HIV and injecting drug use.

D. C. Des Jarlais, M. Carballo

Research output: Contribution to journalArticlepeer-review

Abstract

IV drug users and the spread of HIV infections follows the transportation routes of heroin and cocaine distribution and localizes in areas of production and refinement. 80 countries report IV drug use. The major routes are out of the "Golden Triangle" in southeast Asia, along the "Balkan Route" from the middle east to western Europe, and from the Andes to Atlantic ports in Brazil. Modernization has contributed to easier access for drug entry into regions. Economic dislocation may provide people with incentives to engage in lucrative distribution and manufacture of drugs. The new appearance of drug use in some countries and the spread of IV drug users into other countries presents a complex and difficult task. At present there are insufficient means to control IV drug use. Punitive laws, which are usually the first effort to control IV drug use, have not been found to be effective in prevention. The result of punitive laws is usually an increase in drug prices, which may lead to switching to IV drug use. HIV infection, which is spread through shared drug injection equipment, has been reported in over 50 countries. HIV enters the IV drug user community through "bridge persons" who contracted HIV through homosexual/bisexual means and share the same injection equipment. HIV transmission occurs also because IV drug user travel, i.e., 20% of IV drug users in a WHO study in 14 cities said shared needles were used outside the home city within the previous 2 years. Drug users have indicated a willingness to engage in prevention, however, the difficulties in providing a public health approach to HIV prevention are exacerbated by political factors. Punitive approaches are preferred and many political leaders deny the presence of HIV and IV drug use problems in their communities. Some place limitations on legal distribution of sterile injection equipment. The hope is that HIV prevention approaches will be accepted as the best alternative. These approaches should avoid stigmatization and treat IV drug users as competent individuals who are capable of changing risk behavior.

Original languageEnglish (US)
Pages (from-to)5, 11-12
JournalAIDS & society
Volume4
Issue number2
StatePublished - Jan 1993

ASJC Scopus subject areas

  • Medicine(all)

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