HIV in drug users "alarmingly high" -new study finds
By Oluatoyin Alleyne
Stabroek News
February 13, 2007
A new study here has found that HIV prevalence among people who use illicit drugs is "alarmingly high", highlighting a strong correlation between HIV and substance abuse.
Some 172 persons were interviewed in the study and HIV tests were conducted with the results showing that there was an overall HIV rate of 16.9%. Women in the study had an HIV rate at an "astounding 52.9%". Out of the 172, 17% of the persons were found to be HIV infected and out of that number 13% of the men were positive with some 53% of the females being positive.
Following the results, Clarence Young of the Ministry of Health, Division of Health Sciences Education, which was a partner in the study, said that when they started the study they had decided that if they found 2% of the persons were infected it would have been significant. However, they were all alarmed to find such a large number of persons infected.
Cocaine readily available
He said in light of that number, no longer can the issue be ignored but rather it is something that needs to be looked at closely and he would even say that there is a correlation between the infection rate and substance use. He also pointed out that cocaine is readily available and drug users can get a `fix' for as little as $100 while stating that it is not an issue of willpower as the addicts are powerless and they must be motivated to seek help.
Young was at the time speaking at the Main Street location of the Canadian International Development Agency (CIDA) where he presented the findings of the study.
The research participants came from all areas of Georgetown, such as Bourda, Leopold Street, Alexander Street, Albouystown and Kitty, and more men than women were interviewed with the age range of the interviewees being between 18 and 69. However, they reported that their drug use began as early as 12 years old. They said that they used crack cocaine but alcohol and marijuana were the main drugs of choice. It was stated that reports of individuals injecting drugs was low at 3.5% but 14% stated they had seen someone inject in the city.
"Many share characteristics of being single, homeless, and having had involvement with the criminal justice system," the report said. Meanwhile, a majority stated they would like to get into an addiction treatment programme, but they faced many barriers in doing so. Accord-ing to the study, 13.4% of the participants were commercial sex workers.
The study found that 47% of the participants were homeless, with the main sources of income being temporary work and begging; 77% had been to prison, 42% had committed a drug-related offence and 46% had access to health care in the past 12 months.
The study also found that 18% of the participants reported having between 1 to 5 lifetime sexual partners, 24% had 6 to 19; 30% 20 to 99, 23% 100 to 499 and 5% over 500 partners. Thirteen percent were involved in commercial sex work.
On the issue of the drug used by the participants the study found that 97% had used crack, 88% had used alcohol; 88% had used marijuana while 90% used crack daily and six persons reported having injected drugs while 24 had seen someone doing it.
Mental illness also came into play during the study with 4% reporting having been previously diagnosed with a mental illness, 37% had experienced a drug overdose, 61% reported having had a previous STI, 18% had been diagnosed with tuberculosis and 36% had been previously tested for HIV.
Interestingly the study said that 88% wanted addiction treatment while 19% actually received treatment and 62% said it was too costly to access treatment, 12% were unaware of treatment programmes and 20% actually had no desire to quit.
The study found that there is need to develop a strategy to address HIV and substance users and this should include a broad-based, comprehensive response from a wide variety of stakeholders.
Further, there is need for a public health response that addresses the complex nature of HIV and substance use, and is flexible, appropriate and informed. The response requires "Addiction services that are prepared to respond to people in the varying stages of their substance use and can facilitate HIV prevention, testing, and treatment," the study said.
It was suggested that addictions must be seen as a health issue that is complex. Moreover, actions must be broad based and comprehensive and partnerships are necessary. An oversight body is also essential among other recommendations.
Suggested areas of activities are prevention, treatment, harm reduction, enforcement and governance and one of the preventative measures suggested was working with alcohol producers to modify advertising campaigns and location of ads. Also suggested were addiction awareness and education programmes for the general public, including associated HIV risks. Another recommendation was drug addiction counselling for children in schools that is realistic, appropriate and informative as well as a strong system for sports, arts and recreation for children and young people to avert harmful drug use. In the area of treatment it was suggested among other things that programmes be developed with specially trained staff to work with those with coexisting addictions and mental health issues and also to promote self-help groups across the country. Also it was suggested that there should be specific programming for those with fatal alcohol syndrome and attention deficit hyperactivity disorder.
As for governance it was suggested that the health ministry take the lead with the development of a drug use secretariat. Further there should be broad-based awareness by politicians, government bureaucrats and officials of addiction issues and their relation to HIV and harm reduction.