HIV PREVENTION AMONG INJECTING DRUG USERS: RESPONSES IN DEVELOPING AND
TRANSITIONAL COUNTRIES

Andrew L. Ball of the World Health Organization and colleagues report on
the role of intravenous drug use in the incidence of HIV in developing
nations or countries in transition. HIV infection due to intravenous drug
use has been reported in 98 countries. Currently, information on the
problem is very limited, but it appears that injection drug use is the
major mode of HIV transmission in Kazakhstan, Malaysia, Vietnam, China,
North America, Eastern Europe, the Newly Independent States, and the Middle
east. Additionally, it is becoming more of an issue in West Africa and
Latin America. The greatest rising problem has been seen in the Newly
Independent States and in Eastern Europe. In Ukraine, there were about 50
HIV infections reported annually until 1995. However by the end of 1996,
there were over 12,000 reported, with at least half of the infections due
to injection drug use. Similar increases were observed in Belarus, Moldova,
and the Russian Federation. Strategies to deal with drug use have been
started in some of the developing nations. The authors note that the
implementation of these programs depends on three important steps: an
assessment of the situation, the identification and development of
effective intervention, and the location of the intervention within a
public health context. Interventions include the provision of information
on HIV transmission, condom and bleach distribution, opioid substitution
pharmacotherapy, needle-exchanges, peer education programs, IDU outreach
programs, and social network intervention. The authors assert that there
needs to be a supportive policy environment and a public health response
involving intersectoral cooperation in order to achieve effective
intervention.

Checked-by: Mike Gogulski