III. Introduction

Drug use in Asian countries continues to increase and new and ever more hazardous and harmful drug use patterns are continuing to emerge. Many use multiple substances, inject in preference to smoking, 'chasing' or snorting, share needles, syringes, drug paraphernalia and drug solutions and preparations indiscriminately, and use alcohol and other psychoactive drugs excessively. These drug use behaviours occur in the context of countries in Asia, which are highly affected by HIV/AIDS. The present study was commissioned by the UNAIDS Asia Pacific Intercountry Team, Bangkok, to follow upon the report 'Situation Assessment of Injecting Drug use in South East and East Asia in the context of HIV' which was conducted by the Asian Harm Reduction Network (AHRN) in 1997¹. The situation assessment indicated that urgent action is needed to reduce the transmission of HIV/AIDS among drug users and their sexual partners.

¹ Asian Harm Reduction Network (AHRN) 1999, The Hidden Epidemic: A situation Assessment of Drug Use in South East and East Asia in the Context of HIV vulnerability. Dr. Nick Crofts is the principal author of the work.

The main purpose of the present study was to establish a basis for effective assistance to governments in the development and implementation of policies and programmes for the prevention of the transmission of HIV among drug users. The study set out to examine drug and HIV laws, policies and strategies focusing on seven countries: China, India, Malaysia, Myanmar, Nepal, Thailand and Viet Nam. The study was not designed to compare the situation across countries nor to critique national laws and policies but rather, as an exploration of factors nationally and regionally which are serving to either facilitate or hinder efforts aimed at reducing HIV/AIDS vulnerability among drug users and their sexual partners.

The study took place between March and May 1999. Each of the seven study-countries was visited by a researcher for 5 working days (with the exception of India, which was visited for 9 working days). The researchers interviewed key informants (often selected by government officials), undertook field-visits, and studied available published literature and other documentation. These included the national drug control plans, the national HIV/AIDS prevention plans, data from HIV sentinel surveillance, reports of national and local studies, project documents and evaluations of ongoing interventions, drug laws and other legislation relevant to HIV/AIDS.

The major issues examined in this study were

(a) The scope and scale of the HIV epidemic in each country in general and among injecting drug users in particular;

(b) The publicly stated policies in each country in respect to HIV and drug use;

(c) The positive and negative impacts of public policy on HIV vulnerability in relation to the use of drugs;

(d) What is currently being done at the policy level and at a practical level to help prevent HIV transmission amongst drug users and their sexual partners;

(e) Specific factors that inhibit the ability of governments and non-government agencies to reduce HIV/AIDS vulnerability among drug users and their sexual partners;

(f) Opportunities for policy reform and the development of interventions that could prevent HIV/AIDS transmission among drug users and their sexual partners;

(g) Whether and how UNAIDS and its co-sponsors could support counties in their efforts to reduce HIV vulnerability among people who use drugs and their sexual partners.