Limits...
Barriers and Potential Improvements for Needle and Syringe Exchange Programs (NSPs) in China: A Qualitative Study from Perspectives of Both Health and Public Security Sectors.

Koo FK, Chen X, Chow EP, Jing J, Zheng J, Zhao J, Zhang L - PLoS ONE (2015)

Bottom Line: Semi-Structured individual interviews were conducted in Mandarin to address three aspects of NSPs: (1) participants' attitudes towards NSPs, (2) participants' opinions on the effectiveness and barriers of NSPs, and (3) suggestions for improving the program.Both groups recognised the importance and effectiveness of NSPs in HIV prevention, but public security officials regarded NSPs as a temporary intervention in place of punitive measures.Close cooperation between the health and public security sectors, engagement of the drug user community and an enabling policy environment were reportedly to be critical for potential improvements of NSPs in China.

View Article: PubMed Central - PubMed

Affiliation: Sydney Nursing School, The University of Sydney, Sydney, NSW, Australia.

ABSTRACT
This study explores the acceptability, the barriers to the implementation of needle and syringe exchange programs (NSPs) and the potential improvement strategies in China from the perspectives of governmental health and public security officials. Purposive sampling was used for recruitment of participants who had been involved in NSPs implementation. Semi-Structured individual interviews were conducted in Mandarin to address three aspects of NSPs: (1) participants' attitudes towards NSPs, (2) participants' opinions on the effectiveness and barriers of NSPs, and (3) suggestions for improving the program. Content analysis was used to analyse the translated interview data. A total of 68 participants from 12 Hunan counties were interviewed (34 from each of the Bureau of Health and the Narcotic Division). Both groups recognised the importance and effectiveness of NSPs in HIV prevention, but public security officials regarded NSPs as a temporary intervention in place of punitive measures. Most health officials (32/34) regarded the main barriers to its implementation as administrative and structural, whereas participants from Narcotics Division (n=24) questioned the legitimacy of NSPs and concerned about the poor management of drug users' risk behaviours. Close cooperation between the health and public security sectors, engagement of the drug user community and an enabling policy environment were reportedly to be critical for potential improvements of NSPs in China. Misconceptions about NSPs encourage drug users' addictive behaviour, and an unclear leadership and insufficient support de-motivate the participants from the Bureau of Health and the Narcotics Division to actively support the program implementation.

No MeSH data available.


Related in: MedlinePlus

The distribution of study participants from ministries and health and public security in 12 counties of Hunan Province.
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4482722&req=5

pone.0130654.g001: The distribution of study participants from ministries and health and public security in 12 counties of Hunan Province.

Mentions: The study was conducted in 2008 in Hunan province, China. Hunan is located in South China, bordered by Guangdong and Guangxi provinces to the south and Guizhou province to the west. All three adjacent provinces are traditional drug-trafficking provinces with exceptionally high HIV prevalence levels among IDUs [24]. Hunan’s location has led to its role of channeling illicit drugs to other Chinese provinces [25]. Since 2003, the Hunan provincial Center for Disease Control and Prevention (CDC), Bureau of Health and Narcotics Division of Public Security (Narcotic Division) jointly implemented NSPs in 12 counties in Hunan Province. In order to explore the acceptability, the barriers and the attitudes from these two parties towards the current NSPs, purposive sampling was employed for this study to recruit participants who had been involved in its implementation. Strict criteria have been utilised in the recruitment process to facilitate diversity of feedback on NSPs. Sample recruitment was conducted from 34 participating NSP sites in the 12 Hunan counties (Fig 1). Potential participants who were full time staff and currently or previously working in the Bureau of Health and the Narcotic Division in Hunan were recruited for the interviews. Face-to-face individual interviews were conducted in Mandarin by well-trained interviewers from Hunan provincial CDC. Semi-structured interview questions were designed to address three aspects of NSPs: (1) participants’ attitudes towards NSPs; (2) participants’ opinions on the effectiveness and barriers of NSPs; and (3) suggestions for improving the program.


Barriers and Potential Improvements for Needle and Syringe Exchange Programs (NSPs) in China: A Qualitative Study from Perspectives of Both Health and Public Security Sectors.

Koo FK, Chen X, Chow EP, Jing J, Zheng J, Zhao J, Zhang L - PLoS ONE (2015)

The distribution of study participants from ministries and health and public security in 12 counties of Hunan Province.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4482722&req=5

pone.0130654.g001: The distribution of study participants from ministries and health and public security in 12 counties of Hunan Province.
Mentions: The study was conducted in 2008 in Hunan province, China. Hunan is located in South China, bordered by Guangdong and Guangxi provinces to the south and Guizhou province to the west. All three adjacent provinces are traditional drug-trafficking provinces with exceptionally high HIV prevalence levels among IDUs [24]. Hunan’s location has led to its role of channeling illicit drugs to other Chinese provinces [25]. Since 2003, the Hunan provincial Center for Disease Control and Prevention (CDC), Bureau of Health and Narcotics Division of Public Security (Narcotic Division) jointly implemented NSPs in 12 counties in Hunan Province. In order to explore the acceptability, the barriers and the attitudes from these two parties towards the current NSPs, purposive sampling was employed for this study to recruit participants who had been involved in its implementation. Strict criteria have been utilised in the recruitment process to facilitate diversity of feedback on NSPs. Sample recruitment was conducted from 34 participating NSP sites in the 12 Hunan counties (Fig 1). Potential participants who were full time staff and currently or previously working in the Bureau of Health and the Narcotic Division in Hunan were recruited for the interviews. Face-to-face individual interviews were conducted in Mandarin by well-trained interviewers from Hunan provincial CDC. Semi-structured interview questions were designed to address three aspects of NSPs: (1) participants’ attitudes towards NSPs; (2) participants’ opinions on the effectiveness and barriers of NSPs; and (3) suggestions for improving the program.

Bottom Line: Semi-Structured individual interviews were conducted in Mandarin to address three aspects of NSPs: (1) participants' attitudes towards NSPs, (2) participants' opinions on the effectiveness and barriers of NSPs, and (3) suggestions for improving the program.Both groups recognised the importance and effectiveness of NSPs in HIV prevention, but public security officials regarded NSPs as a temporary intervention in place of punitive measures.Close cooperation between the health and public security sectors, engagement of the drug user community and an enabling policy environment were reportedly to be critical for potential improvements of NSPs in China.

View Article: PubMed Central - PubMed

Affiliation: Sydney Nursing School, The University of Sydney, Sydney, NSW, Australia.

ABSTRACT
This study explores the acceptability, the barriers to the implementation of needle and syringe exchange programs (NSPs) and the potential improvement strategies in China from the perspectives of governmental health and public security officials. Purposive sampling was used for recruitment of participants who had been involved in NSPs implementation. Semi-Structured individual interviews were conducted in Mandarin to address three aspects of NSPs: (1) participants' attitudes towards NSPs, (2) participants' opinions on the effectiveness and barriers of NSPs, and (3) suggestions for improving the program. Content analysis was used to analyse the translated interview data. A total of 68 participants from 12 Hunan counties were interviewed (34 from each of the Bureau of Health and the Narcotic Division). Both groups recognised the importance and effectiveness of NSPs in HIV prevention, but public security officials regarded NSPs as a temporary intervention in place of punitive measures. Most health officials (32/34) regarded the main barriers to its implementation as administrative and structural, whereas participants from Narcotics Division (n=24) questioned the legitimacy of NSPs and concerned about the poor management of drug users' risk behaviours. Close cooperation between the health and public security sectors, engagement of the drug user community and an enabling policy environment were reportedly to be critical for potential improvements of NSPs in China. Misconceptions about NSPs encourage drug users' addictive behaviour, and an unclear leadership and insufficient support de-motivate the participants from the Bureau of Health and the Narcotics Division to actively support the program implementation.

No MeSH data available.


Related in: MedlinePlus