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'Social evils' and harm reduction : the evolving policy environment for human immunodeficiency virus prevention among injection drug users in China and Vietnam

Identifieur interne : 000673 ( PascalFrancis/Curation ); précédent : 000672; suivant : 000674

'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 [États-Unis] ; ZUNYOU WU [République populaire de Chine] ; TRAN TIEN DUC [Viêt Nam] ; David Stephens [Viêt Nam] ; Sheena Sullivan [République populaire de Chine] ; WEI LIU [République populaire de Chine] ; YI CHEN [République populaire de Chine] ; Doan Ngu [Viêt Nam] ; Don C. Des Jarlais [États-Unis]

Source :

RBID : Pascal:08-0099532

Descripteurs français

English descriptors

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.
pA  
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A08 01  1  ENG  @1 'Social evils' and harm reduction : the evolving policy environment for human immunodeficiency virus prevention among injection drug users in China and Vietnam
A11 01  1    @1 HAMMETT (Theodore M.)
A11 02  1    @1 ZUNYOU WU
A11 03  1    @1 TRAN TIEN DUC
A11 04  1    @1 STEPHENS (David)
A11 05  1    @1 SULLIVAN (Sheena)
A11 06  1    @1 WEI LIU
A11 07  1    @1 YI CHEN
A11 08  1    @1 NGU (Doan)
A11 09  1    @1 DES JARLAIS (Don C.)
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A14 03      @1 Health Policy Initiative @2 Hanoi @3 VNM @Z 3 aut. @Z 4 aut.
A14 04      @1 Guangxi Center for HIV/AIDS Prevention and Control @2 Manning @3 CHN @Z 6 aut. @Z 7 aut.
A14 05      @1 Consultant to Lang Son Provincial Health Service, Ho Chi Minh City @3 VNM @Z 8 aut.
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Pascal:08-0099532

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<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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</fA06>
<fA08 i1="01" i2="1" l="ENG">
<s1>'Social evils' and harm reduction : the evolving policy environment for human immunodeficiency virus prevention among injection drug users in China and Vietnam</s1>
</fA08>
<fA11 i1="01" i2="1">
<s1>HAMMETT (Theodore M.)</s1>
</fA11>
<fA11 i1="02" i2="1">
<s1>ZUNYOU WU</s1>
</fA11>
<fA11 i1="03" i2="1">
<s1>TRAN TIEN DUC</s1>
</fA11>
<fA11 i1="04" i2="1">
<s1>STEPHENS (David)</s1>
</fA11>
<fA11 i1="05" i2="1">
<s1>SULLIVAN (Sheena)</s1>
</fA11>
<fA11 i1="06" i2="1">
<s1>WEI LIU</s1>
</fA11>
<fA11 i1="07" i2="1">
<s1>YI CHEN</s1>
</fA11>
<fA11 i1="08" i2="1">
<s1>NGU (Doan)</s1>
</fA11>
<fA11 i1="09" i2="1">
<s1>DES JARLAIS (Don C.)</s1>
</fA11>
<fA14 i1="01">
<s1>Abt Associates Inc</s1>
<s2>Cambridge, MA</s2>
<s3>USA</s3>
<sZ>1 aut.</sZ>
</fA14>
<fA14 i1="02">
<s1>National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention</s1>
<s2>Beijing</s2>
<s3>CHN</s3>
<sZ>2 aut.</sZ>
<sZ>5 aut.</sZ>
</fA14>
<fA14 i1="03">
<s1>Health Policy Initiative</s1>
<s2>Hanoi</s2>
<s3>VNM</s3>
<sZ>3 aut.</sZ>
<sZ>4 aut.</sZ>
</fA14>
<fA14 i1="04">
<s1>Guangxi Center for HIV/AIDS Prevention and Control</s1>
<s2>Manning</s2>
<s3>CHN</s3>
<sZ>6 aut.</sZ>
<sZ>7 aut.</sZ>
</fA14>
<fA14 i1="05">
<s1>Consultant to Lang Son Provincial Health Service, Ho Chi Minh City</s1>
<s3>VNM</s3>
<sZ>8 aut.</sZ>
</fA14>
<fA14 i1="06">
<s1>Beth Israel Medical Center New York</s1>
<s2>NY</s2>
<s3>USA</s3>
<sZ>9 aut.</sZ>
</fA14>
<fA20>
<s1>137-145</s1>
</fA20>
<fA21>
<s1>2008</s1>
</fA21>
<fA23 i1="01">
<s0>ENG</s0>
</fA23>
<fA43 i1="01">
<s1>INIST</s1>
<s2>12616</s2>
<s5>354000183410820140</s5>
</fA43>
<fA44>
<s0>0000</s0>
<s1>© 2008 INIST-CNRS. All rights reserved.</s1>
</fA44>
<fA45>
<s0>45 ref.</s0>
</fA45>
<fA47 i1="01" i2="1">
<s0>08-0099532</s0>
</fA47>
<fA60>
<s1>P</s1>
</fA60>
<fA61>
<s0>A</s0>
</fA61>
<fA64 i1="01" i2="1">
<s0>Addiction : (Abingdon. Print)</s0>
</fA64>
<fA66 i1="01">
<s0>GBR</s0>
</fA66>
<fC01 i1="01" l="ENG">
<s0>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.</s0>
</fC01>
<fC02 i1="01" i2="X">
<s0>002B18C05A</s0>
</fC02>
<fC02 i1="02" i2="X">
<s0>002B03</s0>
</fC02>
<fC02 i1="03" i2="X">
<s0>002B30A11</s0>
</fC02>
<fC03 i1="01" i2="X" l="FRE">
<s0>Toxicomanie</s0>
<s5>01</s5>
</fC03>
<fC03 i1="01" i2="X" l="ENG">
<s0>Drug addiction</s0>
<s5>01</s5>
</fC03>
<fC03 i1="01" i2="X" l="SPA">
<s0>Toxicomanía</s0>
<s5>01</s5>
</fC03>
<fC03 i1="02" i2="X" l="FRE">
<s0>Aspect social</s0>
<s5>02</s5>
</fC03>
<fC03 i1="02" i2="X" l="ENG">
<s0>Social aspect</s0>
<s5>02</s5>
</fC03>
<fC03 i1="02" i2="X" l="SPA">
<s0>Aspecto social</s0>
<s5>02</s5>
</fC03>
<fC03 i1="03" i2="X" l="FRE">
<s0>Santé publique</s0>
<s5>03</s5>
</fC03>
<fC03 i1="03" i2="X" l="ENG">
<s0>Public health</s0>
<s5>03</s5>
</fC03>
<fC03 i1="03" i2="X" l="SPA">
<s0>Salud pública</s0>
<s5>03</s5>
</fC03>
<fC03 i1="04" i2="X" l="FRE">
<s0>Addiction</s0>
<s2>NM</s2>
<s5>04</s5>
</fC03>
<fC03 i1="04" i2="X" l="ENG">
<s0>Addiction</s0>
<s2>NM</s2>
<s5>04</s5>
</fC03>
<fC03 i1="04" i2="X" l="SPA">
<s0>Adicción</s0>
<s2>NM</s2>
<s5>04</s5>
</fC03>
<fC03 i1="05" i2="X" l="FRE">
<s0>Danger</s0>
<s5>05</s5>
</fC03>
<fC03 i1="05" i2="X" l="ENG">
<s0>Danger</s0>
<s5>05</s5>
</fC03>
<fC03 i1="05" i2="X" l="SPA">
<s0>Peligro</s0>
<s5>05</s5>
</fC03>
<fC03 i1="06" i2="X" l="FRE">
<s0>Réduction</s0>
<s5>06</s5>
</fC03>
<fC03 i1="06" i2="X" l="ENG">
<s0>Reduction</s0>
<s5>06</s5>
</fC03>
<fC03 i1="06" i2="X" l="SPA">
<s0>Reducción</s0>
<s5>06</s5>
</fC03>
<fC03 i1="07" i2="X" l="FRE">
<s0>Politique sanitaire</s0>
<s5>08</s5>
</fC03>
<fC03 i1="07" i2="X" l="ENG">
<s0>Health policy</s0>
<s5>08</s5>
</fC03>
<fC03 i1="07" i2="X" l="SPA">
<s0>Política sanitaria</s0>
<s5>08</s5>
</fC03>
<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>
</standard>
</inist>
</record>

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