National HIV Prevention Conference Atlanta, Georgia, USA — August 29- September 1, 1999

Natl HIV Prev Conf 1999 Aug 29-Sep 1:(abstract no. 741)
Kumar SM, Mudaliar S, Daniels D
1 SAHAI Trust, Madras, India.

ISSUE: Injecting drug use is escalating in South Asia and HIV infection reported among drug users from most countries in the region. In some parts of South Asia a rapid spread of HIV infection has occurred among drug using populations within a short period of time. In this region, transition to injecting from inhalation is facilitated by a number of factors like drug droughts and easy availability of injectable pharmaceutical preparations like buprenorphine and diazepam.

SETTING: In South Asia, heterosexual transmission is the primary route of HIV transmission and contribution by injecting drug use is on the increase. Rapid assessment studies and other studies done in the region indicate high levels of risk behavior like needle sharing, using drugs in common shooting locations, indirect sharing and risky sexual behavior. The unhygienic injecting practices, lack of access to sterile water and bleach contribute to high incidence of adverse health consequences.

PROJECT: With the increased recognition of the potential for HIV epidemic among drug users, some non-governmental organizations in the region have spearheaded community based HIV prevention activities for drug users. Community based outreach education, peer outreach programs incorporating NSE, sublingual buprenorphine substitution, and provision of primary health care have all been successfully implemented in the region. HIV spread among drug users has triggered policy support for HIV prevention among drug users in some parts of the region whereas in other parts, policy and legal environment is not conducive for prevention activities.

RESULTS: In spite of the successful impact of HIV prevention strategies implemented by some NGOs in the region, recent trends indicate that HIV infection is increasing alarmingly among IDUs in the region. Without adequate policy support and governmental endorsement for the HIV prevention activities, it is impossible to cover the majority of drug using populations. Of critical importance is establishing policies that support public health approaches promoting individual and community risk reduction.

LESSONS LEARNED: There is an opportunity to predict and prevent rapid HIV spread among drug users in South Asia. Models that work well have been implemented in the region and the challenge is coverage. The denial and the low priority accorded to IDUs in the region cause concern and political and policy commitment is urgently needed. HIV spread among IDUs has no national boundary and lessons learned from one region should provide opportunities to understand the micro and macro risk environment and design appropriate interventions for drug users in South Asia.

PRESENTER CONTACT INFORMATION:
Name: Dr. M. Suresh Kumar
Address: 10 Vaidyaram Street, T Nagar
MADRAS 600 017 INDIA
Telephone: +91-44-433 2285 / 434 5668
Fax: +91-4-434 6191
E-mail: msuresh@vsnl.com

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Centers for Disease Control and Prevention. National HIV Prevention Conference, 1999. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, August 29- September 1, 1999.

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