A small fraction of the world's HIV-positive injection drug users (IDUs) get the assistance they need to keep themselves healthy and avoid spreading the virus to others, according to reports presented this week at the 18th International AIDS Conference in Vienna.
Among the world's estimated 16 million IDUs, some 3 million to 6.6 million are believed to be HIV-positive. This week in the Lancet, Louisa Degenhardt - of the National Drug and Alcohol Research Center at the University of New South Wales, Australia - and colleagues said criminalization of drug use and marginalization of users increases the risk they will transfer the virus to others. The most common methods of transmission are sharing needles and turning to prostitution to pay for a drug habit.
Of IDUs worldwide:
- 5 percent have access to an established needle-exchange program;
- 8 percent have access to programs that provide substitutes for heroin and other opiates.
In addition, of HIV-positive IDUs, only 4 percent have access to antiretroviral therapy, which can reduce their risk of transmission by 90 percent. These three interventions together have been shown to cut the prevalence of HIV among IDUs by more than half.
UNAIDS last year recommended that 19 percent of HIV prevention funding be directed toward IDUs, but this population was the target of only about 1 percent of prevention allocations.
More than two-thirds of the region's 1.5 million HIV patients reside in Russia. Russia and Ukraine together account for 90 percent of the region's HIV cases.
Dengenhardt's study is one of a series of articles on HIV and drug use published online this week in the Lancet.