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Peer-based behavioral health program for drug users in China: a pilot study

Song-Ying Shen1, Zhou-Bin Zhang2, Joseph D Tucker3, Helena Chang4, Guan-Rong Zhang1 and Ai-Hua Lin1*

Author Affiliations

1 Department of Medical Statistics and Epidemiology, School of Public Health, Sun-Yat-sen University, Guangzhou, PR China

2 Guangzhou Center for Disease Control and Prevention, Guangzhou, PR China

3 Infectious Disease Unit, Massachusetts General Hospital, Boston, MA, USA

4 School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA

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BMC Public Health 2011, 11:693  doi:10.1186/1471-2458-11-693

Published: 7 September 2011



Many injection drug users (IDUs) in China have high risk sexual behaviors that contribute to the spread of HIV infection. Although many IDUs in China move through drug rehabilitation centers, this opportunity for sexual health education has largely been overlooked.


A convenience sample of 667 drug users from two rehabilitation centers in South China was recruited in the study. Two hundred and forty seven drug users from a single Guangdong Province rehabilitation center received the peer-based education intervention, while 420 drug users from another rehabilitation center received routine HIV/STI education and was used as the control. One hundred and eighty nine (22.1%) individuals refused to participate in the study. HIV/STI behavioral and knowledge domains were assessed at 3 months in rehabilitation centers after the intervention (first follow-up) and at 2-23 months in the community after release (second follow-up).


Drug users who completed the intervention reported more frequent condom use with casual sex partners (60.0% vs. 12.5% condom use every time, p = 0.011) and less frequent injection (56.7% vs. 26.4% no injection per day, p = 0.008) at the second follow-up compared to those in the routine education group. Loss to follow up was substantial in both control and intervention groups, and was associated with living far from the detention center and having poor HIV knowledge at baseline.


This study shows that rehabilitation centers may be a useful location for providing behavioral HIV/STI prevention services and referral of individuals to community-based programs upon release. More research is needed on behalf of detained drug users in China who have complex social, medical, and legal needs.