Study Finds 3 Million IDUs Worldwide Are HIV-Positive
Of the 15.9 million injection drug users throughout the world, three million likely are HIV-positive, according to a study published on Wednesday in the Lancet, AFP/Google.com reports (AFP/Google.com, 9/23). The study, which reviewed injection drug use and the prevalence of HIV/AIDS among IDUs in 148 countries, found that a lack of data from Africa, the Middle East and Latin American could be masking a larger issue worldwide, IRIN/PlusNews reports (IRIN/PlusNews, 9/24).
Led by Bradley Mathers of the National Drug and Alcohol Research Centre at the University of New South Wales, the study found that China has the largest number of IDUs, with a mid-range estimate of 2.35 million IDUs and an HIV prevalence of 12.3% among the group. The U.S. has the second highest case load, with about 1.85 million IDUs and an estimated prevalence among them of 15.6%, according to the study. Researchers also noted potentially high HIV prevalence among IDUs in Ukraine and Russia, which could be 42% and 37%, respectively (AFP/Google.com, 9/23). According to the study, HIV prevalence among IDUs is more than 40% in nine countries: Argentina, Brazil, Estonia, Indonesia, Kenya, Myanmar, Nepal, Thailand and Ukraine (Kahn, Reuters, 9/23).
Data on injection drug use was available for only 13 out of 47 countries in sub-Saharan Africa. Mathers said that "a constellation of risk factors exists for the development of injecting drug use" in Africa, including high levels of socioeconomic hardship and the fact that many countries in the region are the source of illegal drugs being smuggled into Europe (IRIN/PlusNews, 9/24).
The report found that Australia and New Zealand have low HIV prevalence among IDUs despite high numbers of users, which researchers attributed to quick introduction of needle-exchange programs in the 1980s (Reuters, 9/23). About 1.5% of IDUs in Australia are HIV-positive, and New Zealand has an HIV prevalence of 1.6% among IDUs (McLean, AAP/The Age, 9/24).
Mathers and his colleagues wrote that injection drug use "occurs in most countries and HIV infection is prevalent among many populations of injecting drug users, representing a major challenge to global health" (Reuters, 9/23). They added that "[t]here is a clear mandate to invest in HIV prevention activities such as needle and syringe programs and opioid substitution treatment" and that more research is needed to accurately measure the scale of the problem.
Kamyar Arasteh and Don Des Jarlais of Beth Israel Medical Center in an accompanying commentary wrote that not enough IDUs were accessing HIV prevention, testing and treatment services but that if "HIV prevention efforts are implemented on a large scale when prevalence is low in injecting drug users, it is possible to avert HIV epidemics in users" (IRIN/PlusNews, 9/24).