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Geneva, Switzerland, UNAIDS, 2017. 12 p.People who use and inject drugs are among the groups at highest risk of exposure to HIV, but remain marginalized and out of reach of health and social services.
Geneva, Switzerland, World Health Organization [WHO], 2015. 34 p.Key populations at higher risk of HIV include people who sell sex, men who have sex with men (MSM), transgender people and people who inject drugs. Young people who belong to one or more of these key populations – or who engage in activities associated with these populations – are made especially vulnerable to HIV by factors including widespread discrimination, stigma and violence, combined with the particular vulnerabilities of youth, power imbalances in relationships and, sometimes, alienation from family and friends. These factors increase the risk that they may engage – willingly or not – in behaviours that put them at risk of HIV, such as frequent unprotected sex and the sharing of needles and syringes to inject drugs. This brief aims to inform discussions about how best to provide health services, programmes and support for young people who inject drugs. It offers a concise account of current knowledge concerning the HIV risk and vulnerability of young people who inject drugs; the barriers and constraints they face to appropriate services; examples of programmes that may work well in addressing their needs and rights; and approaches and considerations for providing services that both draw upon and build the strengths, competencies and capacities of young people who inject drugs.
Bonn, Germany, GTZ, 2016 Apr. 7 p.This factsheet summarises the results of the past collaboration between BACKUP and the International Planned Parenthood Federation (IPPF) on the ‘Shadows and Light’ project. BACKUP Health and the International Planned Parenthood Fed-eration (IPPF) have collaborated over many years to foster greater and more rapid action on SRH and HIV linkages within the Global Fund to fight AIDS, Tuberculosis and Malaria (Global Fund). Recent collaborative work has highlighted gaps in addressing the specific needs of key populations within Global Fund pro-grammes. ‘Shadows and Light’, a three-year project funded by BACKUP Health, aims to address the linked SRH and HIV needs of key populations within four IPPF member associations. The project involved the Family Planning Association of India and transgender people, Reproductive Health Uganda and sex work-ers, Family Health Options Kenya and people who inject drugs, and the Cameroon National Association for Family Welfare and MSM. The project recognised that a comprehensive response to HIV must include initiatives that meet the needs of those who are marginalised, vulnerable, socially excluded and under-served. Based on these linkages, addressing SRH within HIV programmes and services funded by the Global Fund is a key opportunity to ensure sustainability in service provision to key populations.
Geneva, Switzerland, WHO, 2014 Jul.  p.In this new consolidated guidelines document on HIV prevention, diagnosis, treatment and care for key populations, the World Health Organization brings together all existing guidance relevant to five key populations -- men who have sex with men, people who inject drugs, people in prisons and other closed settings, sex workers and transgender people --and updates selected guidance and recommendations. These guidelines aim to: provide a comprehensive package of evidence-based HIV-related recommendations for all key populations; increase awareness of the needs of and issues important to key populations; improve access, coverage and uptake of effective and acceptable services; and catalyze greater national and global commitment to adequate funding and services.
Consultation on strategic information and HIV prevention among most-at-risk adolescents. 2-4 September 2009, Geneva. Consultation report.
New York, New York, UNICEF, 2010. 65 p.The Consultation on Strategic Information and HIV Prevention among Most-at-Risk Adolescents (MARA) focused on experiences in countries where HIV infection is concentrated among men who have sex with men (MSM), injecting drug users (IDUs), and those who sell sex. The meeting facilitated the exchange of information across regions on country-level data collection regarding MARA; identified ways to use strategic information to improve HIV prevention among MARA; and suggested ways to build support for MARA programming among decision-makers.
Estimating the level of HIV prevention coverage, knowledge and protective behavior among injecting drug users: what does the 2008 UNGASS reporting round tell us?
Journal of Acquired Immune Deficiency Syndromes. 2009 Dec; 52 Suppl 2:S132-42.OBJECTIVES: The 2001 Declaration of Commitment from the United Nations General Assembly Special Session on HIV/AIDS (UNGASS) set the prevention of HIV infection among injecting drug users (IDUs) as an important priority in the global fight against HIV/AIDS. This article examines data gathered to monitor the fulfillment of this commitment in low-income and middle-income countries (LMICs) where resources to develop an effective response to HIV are limited and where injecting drug use is reported to occur in 99 (of 147) countries, home to 75% of the estimated 15.9 million global IDU population. METHODS: Data relating to injecting drug use submitted by LMICs to the Joint United Nations Programme on HIV/AIDS (UNAIDS) in the 2008 reporting round for monitoring the Declaration of Commitment on HIV/AIDS were reviewed. The quality of the data reported was assessed and country data were aggregated and compared to determine progress in HIV prevention efforts. For each indicator, the mean value weighted for the size of each country's IDU population was determined; regional estimates were also made. RESULTS: Reporting was inconsistent between countries. Forty percent of LMIC (40/99), where injecting occurs, reported data for 1 or more of the 5 indicators pertinent to HIV prevention among IDUs. Many of the data reported were excluded from this analysis because the indicators used by countries were not consistent with those defined by UNAIDS Monitoring and Evaluation Reference Group and could not be compared. Data from 32 of 99 countries met our inclusion criteria. These 32 countries account for approximately two-thirds (68%) of the total estimated IDU population in all LMICs.The IDU population weighted means are as follows: 36% of IDUs tested for HIV in the last year; 26% of IDUs reached with HIV prevention programs in the last year; 45% of IDUs with correct HIV prevention knowledge; 37% of IDUs used a condom at last sexual intercourse; and 63% of IDUs used a clean syringe at last injection. Marked variance was observed in the data reported between different regions. CONCLUSIONS: Data from the 2008 United Nations General Assembly Special Session reporting round provide a baseline against which future progress might be measured. The data indicate a wide variation in HIV service coverage for IDUs and a wide divergence in HIV knowledge and risk behaviors among IDUs in different countries. Countries should be encouraged and assisted in monitoring and reporting on HIV prevention for IDUs.
Supporting civil society organisations to reach key populations in the Latin American and Caribbean region. A look at HIV / AIDS projects financed by the World Bank.
[Brighton, United Kingdom], International HIV / AIDS Alliance, 2006. 52 p.The purpose of this study is to assess the extent to which World Bank financed projects are supporting civil society organisations (CSOs) to reach four key populations (men who have sex with men (MSM), sex workers (SW), intravenous drug users (IDUs) and persons living with HIV/AIDS (PLWHA) in the Latin American and Caribbean (LAC) region. The study refers to the first three key populations (KPs) as 'at-risk KPs' when discussing KPs who may or may not be HIV infected. The study has two main outputs: an initial mapping of World Bank financed AIDS prevention and control projects in LAC and the role of CSOs and KPs in those projects; identification of factors that impede or facilitate CSO access to World Bank resources that target KPs. The International HIV/AIDS Alliance has commissioned this study to improve understanding of the dynamics at the country level with World Bank financed projects concerning CSOs and KPs. (excerpt)
Towards universal access by 2010. How WHO is working with countries to scale-up HIV prevention, treatment, care and support.
Geneva, Switzerland, WHO, Department of HIV / AIDS, 2006. 32 p.In 2005, leaders of the G8 countries agreed to «work with WHO, UNAIDS and other international bodies to develop and implement a package for HIV prevention, treatment and care, with the aim of as close as possible to universal access to treatment for all those who need it by 2010». This goal was endorsed by United Nations Member States at the High-Level Plenary Meeting of the 60th Session of the United Nations General Assembly in September 2005. At the June 2006 General Assembly High Level Meeting on AIDS, United Nations Member States agreed to work towards the broad goal of "universal access to comprehensive prevention programmes, treatment, care and support" by 2010. Working towards universal access is a very ambitious challenge for the international community, and will require the commitment and involvement of all stakeholders, including governments, donors, international agencies, researchers and affected communities. Among the most important priorities is the strengthening of health services so that they are able to provide a comprehensive range of HIV/AIDS services to all those who need them. This document describes the contribution that the World Health Organization (WHO) will make, as the United Nations agency responsible for health, in working towards universal access to HIV prevention, treatment, care and support in the period 2006-2010. It proposes an evidence-based Model Essential Package of integrated health sector interventions for HIV/AIDS that WHO recommends be scaled up in countries, using a public health approach, and provides an overview of the strategic directions and priority intervention areas that will guide WHO's technical work and support to its Member States as they work towards universal access over the next four years. (excerpt)
Towards universal access: scaling up priority HIV / AIDS interventions in the health sector. Progress report, April 2007.
Geneva, Switzerland, WHO, 2007 Apr. 88 p.Drawing on lessons from the scale-up of HIV interventions over the last few years, WHO, as the UNAIDS cosponsor responsible for the health sector response to HIV/AIDS, has established priorities for its technical work and support to countries on the basis of the following five Strategic Directions, each of which represents a critical area where the health sector must invest if significant progress is to be made towards achieving universal access. Enabling people to know their HIV status; Maximizing the health sector's contribution to HIV prevention; Accelerating the scale-up of HIV/AIDS treatment and care; Strengthening and expanding health systems; Investing in strategic information to guide a more effective response. In this context, WHO undertook at the World Health Assembly in May 2006 to monitor and evaluate the global health sector response in scaling up towards universal access and to produce annual reports. This first report addresses progress in scaling up the following health sector interventions. Antiretroviral therapy; Prevention of mother-to-child transmission of HIV (PMTCT); HIV testing and counseling; Interventions for injecting drug users (IDUs); Control of sexually transmitted infections (STIs) to prevent HIV transmission; Surveillance of the HIV/AIDS epidemic. (excerpt)
New York, New York, United Nations Population Fund [UNFPA], 2007.  p.The influence behind faith-based organizations is not difficult to discern. In many developing countries, FBOs not only provide spiritual guidance to their followers; they are often the primary providers for a variety of local health and social services. Situated within communities and building on relationships of trust, these organizations have the ability to influence the attitudes and behaviours of their fellow community members. Moreover, they are in close and regular contact with all age groups in society and their word is respected. In fact, in some traditional communities, religious leaders are often more influential than local government officials or secular community leaders. Many of the case studies researched for the UNFPA publication Culture Matters showed that the involvement of faith-based organizations in UNFPA-supported projects enhanced negotiations with governments and civil society on culturally sensitive issues. Gradually, these experiences are being shared across countries andacross regions, which has facilitated interfaith dialogue on the most effective approaches to prevent the spread of HIV. Such dialogue has also helped convince various faith-based organizations that joining together as a united front is the most effective way to fight the spread of HIV and lessen the impact of AIDS. This manual is a capacity-building tool to help policy makers and programmers identify, design and follow up on HIV prevention programmes undertaken by FBOs. The manual can also be used by development practitioners partnering with FBOs to increase their understanding of the role of FBOs in HIV prevention, and to design plans for partnering with FBOs to halt the spread of the virus. (excerpt)
Manila, Philippines, World Health Organization [WHO], Regional Office for the Western Pacific, 2007. 99 p.Inside Out contains resident education and staff training material primarily for use within drug treatment and rehabilitation centers. Inside Out is specifically written for this purpose: to assist staff and residents of closed settings to act in ways which help prevent the spread of HIV. It is about prevention, prevention, and more prevention. It focuses on providing those in compulsory drug treatment and rehabilitation centers with staff training and resident education materials that promote a harm reduction approach to HIV, both within the center and outside of it: hence the title - Inside Out. (excerpt)
Contact. 2006 Aug; (182):4-5.Saving lives is the paramount goal of all HIV programmes. Successful HIV prevention programmes utilize all approaches known to be effective, not implementing one or a few select actions in isolation. These include promoting sexual abstinence, fidelity among married couple and the use of condoms for those who are not in a position to abstain or be faithful. It also includes ensuring that injecting drug users have access to clean needles and syringes as well as programmes supporting them to stop drug use. The strategies also include assurance that HIV-positive pregnant women receive treatment to prevent HIV transmission to the child. These strategies (See insert) were endorsed by the UNAIDS board last year and provide the framework for re-energizing HIV prevention globally. (excerpt)
Lancet. 2007 Mar 3; 369(9563):720-721.In December, 2006, the Joint UN Programme on HIV/AIDS (UNAIDS) submitted to its governing board a paper on HIV/AIDS and security--a culmination of wide ranging UN discussions on this subject that began with the historic consideration of AIDS in the Security Council in 2000. The paper reprises frequently raised concerns--ie, that high AIDS-related mortality in the military will compromise security in highly affected countries, or that high costs of AIDS will sap public resources needed to ensure security. UNAIDS notes that such destabilisation has not yet occurred, but that "does not mean that… such a threat will not emerge". In such analyses, the effect of AIDS on military strength and public security overshadows what may be a substantially more important link between AIDS and security--ie, the effect of the unfettered pursuit of a public security agenda, including counterterrorism measures, on the lives of people who are most affected by, or vulnerable to, HIV/AIDS. (excerpt)
Peddro. 2001 Dec; 4.The world has been responding to HIV/AIDS for twenty years, and some universal lessons have been learned during that period. One is that effective AIDS responses have to start with the world as it is, not as we would like it to be. A second lesson is that blaming or castigating people at risk of HIV infection simply adds to the stigma, drives risky behaviour underground and fails to stop the spread of the epidemic. And a third lesson is that no matter how well-hidden it may be, HIV transmission via injecting drug use has been at least partly responsible for the epidemic nearly everywhere. Up to now, 114 countries have reported the occurrence of HIV infection among their drug injecting communities. Injecting drug use is either the main mode of transmission of HIV infection or one of the main modes in many countries in Asia, Latin America, Europe, and North America. Even in the epidemic in sub-Saharan Africa, although the great bulk of HIV transmission is attributable to sex, injecting drug use is also a source of risk. Since sharing injecting equipment causes a great deal of contamination, this practice can be responsible for the unpredictable mushrooming of the epidemic. But the spread of HIV as the result of injecting drug use is never confined to the injecting drug users alone: injecting drug users also have sexual partners, and may also be mothers needing to protect their infants from HIV, and in many places the sex trade and drug abuse are closely associated. HIV transmission via injecting drug use therefore has the potential to kick-start much wider epidemics, such as that which occurred at the end of the 1980s in Thailand. (excerpt)
Antiretroviral treatment for injecting drug users in developing and transitional countries 1 year before the end of the "Treating 3 million by 2005. Making it happen. The WHO strategy" (‘3 by 5').
Addiction. 2006 Sep; 101(9):1246-1253.The objective was to describe and estimate the availability of antiretroviral treatment (ART) to injecting drug users (IDUs) in developing and transitional countries. Literature review of grey and published literature and key informants' communications on the estimated number of current/former injecting drug users (IDUs) receiving ART and the proportion of human immunodeficiency virus (HIV) attributed to injecting drug use (IDU), the number of people in ART and in need of ART, the number of people living with HIV/acquired immunodeficiency syndrome (AIDS) (PLWHA) and the main source of ART. Data on former/current IDUs on ART were available from 50 countries (in 19 countries: nil IDUs in treatment) suggesting that ~34 000 IDUs were receiving ART by the end of 2004, of whom 30 000 were in Brazil. In these 50 countries IDUs represent ~15% of the people in ART. In Eastern European and Central Asia IDU are associated with > 80% of HIV cases but only ~2000 (14%) of the people in ART. In South and South-East Asia there were ~1700 former/current IDUs receiving ART (~1.8% of the people in ART), whereas the proportion of HIV cases associated to IDU is > 20% in five countries (and regionally ranges from 4% to 75%). There is evidence that the coverage of ART among current/former IDUs is proportionally substantially less than other exposure categories. Ongoing monitoring of ART by exposure and population subgroups is critical to ensuring that scale-up is equitable, and that the distribution of ART is, at the very least, transparent. (author's)
Choices. 2001 Dec; 18-19.I don't have any used syringes. Somebody has stolen all, Anka was almost begging. In a worn-out black T-shirt and torn jeans, she looked helpless and desperate, standing in the middle of a vacant square, squeezed between Warsaw's main railway station and a Holiday Inn hotel. "I really don't have any," she repeated. "You know it's an exchange. Go and find some," Grzegorz Kalata said, patiently but firmly. Kalata comes to the square -- a meeting point for local drug users -- almost every evening. He is a streetworker from Monar, Poland's leading chain of non-profit detoxification centres. Under a harm reduction programme, partly sponsored by the United Nations Development Programme (UNDP), Kalata gives disposable syringes and needles, bandages, condoms and antiseptics to drug addicts who meet at the square. In return, he collects used syringes and needles in a plastic container, usually full by the end of his visit. After scouring the grass at the site, Anka came back with four used needles. Kalata gave her seven new ones and a package of bandages. On average, Kalata gives out some 200 needles and 150 syringes during an evening. (excerpt)
[Kyiv], Ukraine, UNDP, . 11 p.HIV/AIDS presents the greatest challenge to human development the world has ever seen. With nearly 42 million people living with HIV/ AIDS, 20 million already dead and 15,000 new infections daily, its devastating scale and impact constitute a global emergency that is undermining social and economic development throughout the world and affecting individuals, families, communities and nations. HIV/AIDS reverses gains in human development and denies people the basic opportunities for living long, healthy, creative and productive lives. It impoverishes people and places burdens on households and communities to care for the sick and dying, while claiming the lives of people in their most productive years. HIV/AIDS also results in social exclusion and violations of human dignity and rights affecting people's psychological well-being. While the long-term consequences may not yet be visible here, Ukraine is glimpsing the enormity of the problem in its newly independent country. The number of reported cases of HIV infection in the country has increased 20 times in the past five years yielding estimates of 300,000 to 400,000 people already infected, which is approximately 1% of the adult population. The Declaration of Commitment of the UN General Assembly Special Session on HIV/AIDS notes "the potential exists for a rapid escalation of the epidemic". The dynamics of the spread of the epidemic can be indicative of the potential magnitude of future human development impacts, deepening over time and affecting future generations. (excerpt)
HIV / AIDS prevention, treatment and care among injecting drug users and in prisons. Ministerial Meeting on “Urgent Response to the HIV / AIDS Epidemics in the Commonwealth of Independent States”, Moscow, 31 March to 1 April 2005.
Geneva, Switzerland, UNAIDS, 2005. 9 p.There are an estimated 13.2 million injecting drug users (IDUs) worldwide. Of them, nearly one quarter (3.1 million) live in the 12 countries of the Commonwealth of Independent States (CIS). In addition, the region is home to a large number of non-injecting drug users, who are at risk of becoming injecting drug users. HIV infection among injecting drug users has grown rapidly. There is evidence for example that in the mid-1990s in cities such as Odessa, Svetlogorsk, Nikolayev and St. Petersburg, prevalence among injecting drug users rose up to 60% in a short period of time (less than eight months). In Kaliningrad, a total of 1335 new infections—80% of those due to unsafe injecting drug use—were identified between July 1996 and June 1997. From these HIV epicentres, the virus has, and continues to, spread quickly across the entire region. For example, by the end of 2000, the Russian Federation observed HIV epidemics in 30 cities and in 82 of 89 regions (oblasts). Other CIS countries are undergoing similar epidemics. HIV spreads rapidly among injecting drug users through the use of contaminated injecting equipment and because of poor access to treatment for drug dependency and HIV-prevention services. However, the virus is not only common among injecting drug users. Sexual partners of injecting drug users can also become infected through unsafe sexual behaviour. Children borne to female injecting drug users are frequently HIV-infected. A great number of injecting drug users are involved in sex work, thus spreading the epidemics even further. (excerpt)
Condemned to death: thanks to the US-led drug war, AIDS is exploding among injection drug users. (Thailand).
Nation. 2004 Apr 26; 278(16): p..In addition to the obligatory red ribbons, the logo for the XV international AIDS Conference features three Asian elephants raising their trunks as if in welcome. The world's most important gathering of AIDS specialists will be held this July in Bangkok, a location chosen not only because Asia is thought to be the site of the next big wave of HIV infections but because Thailand is one of only a few developing countries that have thus far seemed able to control them. International experts have hailed Thailand's 100 percent condom program, which in the 1990s distributed some 60 million condoms for free sex establishments, engaged brothel owners and government officials alike to make sure they were used and helped bring down rates of HIV and sexually transmitted infections as much as fourfold. Thailand is also the first developing country to create a functional program to stop mother-to-child HIV transmission, providing free prenatal care and preventive medication to more than three-quarters of pregnant women testing positive for HIV. Last June Kofi Annan's praise of Thailand was one of the few bright spots in an otherwise grim report to the UN General Assembly on lack of global progress against AIDS. (excerpt)
Using standarized methods for research on HIV and injecting drug use in developing / transitional countries: case study from the WHO Drug Injection Study.
BMC Public Health. 2006 Mar 2; 6(1):54.Successful cross-national research requires methods that are both standardized across sites and adaptable to local conditions. We report on the development and implementation of the methodology underlying the survey component of the WHO Drug Injection Study Phase II - a multi-site study of risk behavior and HIV seroprevalence among Injecting Drug Users (IDUs). Standardized operational guidelines were developed by the Survey Coordinating Center in collaboration with the WHO Project Officer and participating site Investigators. Throughout the duration of the study, survey implementation at the local level was monitored by the Coordinating Center. Surveys were conducted in 12 different cities. Prior rapid assessment conducted in 10 cities provided insight into local context and guided survey implementation. Where possible, subjects were recruited both from drug abuse treatment centers and via street outreach. While emphasis was on IDUs, non-injectors were also recruited in cities with substantial non-injecting use of injectable drugs. A structured interview and HIV counseling/testing were administered. Over 5,000 subjects were recruited. Subjects were recruited from both drug treatment and street outreach in 10 cities. Non-injectors were recruited in nine cities. Prior rapid assessment identified suitable recruitment areas, reduced drug users' distrust of survey staff, and revealed site-specific risk behaviors. Centralized survey coordination facilitated local questionnaire modification within a core structure, standardized data collection protocols, uniform database structure, and cross-site analyses. Major site-specific problems included: questionnaire translation difficulties; locating affordable HIV-testing facilities; recruitment from drug treatment due to limited/selective treatment infrastructure; access to specific sub-groups of drug users in the community, particularly females or higher income groups; security problems for users and interviewers, hostility from local drug dealers; and interference by local service providers. Rapid assessment proved invaluable in paving the way for the survey. Central coordination of data collection is crucial. While fully standardized methods may be a research ideal, local circumstances may require substantial adaptation of the methods to achieve meaningful local representation. Allowance for understanding of local context may increase rather than decrease the generalizability of the data. (author's)
Connections. 2006 Feb;  p.Nearly 5 million people worldwide were infected with HIV in 2005, marking the largest jump in new cases since the disease was first recognized in 1981, according to the AIDS Epidemic Update 2005 released by UNAIDS last December in conjunction with World AIDS Day. The virus claimed the lives of 3.1 million people in 2005, with more than half a million of these deaths occurring among children. Although sub-Saharan Africa and Southeast Asia continue to remain the hardest hit areas, the report clearly indicates that the virus is continuing to spread at alarming rates within Eurasia, bringing the region to the brink of a full-blown epidemic. The number of people living with HIV in Eastern Europe and Central Asia reached 1.6 million in 2005, a 20-fold increase from 2003. Even more striking, AIDS claimed the lives of 62,000 people there last year-nearly double the mortality rate attributed to the virus 2003. (excerpt)
Lancet. 2005 Jul 2; 366(9479):1.Last week, WHO distributed to all European ministries of health one of the most important documents on prison health ever published. The report, Status Paper on Prisons, Drugs and Harm Reduction, brings together the wealth of evidence that shows that infectious disease transmission in prisons can be prevented and even reversed by simple, safe, and cheap harm-reduction strategies. Perhaps most importantly, the paper affirms WHO’s commitment to harm reduction, despite opposition from many governments who view such approaches as a tacit endorsement of illegal behaviour. The public-health case for action is strong, but political commitment to this method of combating health problems in prisons remains elusive. Indeed, health problems in prisons are numerous. Prisoners are often from the poorest sectors of society and consequently already suffer from health inequalities. Being in prison commonly exacerbates existing health problems—incarcerating anyone, especially vulnerable groups such as drug users and those with mental illness, has serious health and social consequences. (excerpt)
New York, New York, Human Rights Watch, 2005 Feb-Mar. (1) 2 p.The Commission on Narcotic Drugs (CND) is the central agency in the United Nations system responsible for setting international drug policy. At its 48th session from March 7-14, 2005 in Vienna, the Commission will focus on HIV/AIDS. This year the U.N. Office on Drugs and Crime (UNODC) chairs the consortium of U.N. agencies that makes up the Joint U.N. Programme on HIV/AIDS (UNAIDS), making the Commission’s focus on HIV/AIDS particularly timely. Of the approximately five million new HIV infections in 2004, an estimated 10 percent stemmed from injection drug use. In some countries, such as Russia, injection drug use accounts for up to 75 percent of reported HIV cases. HIV/AIDS among injection drug users is spread chiefly through the sharing of blood-contaminated syringes. This makes it critically important for drug users to have access to noninjected drug opiate substitutes (such as methadone and buprenorphine), as well as sterile injection equipment, until such time as they can stop using drugs. This is especially true given the chronic and relapsing nature of drug addiction and the worldwide scarcity of effective drug treatment. (excerpt)
Geneva, Switzerland, World Health Organization [WHO], Department of HIV / AIDS, 2005.  p.The epidemic of HIV infection and AIDS among injecting drug users (IDUs) and its spread from IDU populations to their sexual partners and the wider community is an important but often neglected aspect of the global AIDS pandemic. This neglect has resulted from: ignorance of the existence or extent of the epidemic; cultural, social and political constraints on the development of responses; and prejudice against people engaged in illegal behaviour such as drug use. Nevertheless, the major reasons these epidemics are so often neglected are the lack of understanding of the importance of controlling the epidemic, ignorance of effective methods for controlling the epidemic and a lack of knowledge about how to develop effective responses. (excerpt)
IDU. Injecting Drug User Intervention Impact Model. Version 2.0, May 2000. A tool to estimate the impact of HIV prevention activities focused on injecting drug users.
London, England, London School of Hygiene and Tropical Medicine, 2000 May. 53 p.IDU 2.0 is one of five simulation models within HIVTools. IDU 2.0 can be used, within a particular setting, to estimate the impact on HIV transmission of prevention activities focusing on the injecting drug users (IDU's). It can also be used to explore the likely impact of different policy options. The program simulates the transmission of HIV between injecting drug users, and the transmission of HIV and STDs between IDU's and their sexual partners, both in the presence and absence of an intervention. The extent to which an intervention may avert HIV infection is estimated using a range of context specific inputs. This includes epidemiological information describing the prevalence of HIV infection among the IDU's and their non-IDU sexual partners at the start of the intervention, and the probabilities of HIV and STD infection. Behavioural inputs are used to describe the patterns of needle sharing, sexual behaviour and condom use among the IDU's reached and not reached by the intervention. Demographic and intervention specific inputs are used to estimate the size of the total IDU population, the proportion of males and females in the IDU population, and the proportion of each reached by the intervention. These are then used to project the overall patterns of needle sharing, sexual behaviour and condom use among IDU's with and without the intervention. (excerpt)