HIV IN DRUG USERS "ALARMINGLY HIGH" -NEW STUDY FINDS

A new study here has found that HIV prevalence among people who use
illicit drugs is "alarmingly high", highlighting a strong correlation
between HIV and substance abuse.

Some 172 persons were interviewed in the study and HIV tests were
conducted with the results showing that there was an overall HIV rate
of 16.9%. Women in the study had an HIV rate at an "astounding
52.9%". Out of the 172, 17% of the persons were found to be HIV
infected and out of that number 13% of the men were positive with
some 53% of the females being positive.

Following the results, Clarence Young of the Ministry of Health,
Division of Health Sciences Education, which was a partner in the
study, said that when they started the study they had decided that if
they found 2% of the persons were infected it would have been
significant. However, they were all alarmed to find such a large
number of persons infected.

Cocaine readily available

He said in light of that number, no longer can the issue be ignored
but rather it is something that needs to be looked at closely and he
would even say that there is a correlation between the infection rate
and substance use. He also pointed out that cocaine is readily
available and drug users can get a 'fix' for as little as $100 while
stating that it is not an issue of willpower as the addicts are
powerless and they must be motivated to seek help.

Young was at the time speaking at the Main Street location of the
Canadian International Development Agency (CIDA) where he presented
the findings of the study.

The research participants came from all areas of Georgetown, such as
Bourda, Leopold Street, Alexander Street, Albouystown and Kitty, and
more men than women were interviewed with the age range of the
interviewees being between 18 and 69. However, they reported that
their drug use began as early as 12 years old. They said that they
used crack cocaine but alcohol and marijuana were the main drugs of
choice. It was stated that reports of individuals injecting drugs was
low at 3.5% but 14% stated they had seen someone inject in the city.

"Many share characteristics of being single, homeless, and having had
involvement with the criminal justice system," the report said.
Meanwhile, a majority stated they would like to get into an addiction
treatment programme, but they faced many barriers in doing so.
Accord-ing to the study, 13.4% of the participants were commercial sex workers.

The study found that 47% of the participants were homeless, with the
main sources of income being temporary work and begging; 77% had been
to prison, 42% had committed a drug-related offence and 46% had
access to health care in the past 12 months.

The study also found that 18% of the participants reported having
between 1 to 5 lifetime sexual partners, 24% had 6 to 19; 30% 20 to
99, 23% 100 to 499 and 5% over 500 partners. Thirteen percent were
involved in commercial sex work.

On the issue of the drug used by the participants the study found
that 97% had used crack, 88% had used alcohol; 88% had used marijuana
while 90% used crack daily and six persons reported having injected
drugs while 24 had seen someone doing it.

Mental illness also came into play during the study with 4% reporting
having been previously diagnosed with a mental illness, 37% had
experienced a drug overdose, 61% reported having had a previous STI,
18% had been diagnosed with tuberculosis and 36% had been previously
tested for HIV.

Interestingly the study said that 88% wanted addiction treatment
while 19% actually received treatment and 62% said it was too costly
to access treatment, 12% were unaware of treatment programmes and 20%
actually had no desire to quit.

The study found that there is need to develop a strategy to address
HIV and substance users and this should include a broad-based,
comprehensive response from a wide variety of stakeholders.

Further, there is need for a public health response that addresses
the complex nature of HIV and substance use, and is flexible,
appropriate and informed. The response requires "Addiction services
that are prepared to respond to people in the varying stages of their
substance use and can facilitate HIV prevention, testing, and
treatment," the study said.

It was suggested that addictions must be seen as a health issue that
is complex. Moreover, actions must be broad based and comprehensive
and partnerships are necessary. An oversight body is also essential
among other recommendations.

Suggested areas of activities are prevention, treatment, harm
reduction, enforcement and governance and one of the preventative
measures suggested was working with alcohol producers to modify
advertising campaigns and location of ads. Also suggested were
addiction awareness and education programmes for the general public,
including associated HIV risks. Another recommendation was drug
addiction counselling for children in schools that is realistic,
appropriate and informative as well as a strong system for sports,
arts and recreation for children and young people to avert harmful
drug use. In the area of treatment it was suggested among other
things that programmes be developed with specially trained staff to
work with those with coexisting addictions and mental health issues
and also to promote self-help groups across the country. Also it was
suggested that there should be specific programming for those with
fatal alcohol syndrome and attention deficit hyperactivity disorder.

As for governance it was suggested that the health ministry take the
lead with the development of a drug use secretariat. Further there
should be broad-based awareness by politicians, government
bureaucrats and officials of addiction issues and their relation to
HIV and harm reduction.