HIV/AIDS and Drug Use in China—Interactions, Impacts, and Issues

Abstract

The interrelationships of HIV/AIDS and drug use and misuse result in complex problems that have been addressed by a variety of sociolegal approaches that often are in contrast to evidence-based medical practices proven effective in reducing associated harms. Like other countries struggling to reduce the incidence and consequences of addiction and HIV/AIDS, China is working to improve systems of care and to revise policies toward drug use and misuse and HIV/AIDS. Greater interaction with researchers and clinicians from around the world can foster increased awareness of effective practices and help implement effective strategies to deal with the problems of HIV/AIDS, and addiction.

Keywords :

• addiction
• HIV/AIDS
• drug use
• China
• methadone

THE AUTHORS

Min Zhao, M.D., Ph.D., is a Professor of Psychiatry and Vice President of Shanghai Mental Health Center at the Shanghai Jiao Tong University School of Medicine, Shanghai, China. She has been a clinician, teacher, and researcher in the drug abuse field for more than 15 years, and has written more than 80 publications and 20 book chapters. She has actively been participating in international collaborations during the past eight years. Her research interests include various topics related to drug abuse, including injecting drug users (IDUs) and the associated HIV risk behaviors involved in the spread of AIDS.

Walter Ling, M.D., is a Professor of Psychiatry and Director of Integrated Substance Abuse Programs (ISAP) at UCLA. He is Board-certified in neurology and psychiatry, and has been active in research and clinical work. His current research includes prescription opiate abuse and dependence, opiate-induced hyperalgesia, and the treatment of pain in opiate-maintained patients. As principal investigator of NIDA's (National Institute on Drug Abuse) Clinical Trial Network's Pacific Region Node, He has extended ISAP's research beyond the US, in collaboration with international researchers in China, Southeast Asia, and Australia.

Notes

¹ The journal's style utilizes the category substance abuse as a diagnostic category. Substances are used or misused; living organisms are and can be abused. Editor's note.

2 Treatment can be briefly and usefully defined as a planned, goal directed, temporally structured change process, of necessary quality, appropriateness and conditions (endogenous and exogenous), which is bounded (culture, place, time, etc.) and can be categorized into professional-based, tradition-based, mutual-help based (AA,NA, etc.) and self-help (“natural recovery”) models. There are no unique models or techniques used with substance users- of whatever types and heterogeneities- which aren't also used with non-substance users. In the West, with the relatively new ideology of “harm reduction” and the even newer Quality of Life (QOL) treatment-driven model there are now a new set of goals in addition to those derived from/associated with the older tradition of abstinence driven models. Treatment is implemented in a range of environments; ambulatory, within institutions which can include controlled environments Treatment includes a spectrum of clinician-caregiver-patient relationships representing various forms of decision-making traditions/models; (1). the hierarchical model in which the clinician-treatment agent makes the decision(s) and the recipient is compliant and relatively passive, (2) shared decision-making which facilitates the collaboration between clinician and patient(s) in which both are active, and (3) the ‘informed model’ in which the patient makes the decision(s). Editor's note.