">article</genre><originInfo><publisher>Blackwell Publishing Ltd</publisher><place><placeTerm type="text">Oxford, UK</placeTerm></place><dateIssued encoding="w3cdtf">2008-01</dateIssued><edition>Submitted 11 May 2007; initial review completed 29 June 2007; final version accepted 11 September 2007</edition><copyrightDate encoding="w3cdtf">2008</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><extent unit="figures">0</extent><extent unit="tables">0</extent><extent unit="formulas">0</extent><extent unit="references">45</extent><extent unit="linksCrossRef">0</extent><extent unit="words">6666</extent></physicalDescription><abstract lang="en">Aims This paper reviews the evolution of government policies in China and Vietnam regarding harm reduction interventions for human immunodeficiency virus (HIV) prevention, such as needle/syringe provision and opioid substitution treatment. Methods The work is based upon the authors' experiences in and observations of these policy developments, as well as relevant government policy documents and legislation. Results Both countries are experiencing HIV epidemics driven by injection drug use and have maintained generally severe policies towards injection drug users (IDUs). In recent years, however, they have also officially endorsed harm reduction. We sought to understand how and why this apparently surprising policy evolution took place. Factors associated with growing support for harm reduction were similar but not identical in China and Vietnam. These included the emergence of effective ‘champions’ for such policies, an ethos of pragmatism and receptivity to evidence, growing collaboration across public health, police and other sectors, the influence of contingent events such as the severe acute respiratory syndrome (SARS) epidemic and pressure from donors and international organizations to adopt best practice in HIV prevention. Conclusions Ongoing challenges and lessons learned include the persistence of tensions between drug control and harm reduction that may have negative effects on programs until a fully harmonized policy environment is established. Excessive reliance on law enforcement and forced detoxification will not solve the problems of substance abuse or of HIV among drug users. Ongoing evaluation of harm reduction programs, as well as increased levels of multi‐sectoral training, collaboration and support are also needed.</abstract><subject lang="en"><genre>keywords</genre><topic>China</topic><topic>harm reduction</topic><topic>HIV prevention</topic><topic>injection drug users</topic><topic>policy</topic><topic>Vietnam</topic></subject><relatedItem type="host"><titleInfo><title>Addiction</title></titleInfo><genre type="journal" authority="ISTEX" authorityURI="https://publication-type.data.istex.fr" valueURI="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</genre><identifier type="ISSN">0965-2140</identifier><identifier type="eISSN">1360-0443</identifier><identifier type="DOI">10.1111/(ISSN)1360-0443</identifier><identifier type="PublisherID">ADD</identifier><part><date>2008</date><detail type="volume"><caption>vol.</caption><number>103</number></detail><detail type="issue"><caption>no.</caption><number>1</number></detail><extent unit="pages"><start>137</start><end>145</end><total>9</total></extent></part></relatedItem><relatedItem type="references" displayLabel="cit1"><titleInfo><title>Joint United Nations Programme on HIV/AIDS (UNAIDS).Report on the Global HIV/AIDS Epidemic.Geneva: UNAIDS; 2000.</title></titleInfo><name type="corporate"><namePart>Joint United Nations Programme on HIV/AIDS (UNAIDS).</namePart></name><note type="citation/reference">Joint United Nations Programme on HIV/AIDS (UNAIDS). 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Available at: http://www.populationaction.org/resources/CaseStudies/Vietnam/VietnamCS.htm (accessed 6 April 2007).</note><name type="personal"><namePart type="given">W.</namePart><namePart type="family">Turnbull</namePart><role><roleTerm type="text">author</roleTerm></role></name><genre>book</genre><originInfo><publisher>Population Action International</publisher></originInfo><part><date>2007</date></part></relatedItem><identifier type="istex">1BE9947E5FF430575D3F83A424EB043E63630CA4</identifier><identifier type="ark">ark:/67375/WNG-MQ3HC5SF-P</identifier><identifier type="DOI">10.1111/j.1360-0443.2007.02053.x</identifier><identifier type="ArticleID">ADD2053</identifier><accessCondition type="use and reproduction" contentType="copyright">© 2007 The Authors</accessCondition><recordInfo><recordContentSource authority="ISTEX" authorityURI="https://loaded-corpus.data.istex.fr" valueURI="https://loaded-corpus.data.istex.fr/ark:/67375/XBH-L0C46X92-X">wiley</recordContentSource><recordOrigin>Converted from (version ) to MODS version 3.6.</recordOrigin><recordCreationDate encoding="w3cdtf">2019-11-13</recordCreationDate></recordInfo></mods><json:item><extension>json</extension><original>false</original><mimetype>application/json</mimetype><uri>https://api.istex.fr/ark:/67375/WNG-MQ3HC5SF-P/record.json</uri></json:item></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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