Integrated Regional Information Networks - September 10, 2009

"I can't work when I'm not high," he told IRIN/PlusNews. "Ideas don't come to me and I don't recognize the parts. I need to smoke [marijuana] first, and sometimes I shoot up."

Victor, who did not want to give his last name, started smoking marijuana when he was 15 years old and living with his father and stepmother, who mistreated him; loneliness and isolation led him to seek refuge in drugs.

He was soon experimenting with other types of drugs and in 2003 injected heroin for the first time; he has not been able to stop injecting drugs since. Before he started working, he sold many of his personal possessions to pay for heroin and later cocaine.

Victor does not know his HIV status, but said he sometimes shared needles with up to 10 friends. "Having a disposable needle for each person would be the ideal, but it's not easy - that's why we share - but I don't think I have HIV," he said.

"It's too bad drug consumption isn't legal in Mozambique. If it were, needles could easily be provided for people who inject drugs, as is the case now with condoms."

In fact, countries with needle exchange programmes have not legalized drugs, but acknowledge that injecting drug users (IDUs) are at higher risk of HIV and should be targeted with prevention campaigns. According to the UN Office on Drugs and Crime (UNODC), between five and 10 percent of HIV infections worldwide are the result of injecting drug users sharing contaminated needles.

No prevention strategy

Mozambique's 2005-2009 National Strategic Plan for the Fight Against HIV/AIDS does not recognize drug users as a vulnerable group, and there are no official estimates for the number of people infected with HIV as a result of drug use.

Manuel Fernando Condula, coordinator of the National Network of NGOs Against Drugs, said the organization had developed campaigns for raising awareness in communities and schools about the risks of HIV infection linked to injecting drugs. The organization also runs workshops aimed at changing the behaviour of addicts in the Maputo neighbourhoods of Mafalala, Mavalane and Matutuine, where drugs are bought and sold.

"The Network's responsibility is that of reducing drug consumption among addicts and keeping new consumers from starting," Condula said, adding that many people in Mozambique were unaware of the risk of infection from needle-sharing.

Get Jobs, a local NGO working to reduce the spread of HIV by education and connecting sex workers with other types of employment, carried out a survey between 2007 and 2008 in Maputo, Beira - Mozambique's second largest city - and the northern port city of Nacala, to determine the needs and habits of drug users.

The results, which have yet to be made public, will be used to develop a programme targeting addicts. "When the project is executed, I don't believe we'll include the distribution of needles to users, as is done in some countries," Helder Manuel Massingue, who coordinated the study, told IRIN/PlusNews.

"This encourages drug use. I think the proper strategy is to discourage consumption, and reinforce the possibility of detoxification and the reintegration of addicts into society."

Eugenia Teodoro, a clinical psychologist at the health ministry's department of mental health, said there were no specific HIV prevention strategies for IDUs and the number of addicts who shared needles was unknown, but that all drug and alcohol users were thought to be at risk of HIV infection. "We know that someone who is under the effects of alcohol and drugs can easily forget to use a condom," she commented.

The ministry presents lectures on the consequences of alcohol and drug abuse and plans to establish treatment and rehabilitation centres for drug addicts.

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