TY - JOUR
T1 - What has been achieved in HIV prevention, treatment and care for people who inject drugs, 2010-2012? A review of the six highest burden countries
AU - Degenhardt, Louisa
AU - Mathers, Bradley M.
AU - Wirtz, Andrea L.
AU - Wolfe, Daniel
AU - Kamarulzaman, Adeeba
AU - Carrieri, M. Patrizia
AU - Strathdee, Steffanie A.
AU - Malinowska-Sempruch, Kasia
AU - Kazatchkine, Michel
AU - Beyrer, Chris
N1 - Funding Information:
We wish to acknowledge the Johns Hopkins School of Public Health graduate students who assisted us with the updates of the systematic reviews, namely: Tricia Aung, Erica Layer, Hieu Pham, Ju Nyeong Park, Benjamin A. Williams, and Kelsey Wright. The Center for Public Health and Human Rights, Johns Hopkins School of Public Health, and the Global Drug Policy Program, Open Society Foundation. Louisa Degenhardt is supported by an Australian National Health and Medical Research Council (NHMRC) Principal Research Fellowship. The National Drug and Alcohol Research Centre at the University of NSW is supported by funding from the Australian Government under the Substance Misuse Prevention and Service Improvements Grants Fund.
PY - 2014/1
Y1 - 2014/1
N2 - Objective: In 2010 the international HIV/AIDS community called on countries to take action to prevent HIV transmission among people who inject drugs (PWID). To set a baseline we proposed an "accountability matrix", focusing upon six countries accounting for half of the global population of PWID: China, Malaysia, Russia, Ukraine, Vietnam and the USA. Two years on, we review progress. Design: We searched peer-reviewed literature, conducted online searches, and contacted experts for 'grey' literature. We limited searches to documents published since December 2009 and used decision rules endorsed in earlier reviews. Results: Policy shifts are increasing coverage of key interventions for PWID in China, Malaysia, Vietnam and Ukraine. Increases in PWID receiving antiretroviral treatment (ART) and opioid substitution treatment (OST) in both Vietnam and China, and a shift in Malaysia from a punitive law enforcement approach to evidence-based treatment are promising developments. The USA and Russia have had no advances on PWID access to needle and syringe programmes (NSP), OST or ART. There have also been policy setbacks in these countries, with Russia reaffirming its stance against OST and closing down access to information on methadone, and the USA reinstituting its Congressional ban on Federal funding for NSPs. Conclusions: Prevention of HIV infection and access to HIV treatment for PWID is possible. Whether countries with concentrated epidemics among PWID will meet goals of achieving universal access and eliminating new HIV infections remains unknown. As long as law enforcement responses counter public health responses, health-seeking behaviour and health service delivery will be limited.
AB - Objective: In 2010 the international HIV/AIDS community called on countries to take action to prevent HIV transmission among people who inject drugs (PWID). To set a baseline we proposed an "accountability matrix", focusing upon six countries accounting for half of the global population of PWID: China, Malaysia, Russia, Ukraine, Vietnam and the USA. Two years on, we review progress. Design: We searched peer-reviewed literature, conducted online searches, and contacted experts for 'grey' literature. We limited searches to documents published since December 2009 and used decision rules endorsed in earlier reviews. Results: Policy shifts are increasing coverage of key interventions for PWID in China, Malaysia, Vietnam and Ukraine. Increases in PWID receiving antiretroviral treatment (ART) and opioid substitution treatment (OST) in both Vietnam and China, and a shift in Malaysia from a punitive law enforcement approach to evidence-based treatment are promising developments. The USA and Russia have had no advances on PWID access to needle and syringe programmes (NSP), OST or ART. There have also been policy setbacks in these countries, with Russia reaffirming its stance against OST and closing down access to information on methadone, and the USA reinstituting its Congressional ban on Federal funding for NSPs. Conclusions: Prevention of HIV infection and access to HIV treatment for PWID is possible. Whether countries with concentrated epidemics among PWID will meet goals of achieving universal access and eliminating new HIV infections remains unknown. As long as law enforcement responses counter public health responses, health-seeking behaviour and health service delivery will be limited.
KW - Injecting drug use, HIV, Needle and syringe programme
KW - Opioid substitution therapy, Antiretroviral therapy, Prevention
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U2 - 10.1016/j.drugpo.2013.08.004
DO - 10.1016/j.drugpo.2013.08.004
M3 - Short survey
C2 - 24113623
AN - SCOPUS:84892957443
VL - 25
SP - 53
EP - 60
JO - International Journal of Drug Policy
JF - International Journal of Drug Policy
SN - 0955-3959
IS - 1
ER -