|Drug Use and HIV Vulnerability (UNAIDS, 2001, 238 p.)|
|Chapter 1: Main report|
In many of the study-countries minor modifications to the drug control legislation are necessary in order to implement more effective HIV/AIDS prevention among drug users.
High-risk behaviours are commonplace among drug users in all the study-countries and there is an observable trend of multiple drug use.
In general, drug policies in the study-countries are not supportive of effective HIV prevention among drug users. With the exception of law enforcement, drug problems are not generally accorded high funding priority.
There is inadequate dialogue between drug control and HIV/AIDS control agencies in the seven study-countries. Consequently there are few programmes in the region, which directly address problems presented by the interface between drug use and HIV/AIDS.
Measures to prevent the spread of HIV among drug users and their sexual partners are often localised, short-term, under-funded and insufficient in scope.
Adherence to traditional values is strong in many of the study-countries making debate on HIV/AIDS prevention and sexual behaviour sensitive.
Drug treatment almost invariably focuses on detoxification treatment. Drug users are afforded little choice of treatment, which is mostly compulsory, residential and long-term.
Drug treatment personnel are often non-specialists in the drug field, and derived from the labour, public security or non-governmental sectors. The need for training was observed in all the study-countries. Most treatments on offer include a strong penal element.
Sensitivities of countries to implied criticism from abroad has to be noted. Change will have to be incremental, building, modifying and expanding on interventions that are already in place.
In all the study-countries there were many opportunities for the development of interventions to enhance the efficacy of HIV/AIDS prevention. This assertion is based on the following observations:
(a) The need for adequate responses to the HIV/AIDS epidemic is acknowledged and understood in all the study-countries;
(b) The legal impediments enshrined in the drug control legislation were often not serious and may require minor modification to regulations;
(c) UNAIDS Theme Groups on HIV/AIDS in some of the study-countries are in a position to coordinate and facilitate consensus building and collaboration between stake holders.
Drug and HIV policies and the process of policy review and development in the study-countries were difficult to determine and had to be deduced from multiple sources including verbal briefing by numerous key informants and accompanying documentation.