Long-term follow-up of community-based drug and HIV prevention intervention in Yunnan, China.

摘要

In 1997, village leaders of Longchuan County in Yunnan Province (Southwest China) implemented a drug prevention program that included HIV/AIDS workshops, video showings, entertainment, agricultural assistance, and poverty alleviation strategies. This intervention was enacted in response to the high prevalence of drug use and growing prevalence of HIV/AIDS in the area. The villages that implemented the intervention had a 2.7 fold greater decrease in incidence of new drug users compared to control villages. The greatest reductions were observed in the youngest age groups, among single individuals, among Jingpo minority people, and among illiterate and semiliterate individuals, the groups most at risk for initiating drug use.;This project assessed the long-term effect of this community-based intervention using qualitative and quantitative methods. Thirty in-depth interviews were conducted with key leaders in the community in May 2007. Data from these interviews showed that prevention programs, such as educational programs and the cultural activity room, still remain after ten years. The knowledge and motivation that was developed by the 1997 intervention also prompted villagers to develop Village Protection Teams, which have been effective at keeping the number of drug users in the community low. Strict government enforcement of anti-narcotics laws has also increased in recent years, but without constant sustained action was not effective. Combined, community-based prevention programs combined with law enforcement may help create an effective long-term strategy against the drug problems in the community.;In June 2008, males and females aged 15 to 39 from the originally participating villages were invited to participate in a cross-sectional questionnaire assessing current knowledge, attitudes, and behaviors concerning HIV/AIDS and drug use (n=883). Data from the questionnaire showed that being Jingpo, being illiterate, smoking, drinking alcohol, and having pre/extra-martial sex remain strongly associated with drug initiation among males. Drug use among females remains low. Though knowledge about HIV/AIDS was significantly higher in intervention villages, there was no significant difference detected in HIV infections, AIDS deaths, or attitudes about drugs and HIV infections between control and intervention villages. Continued focus is needed for community-based program to continue to improve knowledge, attitudes, and behaviors concerning drugs and HIV/AIDS in Longchuan.