HIV RISK BEHAVIORS BUT ABSENCE OF INFECTION AMONG DRUG-USERS IN DETOXIFICATION CENTERS OUTSIDE YUNNAN PROVINCE, CHINA, 1993

Objectives: To date, HIV spread in China has occurred principally amon g injecting drug users (IDU) in remote border regions of Yunnan provin ce. We therefore sought to better understand the risks for and prevale nce of HIV infection among drug users in parts of China outside Yunnan province. Methods: A behavioral survey of drug use and AIDS-related k nowledge was conducted among all consenting drug users who entered tre atment from 1 November to 31 December 1993 in seven provincial drug de toxification centers outside Yunnan province. After giving verbal info rmed consent, all drug users were tested for HIV. Results: Of the 1293 study participants, 207 (16%) reported injecting drugs. The proportio n of IDU among all drug users varied widely by region, from 1% in Sha' anxi and Gansu provinces in the northwest region to 58% in Guangxi pro vince in the south. IDU were more likely than non-IDU to be single and unemployed or self-employed, but did not differ in other demographic aspects. Among all drug users, 2% reported sharing needles without cle aning equipment, while 5% shared with some cleaning. Although 1060 (82 %) drug users had heard of AIDS and most knew about its sexual (79%), parenteral (77%), and perinatal (60%) modes of transmission, many had misconceptions about its spread by casual contact. Of the 207 IDU test ed for HIV, none were HIV-positive (95% confidence interval, 0-1.4). C onclusion: The absence of HIV infections detected in this study sugges ts that the prevalence of HIV is currently low among IDU in China outs ide Yunnan province. However, the behavior of these IDU puts them at h igh risk for HIV infection. Prevention efforts are needed to prevent t he spread of HIV among IDU throughout China and to avoid the experienc e of neighboring countries in Asia.