Jamra primary scholl for children affected by HIV/AIDS, drugs or poverty, Senegal (c) Nell Freeman/Alliance Participants in the Photovioce project, Ecuador © Marcela Nievas for the Alliance
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Drug users leading the HIV response in China


Reading HIV info at a Chinese support centre © Kevin Sare/Alliance

Intravenous drug users constitute the single largest population group vulnerable to HIV infection in China. The Five Hearts Service Centre in Emei, Sichuan, China is a group of injecting drug users who work with the Chinese Government’s Centre for Disease Control and Prevention (CDC) to run a needle exchange programme.

The project is a model for involving drug users in HIV prevention programmes largely due to the CDC’s openness to trying new ways to slow the spread of HIV in China.

The programme capitalises on both the community members’ networks and know-how to reach other IDUs and the CDC’s networks and know-how to deliver health services.

The project demonstrates that drug users can play a vital role in the response to HIV. It also shows how a community programme can help to build the package of essential services that are required to stop HIV and reduce the harm associated with drug use. It also demonstrates that civil society and government programmes can complement each other and improve the HIV response.  

From hell to hope

Huang Yaping is 42 years old member of Five Hearts in Emei. He shares his journey of moving from being an injecting drug user to providing peer support to other people who use drugs.

“I used to be an attendant at the Emeishan Hotel but became unemployed in 1999 when the hotel owner changed. It was while I was jobless that I was offered heroin and became a drug user.

‘Heroin is a luxury’ my friends said. ‘It is only for the rich, successful people who have got a taste for it. Men in the street can’t even have a sniff of it.’

“I accepted their offer because I did not have much knowledge about the harm of narcotics or consequences of drug use. Chinese people believe that it is impolite not to reciprocate gifts so I offered drugs to my friends. As I used the drugs more and more frequently I became addicted without knowing what I was doing.

“Between 2001 and 2003 I spent more than half my savings on drugs. My family and friends left me. My health was deteriorating and I lost a lot of weight.

“My daughter couldn’t bear to see me suffer from heroin so forced me to move to my mother-in-laws home for a while. I managed to free myself from the control of heroin but when I returned to Emei I couldn’t resist my friends’ temptation and I relapsed. I shuffled between drug using and rehabilitation.

Community support

“In 2006 I heard about Five Hearts Drop-In Centre (5HDC) from my drug-using friends. Out of curiosity I went to the Centre for help. For the first time I got to know that 5HDC was a local organisation for injecting drug users and HIV and AIDS prevention run by the Alliance and the Sichuan STD/HIV Association.

“The centre provides needle exchange, condom promotion and knowledge for us IDUs. Through peer education the Centre runs various behaviour change programmes to reduce drug use harm at an individual, family and community level. I was excited to know that such an organisation existed to serve IDU communities.

“From then on I looked at the Centre as a haven. I would go there whenever I had a problem. I learned the importance of clean needles, first aid for overdosing, STD/HIV prevention, correct condom use and various ‘dos’ and don’ts.

Empowered to act

“Slowly, I realised that I should share my knowledge and pass it to my peers. In 2007 I had the honour of becoming a peer educator at the 5HDC and began providing needle exchange services.

“I told people about the harm contaminated needles can do and the importance of using clean needles every time. I also used my first aid skills to provide my peers with practical support.

“With help from 5HDC I changed from a person ignorant of HIV to a volunteer who passes on all kinds of knowledge to my peers. From being a burden on society I have become someone who plays their role in society. I thank 5HDC and the Alliance for saving me from life’s darkness. I will use my knowledge to help more drug users in the future.”

    I was excited to know that such an organisation existed to serve IDU communities