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Crossing Over: Drug Network Characteristics and Injection Risk Along the China–Myanmar Border

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Abstract

Border areas are important locations for understanding HIV transmission. This study examines individual and network correlates of border crossing and equipment sharing among methadone maintenance clients in Ruili City, a Chinese city on the Myanmar border. Data are from 298 clients enrolled in the Ruili Methadone Treatment Center. Clients were interviewed about drug use, HIV/AIDS knowledge, treatment motivation, and their social networks. Multinomial and logistic regression analysis were performed. Thirty percent of clients reported injecting in Myanmar. Compared to drug networks that usually inject in China, networks that inject equally in both places (border crossing) are more likely to share equipment. The association between HIV positive status and border-crossing was marginally significant and robust. Results indicate some added degree of risk among clients and drug networks who border-cross to use drugs. More research is needed to understand this phenomenon.

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References

  1. UNAIDS. AIDS Epidemic Update 2009: Asia fact sheet. Geneva: Joint United Nations Programme on HIV/AIDS; 2009.

  2. Beyrer C, Razak MH, Lisam K, Chen J, Lui W, Yu XF. Overland heroin trafficking routes and HIV-1 spread in South and South-East Asia. AIDS. 2000;14(1):75–83.

    Article  PubMed  CAS  Google Scholar 

  3. Beyrer C. HIV/AIDS: HIV epidemiology update and transmission factors: Risks and risk contexts—16th international AIDS conference epidemiology plenary. Clin Infect Dis. 2007;44(7):981–7.

    Article  PubMed  Google Scholar 

  4. UNESCO. HIV/AIDS in the GMS: a cross-border problem. Bulletin for prevention education in the greater Mekong subregion, Issue 1, 1–3. Thailand: HIV/AIDS Clearing House of the UNESCO Asia and Pacific Regional Bureau for Education; 2004.

  5. du Guerny J, Hsu L-N, Hong C. Population movement and HIV/AIDS: the case of Ruili, Yunnan, China. UNDP Southeast Asia HIV and Development Programme; August 2003

  6. Strathdee SA, Lozada R, Ojeda VD, Pollini RA, Brouwer KC, Vera A, et al. Differential effects of migration and deportation on HIV infection among male and female injection drug users in Tijuana, Mexico. PLoS One. 2008;3(7):e2690.

    Article  PubMed  Google Scholar 

  7. Beesey A. HIV vulnerability and mobile populations: Thailand and its borders. Dev Bull. 2000;52(52):38–41.

    PubMed  Google Scholar 

  8. Zhao C, Liu Z, Zhao D, Liu Y, Liang J, Tang Y, et al. Drug abuse in China. Ann N Y Acad Sci. 2004;1025:439–45.

    Article  PubMed  Google Scholar 

  9. Zheng X, Tian C, Choi K-H, et al. Injecting drug use and HIV infection in southwest China. AIDS. 1994;8:1141–7.

    Article  PubMed  CAS  Google Scholar 

  10. Xia M, Kreiss JK, Holmes KK. Risk factors for HIV infection among drug users in Yunnan province, China: association with intravenous drug use and protective effect of boiling reusable needles and syringes. AIDS. 1994;8:1701–6.

    Article  PubMed  CAS  Google Scholar 

  11. Yu ESH, Xie Q, Zhang K, et al. HIV infection and AIDS in China, 1985 through 1994. Am J Public Health. 1996;86:1116–22.

    Article  PubMed  CAS  Google Scholar 

  12. Ministry of Health, P. R. China and UN Theme Group on HIV/AIDS in China. China responds to AIDS: HIV/AIDS situation and needs assessment report. Beijing: Chinese Ministry of Health, November 1997.

  13. Zheng X, Tian C, Choi KH, Zhang J, Cheng H, Yang X, et al. Injecting drug use and HIV infection in Southwest China. AIDS. 1994;8(8):1141–7.

    Article  PubMed  CAS  Google Scholar 

  14. Chu TX, Levy JA. Injection drug use and HIV/AIDS transmission in China. Cell Res. 2005;15(11–12):865–9.

    Article  PubMed  Google Scholar 

  15. Chantavanich S. Preventing HIV/AIDS among mobile populations in the greater Mekong subregion, Asian Development Bank, the United Nations Development Program; 2000.

  16. Zheng XW, Zhang JP, Tian CQ, Cheng HH, Yang XZ, Duan S, et al. Cohort study of HIV infection among drug users in Ruili, Longchuan and Luxi of Yunnan Province, China. Biomed Environ Sci. 1993;6(4):348–51.

    PubMed  CAS  Google Scholar 

  17. Yu XF, Chen J, Shao Y, Beyrer C, Liu B, Wang Z, et al. Emerging HIV infections with distinct subtypes of HIV-1 infection among injection drug users from geographically separate locations in Guangxi Province, China. J Acquir Immune Defic Syndr. 1999;22(2):180–8.

    Article  PubMed  CAS  Google Scholar 

  18. Xiao Y, Kristensen S, Sun J, Lu L, Vermund SH. Expansion of HIV/AIDS in China: lessons from Yunnan Province. Soc Sci Med. 2007;64(3):665–75.

    Article  PubMed  Google Scholar 

  19. Wu Z, Sullivan SG, Wang Y, Rotheram-Borus MJ, Detels R. Evolution of China’s response to HIV/AIDS. Lancet. 2007;369(9562):679–90.

    Article  PubMed  Google Scholar 

  20. Des Jarlais DC, Johnston P, Friedmann P, Kling R, Liu W, Ngu D, et al. Patterns of HIV prevalence among injecting drug users in the cross-border area of Lang Son Province, Vietnam, and Ning Ming County, Guangxi Province, China. BMC Public Health. 2005;5:89.

    Article  PubMed  Google Scholar 

  21. Hammett TM, Johnston P, Kling R, Liu W, Ngu D, Tung ND, et al. Correlates of HIV status among injection drug users in a border region of Southern China and Northern Vietnam. J Acquir Immune Defic Syndr. 2005;38(2):228–35.

    Article  PubMed  Google Scholar 

  22. Hammett TM, Kling R, Johnston P, Liu W, Ngu D, Friedmann P, et al. Patterns of HIV prevalence and HIV risk behaviors among injection drug users prior to and 24 months following implementation of cross-border HIV prevention interventions in northern Vietnam and southern China. AIDS Educ Prev. 2006;18(2):97–115.

    Article  PubMed  Google Scholar 

  23. Bergenstrom A, Htoon YS, Sharma M, Garg R, Macdonald V, Awng H, Buhler M, Gang S. Myanmar country advocacy brief injecting drug use and HIV. A joint publication by United Nations Regional Task Force on injecting drug use and HIV/AIDS for Asia and the Pacific and HIV/AIDS Asia Regional Program, 2010.

  24. De P, Cox J, Boivin J-F, Platt RW, Jolly AM. The importance of social networks in their association to drug equipment sharing among injection drug users: a review. Addiction. 2007;102(11):1730–9.

    Article  PubMed  Google Scholar 

  25. Williams CT, Latkin CA. Neighborhood socio-economic status, personal networks, and adult heroin and cocaine use. Am J Prev Med. 2007;32(6S):S203–10.

    Article  PubMed  Google Scholar 

  26. Williams CT, Metzger D. Race and distance effects on regular syringe exchange program use and other injection risks: a geo-behavioral analysis. Am J Public Health. (in press)

  27. Latkin C, Mandell W, Vlahov D, Oziemkowska M, Celentano D. People and places: behavioral settings and personal network characteristics as correlates of needle sharing. J Acquir Immune Defic Syndr Hum Retrovirol. 1996;13:273–80.

    Article  PubMed  CAS  Google Scholar 

  28. Rothenberg RB, Potterat JJ, Woodhouse DE, Muth SQ, Darrow WW, Klovdahl AS. Social network dynamics and HIV transmission. AIDS. 1998;12:1529–36.

    Article  PubMed  CAS  Google Scholar 

  29. Loftus E, Smith K, Klinger M, Fiedler J. Memory and mismemory for health events. In: Tanur JM, editor. Questions about questions: Inquiries into the cognitive bases of surveys. New York: Russell Sage Foundation; 1991. p. 102–37.

    Google Scholar 

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Acknowledgements

This study was conducted through a dissertation award to W. Liu by the AIDS International Training and Research Program at UIC through funding from the Fogarty International Center, NIH (D43TW001419-09). The Ruili CDC under the leadership of Dr. Li Zhoulin and the Mayor’s office of the City of Ruili also contributed support.

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Authors and Affiliations

  1. Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, 1603 W Taylor St M/C 923, Chicago, IL, 60612, USA

    Chyvette T. Williams

  2. Division of Health Policy and Administration, University of Illinois at Chicago, Chicago, IL, USA

    Wei Liu & Judith A. Levy

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  1. Chyvette T. Williams
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  2. Wei Liu
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  3. Judith A. Levy
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Correspondence to Chyvette T. Williams.

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Williams, C.T., Liu, W. & Levy, J.A. Crossing Over: Drug Network Characteristics and Injection Risk Along the China–Myanmar Border. AIDS Behav 15, 1011–1016 (2011). https://doi.org/10.1007/s10461-010-9764-2

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