The need to scale up hiv prevention for drug users
This presentation is the property of its rightful owner.
Sponsored Links
1 / 23

The need to scale up HIV prevention for drug users PowerPoint PPT Presentation


  • 34 Views
  • Uploaded on
  • Presentation posted in: General

The need to scale up HIV prevention for drug users. Kasia Malinowska-Sempruch Director International Harm Reduction Development Program Open Society Institute Krakow, September 26, 2004. Fixing, Astrakhan. Overview. Injecting drug use globally and related HIV epidemics

Download Presentation

The need to scale up HIV prevention for drug users

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


The need to scale up hiv prevention for drug users

The need to scale up HIV prevention for drug users

Kasia Malinowska-Sempruch

Director

International Harm Reduction Development Program

Open Society Institute

Krakow, September 26, 2004


The need to scale up hiv prevention for drug users

Fixing, Astrakhan


Overview

Overview

Injecting drug use globally and related HIV epidemics

Current state of knowledge about addiction

OSI’s experience in supporting harm reduction

Related policy issues


Hiv among injecting drug users

HIV among injecting drug users

  • Primary characteristics -- an explosive epidemic /easy to contain (UK, Holland, Canada)

  • In 1992 -- 52 countries reporting HIV among IDUs; in 2002 -- 114.

  • Injecting Drug Use accounts for as much as 10% of new HIV infections globally

  • An estimated 1 of every 3 new infections outside of Africa is among IDUs


Drug use and global hiv epidemic

Drug Use and Global HIV Epidemic

  • Especially in Asia and former Soviet Union, drug policy holds key to future of HIV

    • 52 countries report HIV among IDU’s in 1992, 114 in 2002 (Strathdee and Poundstone, 2002)

    • Outside of Africa, estimated 1 of every 3 new infections comes from contaminated needle (UNAIDS)


The need to scale up hiv prevention for drug users

HIV IN UKRAINE:

estimated 1% prevalence

UNAIDS Global Epidemic Update, 2002

Photo: Jacqueline Mia Foster


Explosive nature of hiv infections among injecting drug users in russia

Explosive nature of HIV infections among injecting drug users in Russia

  • In Svetlagorsk, Belarus, 1 year after the first HIV case, 67% of IDUs were estimated to be infected.

  • In St. Petersburg, prevalence among IDUs was 0.3% in 1998, 19.3% by 2000.


The need to scale up hiv prevention for drug users

Asia

  • China - as many as 1 million HIV cases, 70% among IDUs

  • Malaysia—76% of all HIV cases among IDUs

  • Iran—75% HIV cases are among IDUs

  • Vietnam—65% HIV cases are among IDUs

  • 80% IDUs HIV+ in Manipur (India)

  • 90% IDU’s HIV+ in Myitikina (Burma)

  • In Chiang Rai, Thailand, HIV prevalence among IDUs increased from 1% in 1988 to 61% in 1989


The need to scale up hiv prevention for drug users

Drug Addiction Prevalence Rate in KyrgyzstanNational Centre of Addictions of the Ministry of Health of Kyrgyzstan

5591

80-100 000

1290

5591


The need to scale up hiv prevention for drug users

HIV prevalence among IDUs

National Centre of Addictions of the Ministry of Health of Kyrgyzstan

1 Jan 2001

1 Jan 2003

<20%

30.2%

69.8%

Injecting Drug Users

Non-Injection Infection

>80%


Ancient history dr ernest bishop nyc 1920

Ancient historyDr. Ernest Bishop (NYC), 1920

  • “We have regarded failure to abstain from narcotics as evidence of weak will-power.”

  • “We have prayed over our addicts, cajoled them, exhorted them, imprisoned them, treated them as insane and made them social outcasts” – and we’ve consistently failed!

    Bishop, The Narcotic Drug Problem. Macmillan; NY 1920

The Baron Edmond de Rothschild

Chemical Dependency Institute


World health organization addiction is a brain disease 1997

World Health Organization:Addiction is a brain disease, 1997

  • “Research has shown that substance dependence is a chronic relapsing disorder with a biological and genetic basis, and is not simply due to lack of will. . . “

  • “Substance dependence is as much a disorder of the brain as any neurological or psychiatric illness.”

    WHO. “Neuroscience of psychoactive substance use and dependence.”

    ISBN 92-4-159124-2

The Baron Edmond de Rothschild

Chemical Dependency Institute


National institute on drug abuse addiction is a brain disease 1997

National Institute on Drug Abuse Addiction is a brain disease, 1997

  • “Addiction unequivocally is a disease of the brain that can be effectively treated”

  • “Strongly recommends expanding access to methadone treatment”

  • NIDA Notes, 1997 at http://www.drugabuse.gov/NIDA_Notes/NNVol12/NIPanel.html

The Baron Edmond de Rothschild

Chemical Dependency Institute


Harm reduction 1984

Harm reduction1984

British Home Office publication perhaps earliest published reference to harm reduction:

  • “An important aspect of prevention is the reduction of harm associated with misuse –by measures directed at the user rather than the non-user.”

    * British Home Office Prevention – Report of the Advis Counc on misuse of drugs, 1984

The Baron Edmond de Rothschild

Chemical Dependency Institute


Osi supported harm reduction programs

Albania

Azerbaijan

Belarus

Bulgaria

Croatia

Czech Republic

Estonia

Georgia

Kazakhstan

Kyrgyzstan

Latvia

Lithuania

Macedonia

Moldova

Poland

Romania

Russia

Slovakia

Slovenia

Tajikistan

Turkmenistan

Ukraine

Uzbekistan

OSI-Supported Harm Reduction Programs


Lessons learnt

Lessons learnt

  • Drug users are compliant, if services are organized in reasonable manner

  • HIV treatment must accompany prevention

  • Harm reduction is EASY

  • Pilots are not enough – programs need to be taken to scale

  • Drug policies need to be re-visited for HIV prevention to be effective


The need to scale up hiv prevention for drug users

Drug policies need to be re-visited

Photo: Hans Jürgen Burkard


The need to scale up hiv prevention for drug users

OTHER CONSIDERATIONS -- Heroin overdose, Volgograd


The need to scale up hiv prevention for drug users1

The need to scale up HIV prevention for drug users

Kasia Malinowska-Sempruch

Director

International Harm Reduction Development Program

Open Society Institute

Krakow, September 26, 2004


  • Login