Important note: Information in this article was accurate in 2001. The state of the art may have changed since the publication date.
Bangkok Post - January 3, 2001
Anucha Charoenpo and Aphaluck Bhatiasevi
Law enforcement and political policies are the two main barriers impeding implementation of effective prevention measures targeted to control the spread of HIV among intravenous drug users, said the report reviewed by the United Nations International Drug Control Programme (UNDCP).
The report said measures implemented to prevent the spread of HIV among drug users are frequently localised, short-term, under-funded and insufficient in scope.
Moreover, adherence to traditional values is still strong, leading to sensitivity over any debate on HIV/Aids prevention and sexual behaviour.
The report also identified the low funding priority for drug problems in the region, with the exception of law enforcement, and the inadequate dialogue between drug control and HIV prevention agencies.
As a result, few programmes in the region directly address the link between drug use and HIV vulnerability, said the report.
Serious intervention programmes which can effectively control the spread of HIV among intravenous drug users include needle and syringe exchange and distribution programmes; and drug treatment as part of a comprehensive package.
On a more positive note, the report showed governments may be ready to review their policies concerning interventions to reduce HIV transmission among intravenous drug users if there are mechanisms to build consensus and collaboration among the main stakeholders.
The making of the report, completed under the guidance of a regional task of experts in drug control and public health, involved representatives from China, India, Malaysia, Burma, Nepal, Thailand and Vietnam.
Prof Usa Duangsa, of Chiang Mai University, said despite being one of the major contributors to HIV/Aids infection, intravenous drug use has not received as much attention as programmes aimed at preventing sexual transmission of the disease.
Despite efforts to implement harm reduction programmes, Prof Usa observed a continuous conflict of opinion among non-governmentalorganisations, state authorities and academics.
"While needle exchange programmes implemented by NGOs in small communities have proven effective in reducing new HIV infections, a large number of state authorities and academics still feel that it could in turn encourage drug use among the communities," she said.
In Thailand, harm reduction efforts are being implemented only in specific communities, such as programmes for hilltribes in Mae Chan district of Chiang Rai, and in the Klong Toey slum community.
Prof Usa said there are concerns that ineffective control over the use of new needles would worsen drug use situations, if the programme is expanded to a larger community.
Authorities concerned could, however, implement other harm reduction efforts, such as counselling, encouraging young people to get involved in sports activities, and creating an understanding among community members, she said.
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