title: Integrated respondent-driven sampling and peer support for persons who inject drugs in Haiphong, Vietnam: a case study with implications for interventions.
abstract: Combined prevention for HIV among persons who inject drugs (PWID) has led to greatly reduced HIV transmission among PWID in many high-income settings, but these successes have not yet been replicated in resource-limited settings. Haiphong, Vietnam experienced a large HIV epidemic among PWID, with 68% prevalence in 2006. Haiphong has implemented needle/syringe programs, methadone maintenance treatment (MMT), and anti-retroviral treatment (ART), but there is an urgent need to identify high-risk PWID and link them to services. We examined integration of respondent-driven sampling (RDS) and strong peer support groups as a mechanism for identifying high-risk PWID and linking them to services. The peer support staff performed the key tasks that required building and maintaining trust with the participants, including recruiting the RDS seeds, greeting and registering participants at the research site, taking electronic copies of participant fingerprints (to prevent multiple participation in the study), and conducting urinalyses. A 6-month cohort study with 250 participants followed the RDS cross-sectional study. The peer support staff maintained contact with these participants, tracking them if they missed appointments, and providing assistance in accessing methadone and ART. The RDS recruitment was quite rapid, with 603 participants recruited in three weeks. HIV prevalence was 25%, Hepatitis C (HCV) prevalence 67%, and participants reported an average of 2.7 heroin injections per day. Retention in the cohort study was high, with 86% of participants re-interviewed at 6-month follow-up. Assistance in accessing services led to half of the participants in need of methadone enrolled in methadone clinics, and half of HIV-positive participants in need of ART enrolled in HIV clinics by the 6-month follow-up. This study suggests that integrating large-scale RDS and strong peer support may provide a method for rapidly linking high-risk PWID to combined prevention and care, and greatly reducing HIV transmission among PWID in resource-limited settings.
authors.affiliation: a The Baron Edmond de Rothschild Chemical Dependency Institute, Icahn School of Medicine at Mount Sinai , New York , NY , USA.
authors.forename: Don
authors.initials: D
authors.lastname: Des Jarlais
authors.affiliation: b Hai Phong University of Medicine and Pharmacy , Hai Phong , Vietnam.
authors.forename: Huong Thi
authors.initials: HT
authors.lastname: Duong
authors.affiliation: b Hai Phong University of Medicine and Pharmacy , Hai Phong , Vietnam.
authors.forename: Khue
authors.initials: K
authors.lastname: Pham Minh
authors.affiliation: c Supporting Community Development Initiatives , Hanoi , Vietnam.
authors.forename: Oanh Hai Thi
authors.initials: OH
authors.lastname: Khuat
authors.affiliation: c Supporting Community Development Initiatives , Hanoi , Vietnam.
authors.forename: Thanh Tuyet Thi
authors.initials: TT
authors.lastname: Nham
authors.affiliation: a The Baron Edmond de Rothschild Chemical Dependency Institute, Icahn School of Medicine at Mount Sinai , New York , NY , USA.
authors.forename: Kamyar
authors.initials: K
authors.lastname: Arasteh
authors.affiliation: a The Baron Edmond de Rothschild Chemical Dependency Institute, Icahn School of Medicine at Mount Sinai , New York , NY , USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Feelemyer
authors.affiliation: d Department of Sociology , Cornell University , Ithaca , NY , USA.
authors.forename: Douglas D
authors.initials: DD
authors.lastname: Heckathorn
authors.affiliation: e Inserm U1058, Etablissement Français du Sang , University of Montpellier , Montpellier , France.
authors.forename: Marianne
authors.initials: M
authors.lastname: Peries
authors.affiliation: e Inserm U1058, Etablissement Français du Sang , University of Montpellier , Montpellier , France.
authors.forename: Jean Pierre
authors.initials: JP
authors.lastname: Moles
authors.affiliation: e Inserm U1058, Etablissement Français du Sang , University of Montpellier , Montpellier , France.|f Infectious Diseases Department , Caremeau University Hospital , Nîmes , France.
authors.forename: Didier
authors.initials: D
authors.lastname: Laureillard
authors.affiliation: e Inserm U1058, Etablissement Français du Sang , University of Montpellier , Montpellier , France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Nagot
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology* / Q000517:prevention & control; D006297:Health Services Accessibility; D006526:Hepatitis C / Q000453:epidemiology; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use; D008875:Middle Aged; D058850:Opiate Substitution Treatment; D010342:Patient Acceptance of Health Care; D018579:Patient Selection; D010379:Peer Group; D015995:Prevalence; D012944:Social Support; D015819:Substance Abuse, Intravenous / Q000534:rehabilitation*; D011795:Surveys and Questionnaires; D014744:Vietnam / Q000453:epidemiology
chemical_list: D019380:Anti-HIV Agents; D008691:Methadone
keywords: HIV; PWID; RDS; Vietnam