HIV Prevention Among Injecting Drug Users
Highlight:
"In 2008 there were numbers of IDUs in 148 countries around the world and the HIV infection among IDUs recorded and reported in 120 countries."
The Harm Reduction Programs that is run in many countries offered a series of package such as:
• Needle Syringe Program
• Substitution program [opioid]
• VCT
• ART
• Prevention and treatment of STIs
• Condoms distribution for IDUs and partners
• Targeted information
• Vaccination and treatment of Hep C
• Prevention, diagnosis and treatment of TB
Key emerging challenges for this area is that there are needs of forming and recognizing special sub-groups of drug users such as female drug users, young drug users, migrant drug users, MSM drug users, prison setting drug use as well as sex work and drug use.
Japan claimed that they were not adopting the NSP and substitution program because NSP is considered as encouraging the using of drugs while substitution program is considered not effective and causing other form of dependency. The implementation of the programs should be based on the situation and circumstances within the region, even within the country. Based on that, Japan requested UNAIDS to review and redraft the decision points. Russia shared that basic approaches should be a moral change, especially for young people to keep them away from drugs. There is a clash between the moralists and scientists in tackling this issue within the Russian Federation countries. Scientific-based finding regarding opioid therapy and NSP are not necessarily the best solutions to tackle the drug use problems. Therefore, Russia is supporting Japanese Delegates and claimed that the tackling of this issue should not be carried out in such a rush.
The NGO Delegation from Europe questioned on how much UNAIDS and the co-sponsors had spent on drug use. All interventions made should be done with the consultation with the key populations and not based on the benefit of certain parties, countries or institutions. A proposal to include spouses and partners of IDUs in a more comprehensive prevention program was addressed. This proposal was endorsed by France with emphasizing on prevention on sexual transmission among IDUs and their spouses/partners.
Denmark, together with its constituents [Switzerland, Austria and Nordic Countries] addressed the concern of low services for IDUs. They considered the access to NSP and information is crucial for all drug users. In addition, they also addressed that the term ‘harm reduction’ is adequate to signify that illicit drugs is harmful, therefore this term should be widely familiarise. Another thing regarding addiction that they mentioned was the need to consider alcohol as one of the substances that add the vulnerability of HIV through sex transmission. Above all, responses to the issues should be under human rights base.
Strengthening the statement from France, Netherlands and its constituents [Belgium, Luxemburg and Portugal] expressed that the Universal Access for IDUs is still very low and that needs to be scaled up based on best practices. Harm Reduction program had evidently demonstrated its effectiveness in reducing the HIV prevalence among drug users, therefore Netherlands and its constituents is calling for designing comprehensive programs for IDUs and in fully support to the recommendations made by the NGO Delegations.
Brazil made comments that access to health is hampered by the attitude of the health workers towards the drug users. Furthermore, even though the Harm Reduction Policies are in place, there is always a huge outcry from the conservative groups within the country. However, Harm Reduction should be explicitly mentioned in the decision point’s document. Brazil specifically sees that there is a need of a clear framework in achieving the goal to reduce HIV prevalence and wants to see the follow up of this issue in the next PCB.
United Kingdom stated that ensuring rapid expand of Harm Reduction Program in the most affected countries is crucial. Apart from that, there is an urgent need to address stigma and discrimination against people who use drugs because it will be impossible to achieve the goals as long as people who use drugs are still criminalised and stigmatised. However, it has to be acknowledged that there is also a significant gap in the drug use trends stated in the Drug Policy Report.
United States of America once again raised the issue of ‘Harm Reduction’ terminology. The UNAIDS, UNODC and WHO Technical Guide had mentioned the term ‘Harm Reduction’ even though the difficulty around the usage of that term had been discussed formerly. The term is considered encouraging the use of illicit drugs and therefore the USA cannot endorse the use of that term. USA requested explicit explanations on the term ‘Harm Reduction’ and would like to see the possibility to revise it and move forward with the prevention agenda.
INPUD expressed their concern about how people who use drugs are often being blamed as the failure of the development of policies. Based on that, INPUD calls UNAIDS to develop integrated responses on treatment of HIV and Hep-C, research for psycho-social support and involvement of people who use drugs in the assessments of all UNAIDS’ outcomes.
The NGO Delegation from Europe questioned on how much UNAIDS and the co-sponsors had spent on drug use. All interventions made should be done with the consultation with the key populations and not based on the benefit of certain parties, countries or institutions. A proposal to include spouses and partners of IDUs in a more comprehensive prevention program was addressed. This proposal was endorsed by France with emphasizing on prevention on sexual transmission among IDUs and their spouses/partners.
Denmark, together with its constituents [Switzerland, Austria and Nordic Countries] addressed the concern of low services for IDUs. They considered the access to NSP and information is crucial for all drug users. In addition, they also addressed that the term ‘harm reduction’ is adequate to signify that illicit drugs is harmful, therefore this term should be widely familiarise. Another thing regarding addiction that they mentioned was the need to consider alcohol as one of the substances that add the vulnerability of HIV through sex transmission. Above all, responses to the issues should be under human rights base.
Strengthening the statement from France, Netherlands and its constituents [Belgium, Luxemburg and Portugal] expressed that the Universal Access for IDUs is still very low and that needs to be scaled up based on best practices. Harm Reduction program had evidently demonstrated its effectiveness in reducing the HIV prevalence among drug users, therefore Netherlands and its constituents is calling for designing comprehensive programs for IDUs and in fully support to the recommendations made by the NGO Delegations.
Brazil made comments that access to health is hampered by the attitude of the health workers towards the drug users. Furthermore, even though the Harm Reduction Policies are in place, there is always a huge outcry from the conservative groups within the country. However, Harm Reduction should be explicitly mentioned in the decision point’s document. Brazil specifically sees that there is a need of a clear framework in achieving the goal to reduce HIV prevalence and wants to see the follow up of this issue in the next PCB.
United Kingdom stated that ensuring rapid expand of Harm Reduction Program in the most affected countries is crucial. Apart from that, there is an urgent need to address stigma and discrimination against people who use drugs because it will be impossible to achieve the goals as long as people who use drugs are still criminalised and stigmatised. However, it has to be acknowledged that there is also a significant gap in the drug use trends stated in the Drug Policy Report.
United States of America once again raised the issue of ‘Harm Reduction’ terminology. The UNAIDS, UNODC and WHO Technical Guide had mentioned the term ‘Harm Reduction’ even though the difficulty around the usage of that term had been discussed formerly. The term is considered encouraging the use of illicit drugs and therefore the USA cannot endorse the use of that term. USA requested explicit explanations on the term ‘Harm Reduction’ and would like to see the possibility to revise it and move forward with the prevention agenda.
INPUD expressed their concern about how people who use drugs are often being blamed as the failure of the development of policies. Based on that, INPUD calls UNAIDS to develop integrated responses on treatment of HIV and Hep-C, research for psycho-social support and involvement of people who use drugs in the assessments of all UNAIDS’ outcomes.
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