Overland heroin trafficking routes and HIV-1 spread in south and south-east Asia

Chris Beyrer, Myat Htoo Razak, Khomdon Lisam, Jie Chen, Wei Lui, Xiao Fang Yu

Research output: Contribution to journalArticle

Abstract

Objectives: Burma produces approximately 60 of the world's heroin, Laos is the third leading producer. Recent outbreaks of injecting drug use and HIV-1 in Burma, India, China, and Vietnam have been associated with Burmese and Laotian overland heroin trafficking routes. We analyzed findings from narcotics investigations, molecular epidemiology studies of HIV-1, and epidemiologic and behavioral studies of injecting drug use, to evaluate the roles that the heroin export routes play in the spread of drug use and HIV-1 in south and south-east Asia. Methods: We reviewed the medical and narcotics literature, the molecular epidemiology of HIV, and did key informant interviews in India, China, and Burma with injecting drug users, drug traffickers, public health staff, and narcotics control personnel. Results: Four recent outbreaks of HIV-1 among injecting drug users appear linked to trafficking routes. Route 1: From Burma's eastern border to China's Yunnan Province, with initial spread of HIV-1 subtype B, and later C. Route 2: Eastern Burma to Yunnan, going north and west, to Xinjiang Province, with B, C, and a B/C recombinant subtype. Route 3: Burma and Laos, through northern Vietnam, to China's Guangxi Province, subtype E. Route 4: Western Burma, across the Burma-India border to Manipur, predominant subtype C, and B and E. Conclusions: Overland heroin export routes have been associated with dual epidemics of injecting drug use and HIV infection in three Asian countries and along four routes. Molecular epidemiology is useful for mapping heroin routes. Single country narcotics and HIV programs are unlikely to succeed unless the regional narcotic-based economy is addressed. (C) 2000 Lippincott Williams and Wilkins.

Original languageEnglish (US)
Pages (from-to)75-83
Number of pages9
JournalAIDS
Volume14
Issue number1
DOIs
StatePublished - 2000

Keywords

  • Asia
  • HIV/AIDS
  • Heroin trafficking
  • Molecular epidemiology

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

Fingerprint Dive into the research topics of 'Overland heroin trafficking routes and HIV-1 spread in south and south-east Asia'. Together they form a unique fingerprint.

  • Cite this