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YUNNAN PROVINCE, China — PSI opened the first drop-in center in this province, considered the birthplace of HIV/AIDS in China, and is implementing outreach activities with injecting drug users (IDUs) in order to curb the escalating HIV rate, the highest in China. Since 1989, Yunnan has witnessed a rapid increase in the number of HIV cases due to needle/syringe sharing among injecting drug users and, by the mid 1990s, crossover into the general population through sexual transmission bolstered by a rampant sex trade across the borders of Myanmar, Laos and Vietnam. Yunnan has the highest number of IDUs in China with 30,000 IDUs officially reported by the Public Security Bureau. Unfortunately, a clear gap in HIV prevention service delivery exists especially in the private sector. Accessible, affordable and discreet services targeting high-risk populations are essentially non-existent beyond pilot sites. PSI/China-Yunnan, centered in Kunming, capital of Yunnan province, was established in May 2003 with funding from the U.S. Agency for International Development and the British Department for International Development. The project focuses on HIV/AIDS prevention and harm reduction activities for IDUs and in July 2003 established the province's first drop-in center of its kind. The objective of the drop-in center is to increase healthy behavior among current and former IDUs in Kunming, and help support them in a new drug-free life style. Core services in the drop-in center include peer education; multimedia information, education, communication programs; individual counseling; vocational training and self-help groups. Outreach activities target pre- and post-release inmates in the government detoxification centers and the high drug use neighborhoods around the center. PSI's service database and referral system ensure clients gain access to appropriate external services while maximizing cooperation with existing local support programs and other NGOs. PSI educators use a non-judgmental attitude to develop trust with the IDUs, thus laying the foundation for future outreach interventions. PSI/China staff members educate IDUs on HIV transmission and prevention, seek to increase personal risk perception, motivate healthy behaviors and help prevent them from relapsing into drug use. Since quality perception of risk-reducing products and services is low in China, PSI uses the brand Hu Xiang Hao or "Quality-Endorsed" for its drop-in center services and male and female condoms. Brochures and other informational material, posters and playing cards feature the Hu Xiang Hao logo and promote PSI's services as a means to improve one's quality of life with the slogan, "My choice, my health." Educators also reinforce the idea that you cannot tell if someone is HIV positive by looking at them, and otherwise seek to reduce stigma associated with HIV/AIDS. Chinese pop star Coco Lee is filming HIV/AIDS public service announcements for PSI, as well as video CDs which may be used in future outreach and peer education. Recently the drop-in center conducted a membership drive to establish
a flow of regular clients. There are now over 538 members, many of whom
volunteer their time in exchange for center privileges. To date the
center has received over 9600 clients, serviced by seven trained peer
educators and a case intake staff member. — Karrie Carnes, PSI/Washington
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