AEGiS-15IAC: [LbOrC18] INVOLVING PEER EDUCATORS IN HARM REDUCTION: WORKING WITH DRUG USERS IN XICHANG, CHINA

15th International AIDS Conference

Bangkok, Thailand — July 11-July 16, 2004

[LbOrC18] INVOLVING PEER EDUCATORS IN HARM REDUCTION: WORKING WITH DRUG USERS IN XICHANG, CHINA

Int Conf AIDS. 2004 Jul 11-16;15:Abstract No. LbOrC18

L L Zhang¹, C Li²
¹China-UK HIV/AIDS Prevention and Care Project, Chengdu, China; ²Xichang CDC, Xichang, China

ISSUES: Injecting drug users in China are marginalised by discrimination and criminality. Harm reduction approaches are new and yet to gain widespread credibility with authorities, communities and drug users' families. To initiate a community-based peer education process promoting safer injecting, needle exchange and condom use it was necessary to secure the support of other stakeholders. Peer educators had a comparative advantage in reaching IDUs but also required intensive support.

DESCRIPTION: This paper analyses the experience and outcomes of a pilot peer education intervention with injecting drug users in Xichang, Sichuan Province. Xichang is situated on a drug trafficking route from the Golden Triangle into China and has a concentration of heroin users. Needle sharing is common among local IDUs. Ninety per cent of female drug users sell sex. Drug use is a serious criminal offence in China and IDUs are often sentenced to compulsory detoxification or re-education through labour. Before equipping peer educators with needle exchange boxes and supplies of clean injecting equipment it was necessary for to negotiate with the police and issue ID cards to prevent problems with police. Drug users' families were initially hostile. Much time was spent to gain their trust and understanding. As well as careful selection and training, peer educators were supported with one-to-one mentoring by project staff. Needle-sharing and unprotected sex reduced over 12 months.

LESSONS LEARNED: One to one mentoring of peer educators by project staff was labour intensive but rewarding; securing understanding of police and families is essential; the lack of other services for drug users was a constraint.

RECOMMENDATIONS: Peer education among drug users requires intensive support. In China advocacy around harm reduction is necessary. There is a need for other interventions, especially voluntary detoxification and methadone maintenance, alongside needle exchange. Methadone maintenance began in this area as a pilot in early 2004.

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