the hiv epidemic among people who inject drugs
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The HIV Epidemic among People who Inject Drugs. Thomas Kerr Director, Urban Health Research Initiative, BC Centre for Excellence in HIV/AIDS St. Paul ’ s Hospital, Providence Health Care Associate Professor, Division of AIDS Department of Medicine, University of British Columbia. - PowerPoint PPT PresentationTRANSCRIPT
The HIV Epidemic among People who Inject Drugs
Thomas KerrDirector, Urban Health Research Initiative,
BC Centre for Excellence in HIV/AIDSSt. Paul’s Hospital, Providence Health Care
Associate Professor, Division of AIDSDepartment of Medicine, University of British Columbia
People who Inject Drugs: The Global Situation
• 11 - 21 million PWID in 151 countries
• 0.8 – 6.6 million PWID living with HIV/AIDS
• Growing epidemics in former Soviet Union/Eastern Europe & Southeast Asia driven primarily by PWID and transmission to their partners
Mathers et al., Lancet 2008; Mathers et al., Lancet 2010; UNAIDS, 2012
49 countries with HIV prevalence among PWID 22-50% greater than the in general population (UNAIDS, 2012)
Injection Drug Use & HIV/AIDS
Mathers et al., The Lancet, 2008
Access to Evidence-based HIV Prevention & Treatment
• 57 countries reporting: 37% of PWID receiving an HIV test annually
• NEP in 82 countries: 5% of injections covered by sterile syringes
• OST in 71 countries: 8 per 100 PWID covered with OST
Mathers et al., Lancet, 2010Degenhardt et al., 2010; UNAIDS, 2012
Access to Evidence-based HIV Prevention & Treatment
• 57 countries reporting: 37% of PWID receiving an HIV test annually
• NEP in 82 countries: 5% of injections covered by sterile syringes
• OST in 71 countries: 8 per 100 PWID covered with OST
• 47 countries reporting ART for PWID: 4 per 100 PWID receiving ART
Mathers et al., Lancet, 2010Degenhardt et al., 2010; UNAIDS, 2012
AIDS & Behavior, in press
The Lancet, 2010
Journal of Infectious Diseases, 2011
Global heroin supply increased by 380% from 1980-2010Price of heroin in Europe decreased by 79%
Conclusions
• PWID suffer from high rates of preventable HIV infection
• Evidence-based interventions exist but access remains low
• Enforcement and incarceration have failed to reduce the use and supply of drugs and have contributed to the spread of HIV infection and treatment failure
• The barriers to scale-up of prevention and treatment programs are social and structural in nature