Injecting drug users ignored in HIV/AIDS prevention efforts

With sex the main route of transmission of HIV in sub-Saharan Africa, injecting drug users have largely been ignored in HIV/AIDS interventions. But as an increasing number of African countries play a more significant role in the trafficking and transit of drugs such as heroin and cocaine, and the number of injecting drug users grows, concerns are rising about this group's vulnerability to the HI virus. Researchers at a recent conference on the US President's Emergency Plan for AIDS Relief (PEPFAR) warned that despite low rates of HIV caused by sharing drug use paraphernalia on the continent, countries such as Kenya, Tanzania, Nigeria and South Africa, were now beginning to report HIV infections among people injecting drugs. In South Africa, a study conducted by the Medical Research Council and the US Center for Disease Control and Prevention (CDC) found that injecting drug users did not know how to clean needles and dispose of them properly. Director of CDC in South Africa, Okechukwu Nwanyanwu, told delegates that even though people were aware of the risks associated with repeated use of syringes, people were still sharing and using the same needle up to 15 times. Substance abusers were more likely to have sex without condoms, did not how to access HIV/AIDS services such as antiretroviral treatment, and had poor knowledge of HIV/AIDS transmission. Commercial sex workers were identified as particularly vulnerable, as they were "trapped in a cycle of abuse" Nwanyanwu said. Often controlled by pimps, they were given drugs to raise their productivity, and condom use was inconsistent. He called for testing and treatment services to be made available in places accessed by vulnerable people, because fear of stigma and discrimination kept injecting drug users away from public health facilities. "It's not a big problem right now, but it's one that is worrying and rising," noted Nwanyanwu.