HIV HITS DRUG USERS IN MAURITIUS

In contrast to the rest of Southern Africa, intravenous drug users
have become the group most vulnerable to the transmission of HIV in
Mauritius. This has led the Mauritian government to introduce a
syringe- and needle-exchange programme in a bid to stem HIV infection
among Mauritian drug users.

Sexual transmission among heterosexuals is the most common way of HIV
infection in Southern Africa, the region that has become the centre
of the international HIV/Aids pandemic in recent years.

Mauritius is unusual in the region as the HIV prevalence rate among
its population of 1,2-million people is less than 0,5%. Since 1987,
162 Mauritians have died from Aids-related illnesses. Currently, at
least 2A 345 Mauritians are living with HIV/Aids, according to
official figures, but some social workers estimate the number to be
about 10A 000.

Another unusual characteristic of the epidemic in Mauritius is that
drug injection with shared needles has since 2003 been the main mode
of HIV transmission. The sharing of contaminated needles was
responsible for 92% of new HIV infections in 2005 and 85,2% of new
infections in 2006.

Social worker Cadress Runghen ascribes the increased vulnerability of
drug users to HIV/Aids to the fact that anti-Aids messages focused on
sexual behaviour only.

Sensitisation campaigns helped to ensure that the population was made
aware of the risk of HIV infection through sexual means, leading to a
drop in such infections during the 1990s.

But, says Runghen, "nobody kept a check on the drug-addict
community". In the meantime, the HI virus has been spreading like
wildfire among the members of this marginal group.

New legislation To address this and other issues, the Mauritian
Parliament adopted the new HIV and Aids Act at the end of 2006, which
introduced a syringe- and needle-exchange programme and methadone
treatment. Methadone is used to alleviate withdrawal symptoms during
the rehabilitation of drug addicts.

In just a few weeks, 2A 000 syringes used by drug addicts have been
taken out of circulation and replaced by new ones. A few hundred
addicts are now being treated with methadone.

Social workers have started this programme in the capital, Port
Louis, and on the outskirts of the capital at Baie-du-Tombeau, Roche
Bois and Batterie CassA(c)e where a large number of drug addicts live
or come to have their daily dose of heroin or other drugs.

They meet in places that are not generally frequented by other
members of the public. Social workers visit these places to hand out
new syringes and condoms. The used syringes and needles are collected
in a plastic box and destroyed.

Winning confidence Social workers use this contact to sensitise drug
users to HIV/Aids issues. "It is not only a programme to exchange
syringes. It is not a mechanical exercise. We are doing it to reach
out to drug addicts and convince them to go to one of our
rehabilitation centres," says Runghen.

Drug addicts hide themselves from the public eye for fear of being
arrested by the police. The social workers have to win their
confidence. "This is a long process. Drug addicts want to talk to
people. They want to feel the warmth of people who listen to them.
They do not want to be rejected," Runghen adds.

One female drug addict, Nalah (not her real name), says she is now
more aware of HIV/Aids. She and her friends used to share one syringe
for days on end, because pharmacists would not sell them new ones.

"That is why we come to exchange our syringes. When an addict suffers
because you cannot take your daily dose, you will take any syringe
you find to shoot up with," she explains.

Another social worker, Imran Dhannoo, is adamant that the programme
should be directed at those thousands of drug addicts who are
vulnerable and who do not know about the programme. "We should reach
out to them. We should not wait for them to come and see us."

The syringe-exchange programme is one of a number of initiatives in
the comprehensive HIV/Aids legislation introduced last year.

National framework According to Health Minister Satish Faugoo, the
law provides an effective national framework with prevention and care
programmes that will get people involved in curbing the spread of
HIV/Aids while protecting people's human rights.

Emphasis is placed on confidentiality and human rights. Thus, no HIV
test can be undertaken without prior consent of the person being
tested, and the results of tests must be made available to the
person. The law also allows a minor to undergo an HIV test without
the consent of her or his guardian.

The law determines that HIV-positive people be referred for
treatment. Information about the HIV status of an individual is
protected from unauthorised collection, use or disclosure in
healthcare and other settings.

In a bid to stem stigmatisation and discrimination against people
living with HIV, penalties have been introduced to protect their
pension rights and employment conditions, and to prevent prejudice or
ill-treatment of any kind.

Faugoo has said that HIV-positive people should be guaranteed equal
rights to employment and healthcare as are accorded all other members
of Mauritian society. The law makes it illegal to impose HIV testing
as a precondition for employment or continued employment.

It is also an offence for a doctor not to provide treatment to a
person who is HIV-positive or perceived to be HIV-positive. Testing
facilities will be introduced in specific public health institutions,
as well as pre- and post-test counselling. Testing will happen in
accordance with strict guidelines and protocols to ensure the
reliability of results.

Nicolas Ritter, spokesperson for a non-governmental HIV/Aids
organisation, welcomed the new legislation. According to him, many
people are living with HIV without knowing it.

Meanwhile, religious leaders are warning people about their sexual
behaviour. Catholic priest Jocelyn GrA(c)goire has appealed to
Mauritians, saying: "The house is on fire and we cannot save it. But
we should save the furniture. You are being told to use condoms. If
they cannot protect you from pregnancy, how can they protect you from HIV?"

"Better be faithful," added Homa Mungapen, spokesperson for the
Council of Religions.