A community approach to promote healthcare services for people living with HIV who use drugs in Vietnam.

BACKGROUND: People living with HIV who use drugs (PLHWUD) face enormous challenges to access antiretroviral therapy (ART), addiction treatment, and other healthcare services. This study evaluated the effect of a community capacity-building approach on PLHWUD's access to healthcare services. METHODS: A cluster randomized controlled trial was conducted in four provinces of Vietnam. Trained commune health workers in the intervention condition were encouraged to provide services to PLHWUD in the community and engage them in HIV/addiction treatment and care using learned knowledge and skills. A total of 241 PLHWUD participated in surveys at the baseline and every three months for one year. The primary outcome was PLHWUD's reported barriers to seeking healthcare. A linear mixed-effects regression model with a difference in difference approach was used to estimate the intervention effect on the primary outcome. RESULTS: Adjusted analyses indicated that significant intervention effects were observed at the Sixth and ninth month follow-ups for those on ART at the baseline and increased motivation to engage in treatment at the 3-month follow-up (60.2% vs 34.4% for the intervention and control groups, respectively). CONCLUSIONS: The community capacity-building intervention had shown promising yet limited outcomes among a subset of PLHWUD in the community, that is, PLHWUD who had already initiated ART.

Correlates of HIV-infection among men who have sex with men: results from a community-based, cross-sectional study in Tianjin, China.

China has 747,000 confirmed HIV/AIDS cases and sexual transmission between men who have sex with men (MSM) is the most prevalent mode of transmission. Our study aims to (a) examine HIV prevalence and behavioral risk factors for HIV infection among 1900 MSM recruited from a community-based organization in Tianjin, China, and (b) describe HIV treatment outcomes for those diagnosed with HIV. We used multivariable logistic regression to identify which socio-demographics and behaviors were associated with HIV infection. The overall HIV prevalence was 3.95%. Key behavioral risk factors included: receptive sex role, older age at first sex with man, condomless anal sex, and having used 2+ drugs. Of those living with HIV, 83% were successfully enrolled in antiretroviral therapy and those enrolled were all virally suppressed after one year. These findings highlight key behavioral risk factors for HIV infection in Tianjin, China and can inform interventions to preventing further HIV transmission.

[Survey on behaviors of health in poverty area from the mid-west four provinces of China].

OBJECTIVE: To understand ways of life among poverty-stricken farmers from western areas of China. METHODS: Questionnaires on ways of life were designed, using cluster random sampling method to study 5516 rural residents, aged 15 - 69, from 84 administrative villages, 42 project townships and 16 project counties in Shanxi and Gansu, Qinghai, Xinjiang provinces. RESULTS: 5343 valid questionnaires included 2178 males and 3165 females, with the average age as 43.4 years old. 2965 people were with minority ethnicities and another 2378 were Hans. Most of the respondents had received junior high school (37.7%) or primary school (32.1%) education with 62.1% of the respondents working in the agricultural areas. The overall smoking rate among them was 22.4%. The rates of smoking in males in Qinghai and Shanxi provinces were obviously higher than those in other provinces, with the highest seen in Shanxi. The overall rate of alcohol intake was 13.9%, and the highest seen in Shanxi and Qinghai. The alcohol intake in males was higher in Shanxi and Qinghai, than in other provinces while in female it was significantly lower in Shanxi than in the other three provinces. The health related habits were different in the four provinces, including the amount of weekly intake of milk or dairy products, fresh vegetables, bean products, animal viscera, fried food, pickled or smoked food products and livestock meat, with statistically significant differences. CONCLUSION: Life styles of farmers living in the poverty-stricken areas in Gansu, Qinghai, Shanxi and Xinjiang were different. Strategies related to the real situation on each province need to be developed which would include effective health education and with the aid of '12320 hotline services' to help the residents build up a healthy lifestyle.