'Social evils' and harm reduction : the evolving policy environment for human immunodeficiency virus prevention among injection drug users in China and Vietnam
Identifieur interne : 000314 ( PascalFrancis/Corpus ); précédent : 000313; suivant : 000315'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 : (Abingdon. Print) [ 0965-2140 ] ; 2008.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
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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Pour connaître la documentation sur le format Inist Standard.
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Format Inist (serveur)
NO : | PASCAL 08-0099532 INIST |
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ET : | 'Social evils' and harm reduction : the evolving policy environment for human immunodeficiency virus prevention among injection drug users in China and Vietnam |
AU : | HAMMETT (Theodore M.); ZUNYOU WU; TRAN TIEN DUC; STEPHENS (David); SULLIVAN (Sheena); WEI LIU; YI CHEN; NGU (Doan); DES JARLAIS (Don C.) |
AF : | Abt Associates Inc/Cambridge, MA/Etats-Unis (1 aut.); National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention/Beijing/Chine (2 aut., 5 aut.); Health Policy Initiative/Hanoi/Viet Nam (3 aut., 4 aut.); Guangxi Center for HIV/AIDS Prevention and Control/Manning/Chine (6 aut., 7 aut.); Consultant to Lang Son Provincial Health Service, Ho Chi Minh City/Viet Nam (8 aut.); Beth Israel Medical Center New York/NY/Etats-Unis (9 aut.) |
DT : | Publication en série; Niveau analytique |
SO : | Addiction : (Abingdon. Print); ISSN 0965-2140; Royaume-Uni; Da. 2008; Vol. 103; No. 1; Pp. 137-145; Bibl. 45 ref. |
LA : | Anglais |
EA : | 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. |
CC : | 002B18C05A; 002B03; 002B30A11 |
FD : | Toxicomanie; Aspect social; Santé publique; Addiction; Danger; Réduction; Politique sanitaire; Environnement; Virus immunodéficience humaine; SIDA; Prévention; Voie intraveineuse; Drogue illicite; Chine; Vietnam; Homme; Psychiatrie; Psychologie |
FG : | Lentivirus; Retroviridae; Virus; Virose; Infection; Asie; Immunodéficit; Immunopathologie |
ED : | Drug addiction; Social aspect; Public health; Addiction; Danger; Reduction; Health policy; Environment; Human immunodeficiency virus; AIDS; Prevention; Intravenous administration; Illicit drug; China; Vietnam; Human; Psychiatry; Psychology |
EG : | Lentivirus; Retroviridae; Virus; Viral disease; Infection; Asia; Immune deficiency; Immunopathology |
SD : | Toxicomanía; Aspecto social; Salud pública; Adicción; Peligro; Reducción; Política sanitaria; Medio ambiente; Human immunodeficiency virus; SIDA; Prevención; Vía intravenosa; Droga ilícita; China; Vietnam; Hombre; Psiquiatría; Psicología |
LO : | INIST-12616.354000183410820140 |
ID : | 08-0099532 |
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Pascal:08-0099532Le document en format XML
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<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>
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<fC03 i1="08" i2="X" l="FRE"><s0>Environnement</s0>
<s5>09</s5>
</fC03>
<fC03 i1="08" i2="X" l="ENG"><s0>Environment</s0>
<s5>09</s5>
</fC03>
<fC03 i1="08" i2="X" l="SPA"><s0>Medio ambiente</s0>
<s5>09</s5>
</fC03>
<fC03 i1="09" i2="X" l="FRE"><s0>Virus immunodéficience humaine</s0>
<s2>NW</s2>
<s5>11</s5>
</fC03>
<fC03 i1="09" i2="X" l="ENG"><s0>Human immunodeficiency virus</s0>
<s2>NW</s2>
<s5>11</s5>
</fC03>
<fC03 i1="09" i2="X" l="SPA"><s0>Human immunodeficiency virus</s0>
<s2>NW</s2>
<s5>11</s5>
</fC03>
<fC03 i1="10" i2="X" l="FRE"><s0>SIDA</s0>
<s5>12</s5>
</fC03>
<fC03 i1="10" i2="X" l="ENG"><s0>AIDS</s0>
<s5>12</s5>
</fC03>
<fC03 i1="10" i2="X" l="SPA"><s0>SIDA</s0>
<s5>12</s5>
</fC03>
<fC03 i1="11" i2="X" l="FRE"><s0>Prévention</s0>
<s5>17</s5>
</fC03>
<fC03 i1="11" i2="X" l="ENG"><s0>Prevention</s0>
<s5>17</s5>
</fC03>
<fC03 i1="11" i2="X" l="SPA"><s0>Prevención</s0>
<s5>17</s5>
</fC03>
<fC03 i1="12" i2="X" l="FRE"><s0>Voie intraveineuse</s0>
<s5>18</s5>
</fC03>
<fC03 i1="12" i2="X" l="ENG"><s0>Intravenous administration</s0>
<s5>18</s5>
</fC03>
<fC03 i1="12" i2="X" l="SPA"><s0>Vía intravenosa</s0>
<s5>18</s5>
</fC03>
<fC03 i1="13" i2="X" l="FRE"><s0>Drogue illicite</s0>
<s5>19</s5>
</fC03>
<fC03 i1="13" i2="X" l="ENG"><s0>Illicit drug</s0>
<s5>19</s5>
</fC03>
<fC03 i1="13" i2="X" l="SPA"><s0>Droga ilícita</s0>
<s5>19</s5>
</fC03>
<fC03 i1="14" i2="X" l="FRE"><s0>Chine</s0>
<s2>NG</s2>
<s5>20</s5>
</fC03>
<fC03 i1="14" i2="X" l="ENG"><s0>China</s0>
<s2>NG</s2>
<s5>20</s5>
</fC03>
<fC03 i1="14" i2="X" l="SPA"><s0>China</s0>
<s2>NG</s2>
<s5>20</s5>
</fC03>
<fC03 i1="15" i2="X" l="FRE"><s0>Vietnam</s0>
<s2>NG</s2>
<s5>21</s5>
</fC03>
<fC03 i1="15" i2="X" l="ENG"><s0>Vietnam</s0>
<s2>NG</s2>
<s5>21</s5>
</fC03>
<fC03 i1="15" i2="X" l="SPA"><s0>Vietnam</s0>
<s2>NG</s2>
<s5>21</s5>
</fC03>
<fC03 i1="16" i2="X" l="FRE"><s0>Homme</s0>
<s5>22</s5>
</fC03>
<fC03 i1="16" i2="X" l="ENG"><s0>Human</s0>
<s5>22</s5>
</fC03>
<fC03 i1="16" i2="X" l="SPA"><s0>Hombre</s0>
<s5>22</s5>
</fC03>
<fC03 i1="17" i2="X" l="FRE"><s0>Psychiatrie</s0>
<s5>23</s5>
</fC03>
<fC03 i1="17" i2="X" l="ENG"><s0>Psychiatry</s0>
<s5>23</s5>
</fC03>
<fC03 i1="17" i2="X" l="SPA"><s0>Psiquiatría</s0>
<s5>23</s5>
</fC03>
<fC03 i1="18" i2="X" l="FRE"><s0>Psychologie</s0>
<s5>24</s5>
</fC03>
<fC03 i1="18" i2="X" l="ENG"><s0>Psychology</s0>
<s5>24</s5>
</fC03>
<fC03 i1="18" i2="X" l="SPA"><s0>Psicología</s0>
<s5>24</s5>
</fC03>
<fC07 i1="01" i2="X" l="FRE"><s0>Lentivirus</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="01" i2="X" l="ENG"><s0>Lentivirus</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="01" i2="X" l="SPA"><s0>Lentivirus</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="02" i2="X" l="FRE"><s0>Retroviridae</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="02" i2="X" l="ENG"><s0>Retroviridae</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="02" i2="X" l="SPA"><s0>Retroviridae</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="03" i2="X" l="FRE"><s0>Virus</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="03" i2="X" l="ENG"><s0>Virus</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="03" i2="X" l="SPA"><s0>Virus</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="04" i2="X" l="FRE"><s0>Virose</s0>
</fC07>
<fC07 i1="04" i2="X" l="ENG"><s0>Viral disease</s0>
</fC07>
<fC07 i1="04" i2="X" l="SPA"><s0>Virosis</s0>
</fC07>
<fC07 i1="05" i2="X" l="FRE"><s0>Infection</s0>
</fC07>
<fC07 i1="05" i2="X" l="ENG"><s0>Infection</s0>
</fC07>
<fC07 i1="05" i2="X" l="SPA"><s0>Infección</s0>
</fC07>
<fC07 i1="06" i2="X" l="FRE"><s0>Asie</s0>
<s2>NG</s2>
</fC07>
<fC07 i1="06" i2="X" l="ENG"><s0>Asia</s0>
<s2>NG</s2>
</fC07>
<fC07 i1="06" i2="X" l="SPA"><s0>Asia</s0>
<s2>NG</s2>
</fC07>
<fC07 i1="07" i2="X" l="FRE"><s0>Immunodéficit</s0>
<s5>37</s5>
</fC07>
<fC07 i1="07" i2="X" l="ENG"><s0>Immune deficiency</s0>
<s5>37</s5>
</fC07>
<fC07 i1="07" i2="X" l="SPA"><s0>Inmunodeficiencia</s0>
<s5>37</s5>
</fC07>
<fC07 i1="08" i2="X" l="FRE"><s0>Immunopathologie</s0>
<s5>39</s5>
</fC07>
<fC07 i1="08" i2="X" l="ENG"><s0>Immunopathology</s0>
<s5>39</s5>
</fC07>
<fC07 i1="08" i2="X" l="SPA"><s0>Inmunopatología</s0>
<s5>39</s5>
</fC07>
<fN21><s1>052</s1>
</fN21>
<fN44 i1="01"><s1>OTO</s1>
</fN44>
<fN82><s1>OTO</s1>
</fN82>
</pA>
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<server><NO>PASCAL 08-0099532 INIST</NO>
<ET>'Social evils' and harm reduction : the evolving policy environment for human immunodeficiency virus prevention among injection drug users in China and Vietnam</ET>
<AU>HAMMETT (Theodore M.); ZUNYOU WU; TRAN TIEN DUC; STEPHENS (David); SULLIVAN (Sheena); WEI LIU; YI CHEN; NGU (Doan); DES JARLAIS (Don C.)</AU>
<AF>Abt Associates Inc/Cambridge, MA/Etats-Unis (1 aut.); National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention/Beijing/Chine (2 aut., 5 aut.); Health Policy Initiative/Hanoi/Viet Nam (3 aut., 4 aut.); Guangxi Center for HIV/AIDS Prevention and Control/Manning/Chine (6 aut., 7 aut.); Consultant to Lang Son Provincial Health Service, Ho Chi Minh City/Viet Nam (8 aut.); Beth Israel Medical Center New York/NY/Etats-Unis (9 aut.)</AF>
<DT>Publication en série; Niveau analytique</DT>
<SO>Addiction : (Abingdon. Print); ISSN 0965-2140; Royaume-Uni; Da. 2008; Vol. 103; No. 1; Pp. 137-145; Bibl. 45 ref.</SO>
<LA>Anglais</LA>
<EA>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.</EA>
<CC>002B18C05A; 002B03; 002B30A11</CC>
<FD>Toxicomanie; Aspect social; Santé publique; Addiction; Danger; Réduction; Politique sanitaire; Environnement; Virus immunodéficience humaine; SIDA; Prévention; Voie intraveineuse; Drogue illicite; Chine; Vietnam; Homme; Psychiatrie; Psychologie</FD>
<FG>Lentivirus; Retroviridae; Virus; Virose; Infection; Asie; Immunodéficit; Immunopathologie</FG>
<ED>Drug addiction; Social aspect; Public health; Addiction; Danger; Reduction; Health policy; Environment; Human immunodeficiency virus; AIDS; Prevention; Intravenous administration; Illicit drug; China; Vietnam; Human; Psychiatry; Psychology</ED>
<EG>Lentivirus; Retroviridae; Virus; Viral disease; Infection; Asia; Immune deficiency; Immunopathology</EG>
<SD>Toxicomanía; Aspecto social; Salud pública; Adicción; Peligro; Reducción; Política sanitaria; Medio ambiente; Human immunodeficiency virus; SIDA; Prevención; Vía intravenosa; Droga ilícita; China; Vietnam; Hombre; Psiquiatría; Psicología</SD>
<LO>INIST-12616.354000183410820140</LO>
<ID>08-0099532</ID>
</server>
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