Illegal Drug Trade, Focus on Enforcement Promotes Spread of HIV Worldwide, Expert Says

The illegal drug trade has promoted the spread of HIV in many parts of the world, and "excessive reliance on drug enforcement" has reduced the effectiveness of efforts to prevent the spread of the disease, Alex Wodak, an Australian physician, said Tuesday at the XVI International AIDS Conference in Toronto, CP/CBC News reports. According to Wodak -- who directs the Alcohol and Drug Service at St. Vincent's Hospital in Sydney, Australia -- 10% of new HIV cases worldwide occur among injection drug users, and about 30% of new HIV cases outside of Africa occur among IDUs. He added that the "proportion of global HIV infections attributable to injection drug use are growing." Experts for the past 15 years have known that education of IDUs, provision of clean needles, removal of "dirty equipment" from circulation and provision of methadone for heroin addicts can help prevent the spread of HIV, Wodak said. However, he said that a focus on drug enforcement and opposition to some harm reduction programs from the U.S. "prevents these pragmatic approaches being spread throughout the world." Wodak added that the rate of new HIV cases among IDUs has reached "alarming proportions" in areas such as central and eastern Europe and central Asia (Ubelacker, CP/CBC News, 8/15).

IDUs' Access to Treatment
Although IDUs make up a considerable percentage of the population living with HIV in some countries, most do not have access to treatment, in part because of stigma and discrimination, conference attendees said Wednesday, AFP/Channel News Asia reports. According to a report from the Open Society Institute, IDUs in Eastern Europe and Central Asia comprise more than 70% of HIV cases but just 24% of the people who are receiving antiretrovirals, AFP/Channel News Asia reports. In Russia, 80% of the country's estimated 940,000 HIV cases are among IDUs, Kasia Malinowska-Sempruch of OSI said. Adeeba Kamarulzaman, president of the Malaysian AIDS Council, said that IDUs represent 75% of HIV cases in the country, but only 12% of them are receiving antiretrovirals. The report calls on physicians to overcome the stigma and discrimination surrounding treatment of IDUs. Malinowska-Sempruch said, "Governments tell drug users to act responsibly and not to infect others, but the clinics shut the doors in the faces of those seeking to care of themselves. ... The message sent is that some people with HIV are good and pure, and others deserve to die." UNAIDS Executive Director Peter Piot said, "Outside of Africa, nearly one in three HIV infections comes from injecting drugs with contaminated equipment, yet in many countries, drug users are not able to access HIV treatment," adding, "Some 20 years of research and experience confirm that HIV epidemics among inject[ion] drug users can be prevented, stabilized and even reversed using a comprehensive package of HIV treatment and prevention activities" (AFP/Channel News Asia, 8/16).

Kaisernetwork.org is serving as the official webcaster of the conference. View the guide to coverage and all webcasts, interviews and a daily video round up of conference highlights at www.kaisernetwork.org/aids2006.

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