Injecting drug use major cause for HIV and AIDS growth in Indonesia

By, Antara News, May 22, 2007

Jakarta - Injecting drug use and risky sexual behavior have been the major causes for the growth of HIV and AIDS in Indonesia since 1999, Indonesian representative at the 61st United Nations General Assembly session in New York, Adiyatwidi Adiwoso Asmady, said on Monday.

"In Papua, an increasing number of HIV and AIDS cases are attributable to men engaging in commercial sex work and premarital sex without condom use," Adiyatwidi said.

She added that there were an estimated 193,000 HIV-infected people in 2006, and there were over 8,000 people with fully developed AIDS. The highest prevalence of AIDS was found among 20 to 29 year olds.

She said national leadership came from the ministerial level, under the guidance of the National AIDS Commission. Management at the provincial level was in the hands of local AIDS commissions, which were multisectoral bodies comprised of Governmental and non-governmental representatives.

"They worked within the framework of the national AIDS strategy, which emphasized family welfare and religion in combating the spread of HIV," she added.

She said the strategy provided strong support for a practical public health approach to the HIV challenge, including condom promotion and harm reduction strategies for injecting drug users.

According to her, the Government had enhanced the capacity of the National AIDS Commission to provide sterile needles and condoms to high risk groups, among other things.

Adiyatwidi said the health sector budget had increased annually and currently amounted to $13 million. Regional Governments received $1.6 million in 2006, a 100 per cent increase from the 2004 budget.

"The President had meanwhile expressed interest in tackling the HIV, AIDS epidemic by making a 250 per cent increase to the health sector budget in 2007," she pointed out.

In light of the continued growth of the global AIDS epidemic, the international community was called on to renew its commitments made in 2001 and 2006.

It was particularly important that low- and middle-income countries received the financial backing that they needed to achieve their national targets.

Meanwhile, a United Nations press statement said that as the UN General Assembly turned its attention to the global response to HIV and AIDS, Secretary-General Ban Ki-moon promised that the pandemic which had killed more than 25 million people in the course of the last quarter century -- would remain a system-wide priority for the United Nations.

Addressing the Assembly on Monday, as it met one year after last June`s high-level session to review the implementation of the Declaration of Commitment on HIV and AIDS, adopted by Member States in June 2001, Ban stressed that only when the international community worked together with unity of purpose -- unity among Governments, the private sector and civil society -- could it defeat AIDS.

"Today, 40 million people are living with HIV. Almost half of them are women. More women -- including married women -- are living with HIV than ever before," he said, adding that without adequate treatment, all those infected will die beacuse some 8,000 people die of AIDS-related illnesses every day.

The UN chief pointed out that at the same time, another 12,000 become infected with HIV. For every person who starts antiretroviral treatment, six more become infected.(*)

Source: http://www.antara.co.id/en/arc/2007/5/22/injecting-drug-use-major-cause-for-hiv-and-aids-growth-in-indonesia/

Adding HIV Risk Reduction Strategies To Drug Abuse Treatment Has Favorable Outcomes For Pregnant Women At Risk Of Infection

By, Medical News Today, May 14, 2007

Six months after completing an addiction program with an HIV risk-reduction component, 69 HIV-negative, inner-city, pregnant women demonstrated significant increases in favorable attitudes toward condom use as well as factual knowledge about HIV and a significant decrease in the number of sexual partners.

Background: Sexually transmitted HIV infection is rapidly increasing among reproductive-age, noninjection substance abusing women. Data show that 4.3 percent of pregnant women admit using illicit drugs during pregnancy. The period of pregnancy and the early postpartum period represent a window of opportunity for intervening with pregnant women at risk for HIV. Few studies have addressed women's motivation or their ability to employ key behavioral skills for HIV risk reduction during pregnancy.

Study Design: The researchers recruited 81 inner-city minority women receiving alcohol and nonmethadone drug use treatment in a hospital-based addiction program through the pregnancy and postpartum period. Scientists added a foursession cognitive-behavioral skills, HIV prevention training to their intervention plan, and conducted follow-up assessments 6 months later to identify behavioral changes in these women.

What They Found: Among the 69 women who participated in the 6-month follow-up, scientists observed significant increases in favorable attitudes toward condom use and factual knowledge about HIV, and decreases in the number of partners. However, there were no significant differences in response efficacy, intentions to engage in safer sex behaviors, sexual self-efficacy, or alcohol or drug use.

Comments From The Authors: This is perhaps the first prospective evaluation of the determinants of change with regard to HIV-related, high-risk behavior for pregnant alcohol or other drug users in treatment. This information can be very useful in guiding the development of target interventions for this disempowered group of pregnant women.

What's Next: A "one size fits all" approach to HIV prevention among women will not be sufficient. Future studies with larger sample sizes need to address the heterogeneity of women in target populations.

Publication: Dr. Robert Malow of Florida International University and his colleagues published this study in Vol. 41, No. 13, of Substance Use and Misuse.

The National Institute on Drug Abuse (NIDA) is a component of the National Institutes of Health, U.S. Department of Health and Human Services. NIDA supports most of the world's research on the health aspects of drug abuse and addiction. The Institute carries out a large variety of programs to ensure the rapid dissemination of research information and its implementation in policy and practice. Fact sheets on the health effects of drugs of abuse and other topics are available in English and Spanish.

These fact sheets and further information on NIDA research and other activities can be found on the NIDA home page at www.drugabuse.gov.

Source: http://www.medicalnewstoday.com/medicalnews.php?newsid=70861&nfid=rssfeeds

Asian drug users need more HIV prevention help

By, Ben Blanchard, Reuters, May 14, 2007

BEIJING (Reuters) - Asian countries need to wake up to the threat of HIV transmission via intravenous drug use and spend more money on needle exchanges and other programs or risk a rapid rise in new cases, a U.N. health official said on Monday.

Around one-third of new infections worldwide, excluding sub-Saharan Africa, are from injected drug use.

Asia has about 6 million users, and most new HIV cases are blamed on dirty injecting equipment, according to the United Nations.

But less than one-tenth of Asian users have access to prevention services, UNAIDS Asia Pacific Regional Director Prasada Rao told Reuters in an interview.

"If you look at comprehensive interventions, which means giving the option of both needle exchange and drug substitution, I think very few countries are doing it," he said by telephone from a conference in the Polish capital Warsaw.

"They have to prioritize interventions among intravenous drug users and the aim is for at least 80 percent coverage by 2010," Rao added.

"That requires enormous scale up in terms of resources and also in creating an environment where drug users can come out and access these services. Because in most of these countries they are still criminalized, and police raid them and catch them.

"It needs a change of attitude and a change of legislation relating to drug use. Because most often they don't distinguish between the supplier of drugs and the ultimate victim who is the user," he said.

HARM REDUCTION

Injecting drug users can also easily pass on HIV to the general population, so it is essential to reach them, Rao said.

"Most of them are young people, and they have sexual partners," he said. "So it ultimately gets into the general population as an epidemic if you don't control it at the injecting drug user level."

The global cost of such "harm reduction" programs as providing clean needles is estimated at just $200 million a year, the official said.

"We're not spending even half that. It is less than $100 million throughout the world," Rao said. "It is a very small amount of money, but even that, governments are still not putting into ideal programs."

"In some cases, they think it's not really important. In some cases they think these people are not in the mainstream of society so can be ignored. I think the governments are not sensitive enough to the problem of young people and how they get into injecting drug use," he added.

"The important relationship between injecting drug use and HIV -- still many governments are not realizing it."

Bright spots include China, which has started both needle exchanges and drug substitution work, as well as Indonesia, while India has also started on the right path, Rao said.

He singled out Thailand, though, for doing lamentably little.

"Thailand is a glaring example. A country which has done so well at prevention sexually has not started any good program for injecting drug users even though over 30 percent of new infections in Thailand are among injecting drug users."

NIDA Looks at Non-Injection Drug Use and Spread of HIV/AIDS

By, NIH News, May 8, 2007

CDC estimates 250,000 Americans Unaware they are HIV-Positive

More than 500 scientists, clinicians and public health specialists met today at the National Institutes of Health (NIH) to discuss the latest research on drug abuse and the evolving epidemic of HIV/AIDS. This is the first-ever two-day public meeting at NIH to include a focus on non-injection drug use and HIV transmission. The meeting was being held in collaboration with the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the National Institute of Allergy and Infectious Diseases (NIAID), the National Institute on Child Health and Human Development (NICHD), and the National Institute of Mental Health (NIMH).

“Approximately one million people in the United States are living with HIV/AIDS, which disproportionately afflicts minority populations — particularly African Americans,” said NIDA Director Nora D. Volkow, who gave opening remarks at the meeting. “To address this significant public health threat, research at NIH is examining every aspect of HIV/AIDS, drug abuse, and addiction, including the risk behaviors associated with both injection and non-injection drug abuse, and how drugs of abuse can alter brain function and impair decision making.”

Participants today heard from leading scientists about how substance abuse affects HIV/AIDS risk in diverse populations, and of the importance of designing interventions that address their specific needs. Today’s session also looked at neuroeconomics — combining brain imaging and economically-based theories to better explain and predict decision making; and neuroimaging to predict relapse to methamphetamine in treated drug abusers. Also discussed were the importance of combining behavioral therapies, and medication in drug abuse treatment to reduce HIV risk behaviors as well as drug abuse.

The Tuesday afternoon session covered the risky behavior related to commonly abused substances like alcohol and marijuana. Scientists have long recognized that alcohol use is associated with behavior that places people at risk for sexually transmitted infections, and similar studies on marijuana use will also be presented. These studies show that not only is marijuana use associated with risky sexual behavior, but is also associated with poor medical appointment-keeping among infected women.

Wednesday’s session — which concludes at noon, will look at the problem of HIV/AIDS within the Nation’s criminal justice system, including prisons and jails. The large-scale incarceration of drug users has resulted in a disproportionate rate of infection and burden of HIV/AIDS among the prison population, and correctional facilities have emerged as critical settings for interventions to prevent, diagnose, and treat HIV and other infectious diseases. The last session of the conference will examine the challenges of HIV screening, testing and counseling, and prevention strategies for inmates who are reentering society, given concerns about confidentiality, stigma, and limited government resources.

A full agenda and speaker list is available at: http://conferences.masimax.com/riskybehaviors/index.cfm.

The National Institute on Drug Abuse is a component of the National Institutes of Health, U.S. Department of Health and Human Services. NIDA supports most of the world's research on the health aspects of drug abuse and addiction. The Institute carries out a large variety of programs to ensure the rapid dissemination of research information and its implementation in policy and practice. Fact sheets on the health effects of drugs of abuse and further information on NIDA research can be found on the NIDA web site at http://www.drugabuse.gov.

The National Institutes of Health (NIH) — The Nation's Medical Research Agency — includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.


Source: http://www.nih.gov/news/pr/may2007/nida-08.htm