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Injecting drug users fuelling HIV/Aids

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By EVELYN LIRRI,

Posted Saturday, March 7 2015 at 16:55

IN SUMMARY

  • OST is a medical procedure in which an illegal substance such as heroin is replaced with a longer acting but less euphoric one.

  • The report estimates that the prevalence of HIV among people who inject drugs among the countries that were studied is 33.9 per cent in Tanzania, 16.7 per cent in Uganda, 18.3 per cent in Kenya and 9.1 per cent in Senegal.

  • Lack of funding also remains a big challenge in funding HIV prevention services among people who inject drugs.

HIV infections fuelled by people who inject drugs should be tackled as part of a global effort to reduce prevalence of the epidemic, a new report says.

TheGlobal State of Harm Reduction report 2014, released recently notes that new and emerging patterns of drug use in sub-Saharan African countries like Kenya, Uganda, Tanzania and Senegal will require increased access to opioid substitution therapy (OST) such as methadone and buprenorphine and needle syringe programmes (NSP) for people who inject drugs.

OST is a medical procedure in which an illegal substance such as heroin is replaced with a longer acting but less euphoric one.

The medication works by blocking the effects of other opioids or drugs, thereby stopping any craving for them. Methadone for example, is taken in syrup form and, therefore, prevents the risks of injecting an illicit drug of unknown quality with dirty or infected needles.

“HIV infections in sub-Saharan Africa driven by drug use are a matter of concern as they are avoidable,” said Rick Lines, executive director of Harm Reduction International, who produced the report.

The report estimates that the prevalence of HIV among people who inject drugs among the countries that were studied is 33.9 per cent in Tanzania, 16.7 per cent in Uganda, 18.3 per cent in Kenya and 9.1 per cent in Senegal.

“Moreover, because of the geographical location of countries such as Tanzania and Zanzibar along key transit points for the trafficking of heroin, cocaine and other drugs, there is increased availability of these drugs in this part of the region,” the authors noted.

In Uganda, the risk of HIV transmission through injection drug use is not a major threat, according to Anthony Mbonye, director of clinical and community services at Uganda’s Ministry of Health.

“But if we do a study and establish that the contribution of this group to HIV transmission is as high as the other factors, we shall draw appropriate interventions,” said Prof Mbonye.

The Global State of Harm Reduction report says that while there has been a significant effort to reduce the risk of infection from injection use in some countries, it has not grown in proportion to the HIV epidemic among people who inject drugs.

It adds that a scale-up of such interventions will be a critical part of a global effort to end the HIV epidemic.

In Tanzania for example, where the number of people who inject drugs is highest in the East African region, the government has established seven sites where people can access safe syringes.

The country has also set up three community-based OST programmes, with over 1,200 people who inject drugs receiving the methadone medication.

However, many people who inject drugs are still missing out on lifesaving antiretroviral therapy.

“The limited services in the region, coupled with the criminalisation of drug use and minor possession, do little to reduce HIV risks faced by people who inject drugs,” the authors noted in the report.

Lack of funding also remains a big challenge in funding HIV prevention services among people who inject drugs.

The Joint United Nations Programme on HIV/Aids (UNAids) estimates that $2.3 billion is required annually for such prevention programmes. In 2012, the report says, only about $160 million was invested by international donors, approximately seven per cent of what is required.

“In Uganda, funding for harm reduction has generally been viewed as a low priority by the government, although there has been an increased focus from donor NGOs,” the report said.

It further notes that barriers to seeking medical help among people who inject drugs include legal and policy issues and social stigma.

“This can force people who inject drugs to hide injecting equipment and engage in unsafe injecting practices,” the report notes.