Access to clean needles, condoms and counseling allows injection drug users to "stop HIV, look after their health and lead productive lives," Michel Sidibe, executive director of UNAIDS, writes in a Bangkok Post opinion piece. "Thanks to many ... centers worldwide, new HIV infections among drug users are being stopped," he adds. However, "for a majority of policymakers in national drug programs, the term 'harm reduction' invokes silence and controversy," Sidibe writes, adding that there are nearly 16 million IDUs worldwide, three million of whom are estimated to be living with HIV. He adds, "Silence on harm reduction therefore is not an option," and "drug control and HIV programs must work together."
Sidibe writes that these harm reduction programs must be "informed by evidence and grounded in human rights." He continues that many countries still do not provide IDUs with access to harm reduction programs, which "is killing people as much as the drugs themselves." He notes that the most "cost-effective means of reducing HIV-related risk behaviors" include access to clean needles, "opioid substitution therapies and community-based outreach," which prevent the spread of HIV as well as hepatitis and other bloodborne diseases.
According to Sidibe, reaching universal access targets for 2010 will allow nearly 10 million IDUs to access "life-saving harm reduction programs worldwide." He adds that there is no evidence that harm reduction services have led to an increased number of IDUs or that IDUs increase drug use or continue to use them longer because of the programs. He continues, "When law enforcement and public health efforts come together, the outcomes are very successful." Sidibe writes that countries "need to get rid of drug laws that block response to AIDS and drug use," adding that accessing clean needles and substitution therapy should not be illegal. He concludes, "HIV and injecting drug use are two epidemics but need a combined strategy," adding, "We cannot leave it to the next generation to reconcile the separate approaches to HIV and drug control" (Sidibe, Bangkok Post, 4/20).
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