Human immunodeficiency virus (HIV) infection rates and heroin trafficking: Fearful symmetries

Research output: Contribution to journalArticle

Abstract

There is mounting evidence that the spread of the human immunodeficiency virus (HIV) is associated with heroin trafficking routes. The relationship between the two is best illustrated by the routes leading from the two primary regions for the illicit opium poppy cultivation and heroin manufacture: the Golden Triangle of South-East Asia and the Golden Crescent of Central Asia. The producers in the Golden Triangle are the Lao People's Democratic Republic and Myanmar, and those in the Golden Crescent are Afghanistan and Pakistan. Together, those States accounted for perhaps 80-90 per cent of the world heroin supplies in 2002. HIV outbreaks resulting from unsafe injection practices among injecting drug users (IDU) in trafficking zones have been documented in Myanmar itself, in Belarus, China, India, Indonesia, the Islamic Republic of Iran, Malaysia, Pakistan, the Russian Federation, Tajikistan, Thailand, Ukraine, Uzbekistan, Viet Nam and in several States in Eastern Europe. Heroin trafficking in those States has led to serial epidemics: first of heroin use, then of injection, then of blood-borne pathogens, including hepatitis C and HIV. Ethnic and trade relationships in heroin trafficking zones appear to facilitate such epidemics, as does drug testing by petty traders in market nodes. Policy responses, or the lack thereof, have increased the vulnerability of users and their communities, as have the limited drug treatment options available in those zones. While "supply-side" approaches, including interdiction and policing, are likely to continue, those HIV epidemics will require improved drug treatment, access to HIV prevention services, including harm reduction, and new approaches to the prevention of HIV in areas where heroin trafficking occurs.

Original languageEnglish (US)
Pages (from-to)103-116
Number of pages14
JournalBulletin on Narcotics
Volume54
Issue number1-2
StatePublished - 2002

Fingerprint

Heroin
Virus Diseases
HIV
Myanmar
Pakistan
Tajikistan
Uzbekistan
Blood-Borne Pathogens
Republic of Belarus
Laos
Pharmaceutical Preparations
Central Asia
Papaver
Harm Reduction
Afghanistan
Ukraine
Eastern Europe
Injections
Indonesia
Far East

Keywords

  • Afghanistan
  • Burma
  • Heroin
  • HIV infection
  • IDUs
  • Lao People's Democratic Republic
  • Trafficking

ASJC Scopus subject areas

  • Medicine (miscellaneous)

Cite this

Human immunodeficiency virus (HIV) infection rates and heroin trafficking : Fearful symmetries. / Beyrer, Christopher.

In: Bulletin on Narcotics, Vol. 54, No. 1-2, 2002, p. 103-116.

Research output: Contribution to journalArticle

@article{0d763a495bca49a68052f7cdada2df14,
title = "Human immunodeficiency virus (HIV) infection rates and heroin trafficking: Fearful symmetries",
abstract = "There is mounting evidence that the spread of the human immunodeficiency virus (HIV) is associated with heroin trafficking routes. The relationship between the two is best illustrated by the routes leading from the two primary regions for the illicit opium poppy cultivation and heroin manufacture: the Golden Triangle of South-East Asia and the Golden Crescent of Central Asia. The producers in the Golden Triangle are the Lao People's Democratic Republic and Myanmar, and those in the Golden Crescent are Afghanistan and Pakistan. Together, those States accounted for perhaps 80-90 per cent of the world heroin supplies in 2002. HIV outbreaks resulting from unsafe injection practices among injecting drug users (IDU) in trafficking zones have been documented in Myanmar itself, in Belarus, China, India, Indonesia, the Islamic Republic of Iran, Malaysia, Pakistan, the Russian Federation, Tajikistan, Thailand, Ukraine, Uzbekistan, Viet Nam and in several States in Eastern Europe. Heroin trafficking in those States has led to serial epidemics: first of heroin use, then of injection, then of blood-borne pathogens, including hepatitis C and HIV. Ethnic and trade relationships in heroin trafficking zones appear to facilitate such epidemics, as does drug testing by petty traders in market nodes. Policy responses, or the lack thereof, have increased the vulnerability of users and their communities, as have the limited drug treatment options available in those zones. While {"}supply-side{"} approaches, including interdiction and policing, are likely to continue, those HIV epidemics will require improved drug treatment, access to HIV prevention services, including harm reduction, and new approaches to the prevention of HIV in areas where heroin trafficking occurs.",
keywords = "Afghanistan, Burma, Heroin, HIV infection, IDUs, Lao People's Democratic Republic, Trafficking",
author = "Christopher Beyrer",
year = "2002",
language = "English (US)",
volume = "54",
pages = "103--116",
journal = "Bulletin on Narcotics",
issn = "0007-523X",
publisher = "United Nations Office on Drugs and Crime",
number = "1-2",

}

TY - JOUR

T1 - Human immunodeficiency virus (HIV) infection rates and heroin trafficking

T2 - Fearful symmetries

AU - Beyrer, Christopher

PY - 2002

Y1 - 2002

N2 - There is mounting evidence that the spread of the human immunodeficiency virus (HIV) is associated with heroin trafficking routes. The relationship between the two is best illustrated by the routes leading from the two primary regions for the illicit opium poppy cultivation and heroin manufacture: the Golden Triangle of South-East Asia and the Golden Crescent of Central Asia. The producers in the Golden Triangle are the Lao People's Democratic Republic and Myanmar, and those in the Golden Crescent are Afghanistan and Pakistan. Together, those States accounted for perhaps 80-90 per cent of the world heroin supplies in 2002. HIV outbreaks resulting from unsafe injection practices among injecting drug users (IDU) in trafficking zones have been documented in Myanmar itself, in Belarus, China, India, Indonesia, the Islamic Republic of Iran, Malaysia, Pakistan, the Russian Federation, Tajikistan, Thailand, Ukraine, Uzbekistan, Viet Nam and in several States in Eastern Europe. Heroin trafficking in those States has led to serial epidemics: first of heroin use, then of injection, then of blood-borne pathogens, including hepatitis C and HIV. Ethnic and trade relationships in heroin trafficking zones appear to facilitate such epidemics, as does drug testing by petty traders in market nodes. Policy responses, or the lack thereof, have increased the vulnerability of users and their communities, as have the limited drug treatment options available in those zones. While "supply-side" approaches, including interdiction and policing, are likely to continue, those HIV epidemics will require improved drug treatment, access to HIV prevention services, including harm reduction, and new approaches to the prevention of HIV in areas where heroin trafficking occurs.

AB - There is mounting evidence that the spread of the human immunodeficiency virus (HIV) is associated with heroin trafficking routes. The relationship between the two is best illustrated by the routes leading from the two primary regions for the illicit opium poppy cultivation and heroin manufacture: the Golden Triangle of South-East Asia and the Golden Crescent of Central Asia. The producers in the Golden Triangle are the Lao People's Democratic Republic and Myanmar, and those in the Golden Crescent are Afghanistan and Pakistan. Together, those States accounted for perhaps 80-90 per cent of the world heroin supplies in 2002. HIV outbreaks resulting from unsafe injection practices among injecting drug users (IDU) in trafficking zones have been documented in Myanmar itself, in Belarus, China, India, Indonesia, the Islamic Republic of Iran, Malaysia, Pakistan, the Russian Federation, Tajikistan, Thailand, Ukraine, Uzbekistan, Viet Nam and in several States in Eastern Europe. Heroin trafficking in those States has led to serial epidemics: first of heroin use, then of injection, then of blood-borne pathogens, including hepatitis C and HIV. Ethnic and trade relationships in heroin trafficking zones appear to facilitate such epidemics, as does drug testing by petty traders in market nodes. Policy responses, or the lack thereof, have increased the vulnerability of users and their communities, as have the limited drug treatment options available in those zones. While "supply-side" approaches, including interdiction and policing, are likely to continue, those HIV epidemics will require improved drug treatment, access to HIV prevention services, including harm reduction, and new approaches to the prevention of HIV in areas where heroin trafficking occurs.

KW - Afghanistan

KW - Burma

KW - Heroin

KW - HIV infection

KW - IDUs

KW - Lao People's Democratic Republic

KW - Trafficking

UR - http://www.scopus.com/inward/record.url?scp=1542721963&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=1542721963&partnerID=8YFLogxK

M3 - Article

AN - SCOPUS:1542721963

VL - 54

SP - 103

EP - 116

JO - Bulletin on Narcotics

JF - Bulletin on Narcotics

SN - 0007-523X

IS - 1-2

ER -