Pubdate: Tue, 20 Feb 2007
Source: Mail and Guardian (South Africa)
Copyright: Mail & Guardian, 2007
Contact:  http://www.mg.co.za/mg/
Details: http://www.mapinc.org/media/254
Author: Nasseem Ackbarally
Bookmark: http://www.mapinc.org/heroin.htm (Heroin)
Bookmark: http://www.mapinc.org/find?136 (Methadone)
Bookmark: http://www.mapinc.org/rehab.htm (Treatment)

HIV HITS DRUG USERS IN MAURITIUS	

In contrast to the rest of Southern Africa, intravenous drug users 
have become the group most vulnerable to the transmission of HIV in 
Mauritius. This has led the Mauritian government to introduce a 
syringe- and needle-exchange programme in a bid to stem HIV infection 
among Mauritian drug users.

Sexual transmission among heterosexuals is the most common way of HIV 
infection in Southern Africa, the region that has become the centre 
of the international HIV/Aids pandemic in recent years.

Mauritius is unusual in the region as the HIV prevalence rate among 
its population of 1,2-million people is less than 0,5%. Since 1987, 
162 Mauritians have died from Aids-related illnesses. Currently, at 
least 2A 345 Mauritians are living with HIV/Aids, according to 
official figures, but some social workers estimate the number to be 
about 10A 000.

Another unusual characteristic of the epidemic in Mauritius is that 
drug injection with shared needles has since 2003 been the main mode 
of HIV transmission. The sharing of contaminated needles was 
responsible for 92% of new HIV infections in 2005 and 85,2% of new 
infections in 2006.

Social worker Cadress Runghen ascribes the increased vulnerability of 
drug users to HIV/Aids to the fact that anti-Aids messages focused on 
sexual behaviour only.

Sensitisation campaigns helped to ensure that the population was made 
aware of the risk of HIV infection through sexual means, leading to a 
drop in such infections during the 1990s.

But, says Runghen, "nobody kept a check on the drug-addict 
community". In the meantime, the HI virus has been spreading like 
wildfire among the members of this marginal group.

New legislation To address this and other issues, the Mauritian 
Parliament adopted the new HIV and Aids Act at the end of 2006, which 
introduced a syringe- and needle-exchange programme and methadone 
treatment. Methadone is used to alleviate withdrawal symptoms during 
the rehabilitation of drug addicts.

In just a few weeks, 2A 000 syringes used by drug addicts have been 
taken out of circulation and replaced by new ones. A few hundred 
addicts are now being treated with methadone.

Social workers have started this programme in the capital, Port 
Louis, and on the outskirts of the capital at Baie-du-Tombeau, Roche 
Bois and Batterie CassA(c)e where a large number of drug addicts live 
or come to have their daily dose of heroin or other drugs.

They meet in places that are not generally frequented by other 
members of the public. Social workers visit these places to hand out 
new syringes and condoms. The used syringes and needles are collected 
in a plastic box and destroyed.

Winning confidence Social workers use this contact to sensitise drug 
users to HIV/Aids issues. "It is not only a programme to exchange 
syringes. It is not a mechanical exercise. We are doing it to reach 
out to drug addicts and convince them to go to one of our 
rehabilitation centres," says Runghen.

Drug addicts hide themselves from the public eye for fear of being 
arrested by the police. The social workers have to win their 
confidence. "This is a long process. Drug addicts want to talk to 
people. They want to feel the warmth of people who listen to them. 
They do not want to be rejected," Runghen adds.

One female drug addict, Nalah (not her real name), says she is now 
more aware of HIV/Aids. She and her friends used to share one syringe 
for days on end, because pharmacists would not sell them new ones.

"That is why we come to exchange our syringes. When an addict suffers 
because you cannot take your daily dose, you will take any syringe 
you find to shoot up with," she explains.

Another social worker, Imran Dhannoo, is adamant that the programme 
should be directed at those thousands of drug addicts who are 
vulnerable and who do not know about the programme. "We should reach 
out to them. We should not wait for them to come and see us."

The syringe-exchange programme is one of a number of initiatives in 
the comprehensive HIV/Aids legislation introduced last year.

National framework According to Health Minister Satish Faugoo, the 
law provides an effective national framework with prevention and care 
programmes that will get people involved in curbing the spread of 
HIV/Aids while protecting people's human rights.

Emphasis is placed on confidentiality and human rights. Thus, no HIV 
test can be undertaken without prior consent of the person being 
tested, and the results of tests must be made available to the 
person. The law also allows a minor to undergo an HIV test without 
the consent of her or his guardian.

The law determines that HIV-positive people be referred for 
treatment. Information about the HIV status of an individual is 
protected from unauthorised collection, use or disclosure in 
healthcare and other settings.

In a bid to stem stigmatisation and discrimination against people 
living with HIV, penalties have been introduced to protect their 
pension rights and employment conditions, and to prevent prejudice or 
ill-treatment of any kind.

Faugoo has said that HIV-positive people should be guaranteed equal 
rights to employment and healthcare as are accorded all other members 
of Mauritian society. The law makes it illegal to impose HIV testing 
as a precondition for employment or continued employment.

It is also an offence for a doctor not to provide treatment to a 
person who is HIV-positive or perceived to be HIV-positive. Testing 
facilities will be introduced in specific public health institutions, 
as well as pre- and post-test counselling. Testing will happen in 
accordance with strict guidelines and protocols to ensure the 
reliability of results.

Nicolas Ritter, spokesperson for a non-governmental HIV/Aids 
organisation, welcomed the new legislation. According to him, many 
people are living with HIV without knowing it.

Meanwhile, religious leaders are warning people about their sexual 
behaviour. Catholic priest Jocelyn GrA(c)goire has appealed to 
Mauritians, saying: "The house is on fire and we cannot save it. But 
we should save the furniture. You are being told to use condoms. If 
they cannot protect you from pregnancy, how can they protect you from HIV?"

"Better be faithful," added Homa Mungapen, spokesperson for the 
Council of Religions.
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MAP posted-by: Beth Wehrman