The Global HIV Epidemics among People Who Inject Drugs

This publication addresses research questions related to an increase in the levels of access and utilization for four key interventions that have the potential to significantly reduce HIV infections among People Who Inject Drugs (PWID) and their sexual and injecting partners, and hence morbidity and mortality in low and middle-income countries (LMIC). These interventions are drawn from nine consensus interventions that comprise a 'comprehensive package' for PWID. The four interventions are: Needle and Syringe Programs (NSP), Medically Assisted Therapy (MAT), HIV Counseling and Testing (HCT), and Antiretroviral Therapy (ART). The book summarizes the results from several recent reviews of studies related to the effectiveness of the four key interventions in reducing risky behaviors in the context of transmitting or acquiring HIV infection. Overall, the four key interventions have strong effects on the risk of HIV infection among PWID via different pathways, and this determination is included in the documents proposing the comprehensive package of interventions. In order to attain the greatest effect from these interventions, structural issues must be addressed, especially the removal of punitive policies targeting PWID in many countries. The scientific evidence presented here, the public health rationale, and the human rights imperatives are all in accord: we can and must do better for PWID. The available tools are evidence-based, right affirming, and cost effective. What are required now are political will and a global consensus that this critical component of global HIV can no longer be ignored and under-resourced.

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Main Authors: Dutta, Arin, Wirtz, Andrea, Stanciole, Anderson, Oelrichs, Robert, Semini, Iris, Baral, Stefan, Pretorius, Carel, Haworth, Caroline, Hader, Shannon, Beyrer, Chris, Cleghorn, Farley
Language:English
en_US
Published: Washington, DC: World Bank 2013-01
Subjects:ABSTINENCE, ABUSES, ACCESS TO TREATMENT, ACQUIRED IMMUNODEFICIENCY SYNDROME, ADULT POPULATION, AIDS DEATHS, AIDS EPIDEMIC, ANTENATAL CLINIC, ARVS, BACTERIAL INFECTIONS, BEHAVIORAL INTERVENTIONS, BEHAVIORAL RISK, BEHAVIORAL SURVEILLANCE, COMMERCIAL SEX, CONDOM, CONDOM DISTRIBUTION, CONDOM USE, CONDOMS, CRIME, DEMOGRAPHIC PROJECTIONS, DEVELOPING COUNTRIES, DISEASE, DISEASE BURDEN, DISEASE CONTROL, DISEASE PREVALENCE, DRUG ADDICTION, DRUG INJECTION, DRUG TREATMENT, DRUG USER, DRUGS, ENDOCARDITIS, EPIDEMIC, EPIDEMICS, EPIDEMIOLOGICAL SITUATION, EPIDEMIOLOGY, FEMALE, FEMALE SEX WORKERS, GENDER, GLOBAL AIDS EPIDEMIC, GLOBAL CONSENSUS, GLOBAL HIV/AIDS, GLOBAL POLICY, HEALTH SYSTEMS, HEPATITIS, HEROIN USE, HIGH-RISK GROUPS, HIV, HIV EPIDEMICS, HIV INFECTION, HIV INFECTIONS, HIV PREVALENCE, HIV PREVENTION, HIV TEST, HIV TESTING, HIV TRANSMISSION, HIV/AIDS, HUMAN DEVELOPMENT, HUMAN IMMUNODEFICIENCY VIRUS, HUMAN RIGHTS, IMMUNODEFICIENCY, INCIDENCE OF HIV, INFECTIONS AMONG ADULTS, INJECTING DRUG USE, INJECTION DRUG, INJECTION DRUG USE, INVESTMENT IN PREVENTION, LACK OF INFORMATION, LEGAL STATUS, MALARIA, MALE SEX, MEDICINE, MORBIDITY, MORBIDITY & MORTALITY, MORBIDITY AND MORTALITY, MOTHER, MOTHER-TO-CHILD, MOTHER-TO-CHILD TRANSMISSION, NATIONAL AIDS, NATIONAL AIDS CONTROL, NATIONAL PLANS, NEEDLE EXCHANGE, NEEDLE SHARING, NEEDLES, NEW INFECTIONS, NUMBER OF NEW INFECTIONS, NUTRITION, PATIENT, PATIENTS, PEOPLE LIVING WITH HIV, POLICY ANALYSIS, POLICY IMPLICATIONS, POLITICAL SUPPORT, POPULATION ESTIMATES, POPULATION GROUPS, POPULATION SIZE, PREVALENCE, PREVENTION ACTIVITIES, PREVENTION AND CARE, PUBLIC HEALTH, QUALITY OF LIFE, REHABILITATION, RESOURCE ALLOCATIONS, RIGHTS PERSPECTIVE, RISK BEHAVIOR, RISK BEHAVIORS, RISK OF HIV TRANSMISSION, RISK OF INFECTION, RISK POPULATIONS, RISK REDUCTION, RISK-REDUCTION, RISKY BEHAVIOR, RISKY BEHAVIORS, RISKY SEXUAL BEHAVIOR, SAFE SEX, SCIENTIFIC EVIDENCE, SERVICE DELIVERY, SERVICES FOR PEOPLE, SEX, SEX PRACTICES, SEX WITH MEN, SEX WORKER, SEXUAL CONTACT, SEXUAL NETWORKS, SEXUAL PARTNERS, SEXUAL PRACTICES, SEXUAL RISK, SEXUAL RISK BEHAVIOR, SEXUAL RISK BEHAVIORS, SEXUAL TRANSMISSION, SEXUALLY TRANSMITTED INFECTION, SOCIAL MARKETING, SOCIAL VULNERABILITY, SPREAD OF HIV, STERILE INJECTION EQUIPMENT, STERILE SYRINGES, SUBSTANCE ABUSE, SURVEILLANCE DATA, SYRINGES, T-CELL, TB, THERAPY, TREATMENT, TREATMENT ACCESS, TREATMENT SERVICES, TUBERCULOSIS, UNAIDS, UNEMPLOYMENT, UNIVERSAL ACCESS, UNSAFE INJECTION, UNSAFE SEX, USER FEES, VIRAL LOAD, VIRUS, VOLUNTARY COUNSELING, WAR, WORLD HEALTH ORGANIZATION,
Online Access:http://documents.worldbank.org/curated/en/2012/11/17014790/global-hiv-epidemics-among-people-inject-drugs
https://hdl.handle.net/10986/12215
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Summary:This publication addresses research questions related to an increase in the levels of access and utilization for four key interventions that have the potential to significantly reduce HIV infections among People Who Inject Drugs (PWID) and their sexual and injecting partners, and hence morbidity and mortality in low and middle-income countries (LMIC). These interventions are drawn from nine consensus interventions that comprise a 'comprehensive package' for PWID. The four interventions are: Needle and Syringe Programs (NSP), Medically Assisted Therapy (MAT), HIV Counseling and Testing (HCT), and Antiretroviral Therapy (ART). The book summarizes the results from several recent reviews of studies related to the effectiveness of the four key interventions in reducing risky behaviors in the context of transmitting or acquiring HIV infection. Overall, the four key interventions have strong effects on the risk of HIV infection among PWID via different pathways, and this determination is included in the documents proposing the comprehensive package of interventions. In order to attain the greatest effect from these interventions, structural issues must be addressed, especially the removal of punitive policies targeting PWID in many countries. The scientific evidence presented here, the public health rationale, and the human rights imperatives are all in accord: we can and must do better for PWID. The available tools are evidence-based, right affirming, and cost effective. What are required now are political will and a global consensus that this critical component of global HIV can no longer be ignored and under-resourced.