Pubdate: Tue, 13 Feb 2007
Source: Stabroek News (Guyana)
Copyright: 2007 Stabroek News
Author: Oluatoyin Alleyne
Bookmark: (Harm Reduction)
Bookmark: (Treatment)


A new study here has found that HIV prevalence among people who use 
illicit drugs is "alarmingly high", highlighting a strong correlation 
between HIV and substance abuse.

Some 172 persons were interviewed in the study and HIV tests were 
conducted with the results showing that there was an overall HIV rate 
of 16.9%. Women in the study had an HIV rate at an "astounding 
52.9%". Out of the 172, 17% of the persons were found to be HIV 
infected and out of that number 13% of the men were positive with 
some 53% of the females being positive.

Following the results, Clarence Young of the Ministry of Health, 
Division of Health Sciences Education, which was a partner in the 
study, said that when they started the study they had decided that if 
they found 2% of the persons were infected it would have been 
significant. However, they were all alarmed to find such a large 
number of persons infected.

Cocaine readily available

He said in light of that number, no longer can the issue be ignored 
but rather it is something that needs to be looked at closely and he 
would even say that there is a correlation between the infection rate 
and substance use. He also pointed out that cocaine is readily 
available and drug users can get a 'fix' for as little as $100 while 
stating that it is not an issue of willpower as the addicts are 
powerless and they must be motivated to seek help.

Young was at the time speaking at the Main Street location of the 
Canadian International Development Agency (CIDA) where he presented 
the findings of the study.

The research participants came from all areas of Georgetown, such as 
Bourda, Leopold Street, Alexander Street, Albouystown and Kitty, and 
more men than women were interviewed with the age range of the 
interviewees being between 18 and 69. However, they reported that 
their drug use began as early as 12 years old. They said that they 
used crack cocaine but alcohol and marijuana were the main drugs of 
choice. It was stated that reports of individuals injecting drugs was 
low at 3.5% but 14% stated they had seen someone inject in the city.

"Many share characteristics of being single, homeless, and having had 
involvement with the criminal justice system," the report said. 
Meanwhile, a majority stated they would like to get into an addiction 
treatment programme, but they faced many barriers in doing so. 
Accord-ing to the study, 13.4% of the participants were commercial sex workers.

The study found that 47% of the participants were homeless, with the 
main sources of income being temporary work and begging; 77% had been 
to prison, 42% had committed a drug-related offence and 46% had 
access to health care in the past 12 months.

The study also found that 18% of the participants reported having 
between 1 to 5 lifetime sexual partners, 24% had 6 to 19; 30% 20 to 
99, 23% 100 to 499 and 5% over 500 partners. Thirteen percent were 
involved in commercial sex work.

On the issue of the drug used by the participants the study found 
that 97% had used crack, 88% had used alcohol; 88% had used marijuana 
while 90% used crack daily and six persons reported having injected 
drugs while 24 had seen someone doing it.

Mental illness also came into play during the study with 4% reporting 
having been previously diagnosed with a mental illness, 37% had 
experienced a drug overdose, 61% reported having had a previous STI, 
18% had been diagnosed with tuberculosis and 36% had been previously 
tested for HIV.

Interestingly the study said that 88% wanted addiction treatment 
while 19% actually received treatment and 62% said it was too costly 
to access treatment, 12% were unaware of treatment programmes and 20% 
actually had no desire to quit.

The study found that there is need to develop a strategy to address 
HIV and substance users and this should include a broad-based, 
comprehensive response from a wide variety of stakeholders.

Further, there is need for a public health response that addresses 
the complex nature of HIV and substance use, and is flexible, 
appropriate and informed. The response requires "Addiction services 
that are prepared to respond to people in the varying stages of their 
substance use and can facilitate HIV prevention, testing, and 
treatment," the study said.

It was suggested that addictions must be seen as a health issue that 
is complex. Moreover, actions must be broad based and comprehensive 
and partnerships are necessary. An oversight body is also essential 
among other recommendations.

Suggested areas of activities are prevention, treatment, harm 
reduction, enforcement and governance and one of the preventative 
measures suggested was working with alcohol producers to modify 
advertising campaigns and location of ads. Also suggested were 
addiction awareness and education programmes for the general public, 
including associated HIV risks. Another recommendation was drug 
addiction counselling for children in schools that is realistic, 
appropriate and informative as well as a strong system for sports, 
arts and recreation for children and young people to avert harmful 
drug use. In the area of treatment it was suggested among other 
things that programmes be developed with specially trained staff to 
work with those with coexisting addictions and mental health issues 
and also to promote self-help groups across the country. Also it was 
suggested that there should be specific programming for those with 
fatal alcohol syndrome and attention deficit hyperactivity disorder.

As for governance it was suggested that the health ministry take the 
lead with the development of a drug use secretariat. Further there 
should be broad-based awareness by politicians, government 
bureaucrats and officials of addiction issues and their relation to 
HIV and harm reduction.
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MAP posted-by: Beth Wehrman