Drug addicts vulnerable to HIV infection

Drug addicts vulnerable to HIV infection

By Stevie Emilia

JAKARTA (JP): Both the Acquired Immune Deficiency Syndrome
(AIDS) and drug addiction can lead to fatalities. But while AIDS
is still incurable, drug addiction can be treated -- if the addict
kicks the habit before it is too late.

Unfortunately, there are not many drug addicts who can give up
their habit, which makes them -- especially intravenous drug
users -- vulnerable to HIV infection through contaminated
needles.

Zubairi Djoerban of the Pelita Ilmu Foundation revealed that
last month four people with AIDS, who the foundation had been
caring for, died. One of them, less than 20 years of age, used to
be an intravenous drug user, and was the third drug addict in
Jakarta to contract the virus from sharing contaminated needles
with other addicts.

Sharing needles, he said, was a long time habit of intravenous
drug users, not only here in Jakarta but also worldwide.

"But the death stunned us, because so far there's a strong
denial of the existence of IV drug users here," Zubairy, who also
chairs the Indonesian AIDS Society, told participants at a recent
seminar, AIDS and Narcotics on Young People, which was held to
commemorate World AIDS Day.

According to Zubairy, a 1998 report from the Cipto
Mangunkusumo Public Hospital recorded 134 overdoses in the
hospital's emergency room between 1996 to 1997. The victims were
teenagers and adults between 16 and 30 years of age.

More than 20 percent of the cases were caused by the
recreational drug Ecstasy, 6 percent by opiates and 3.7 percent
by barbiturate pills.

Zubairi said that the relationship between narcotics and
HIV/AIDS has been recognized in the United States since the
beginning of the AIDS epidemic.

As of January 1996, the United States listed 183,359 people
with AIDS, or 36 percent of all AIDS cases in the country, who
contracted the virus through intravenous drug use.

However, it is not only the drug addicts who are infected with
the virus, but also their partners and children. Of the 183,359
intravenous drug use AIDS cases in the United States, 161,891 of
the people were drug addicts, 18,710 were their partners and
3,758 were their children, he said.

In Asia, he added, there was also an increase in drug addicts
being infected with HIV.

Bangkok, which had an almost zero prevalence -- one percent --
of HIV infection among drug addicts at the end of 1987, has
recorded a rapid increase in such cases. In March 1988, the
percentage rose to 15 percent and then 43 percent by the end of
1988.

But in Indonesia, the problem is not yet widely recognized.
Most people still relate HIV/AIDS with sexual relations.

And the government's so-called monthly surveillance system
cannot provide a clear picture of drug-related HIV/AIDS cases
here.

Out of 815 HIV/AIDS cases reported up to November of this year
-- 39 of which were reported in November alone -- only six of the
cases involve intravenous drug users. Three of these people were
HIV-positive and the other three already have full-blown AIDS.

No one, however, really knows the real number of people living
with HIV/AIDS in Indonesia. The same is true of drug addicts,
though official figures put the number at around 150,000 people
across the country.

Experts believe that the real numbers of people living with
HIV/AIDS and drug addicts are far higher than those being
reported.

"Even though there are no real figures, we can't dismiss the
threat of HIV infection on drug addicts," Zubairi said.

With continuous reports of the confiscation of narcotics and
the arrests of drug traffickers in the media, the threat is
obviously real.

David Djaelani Gordon, who, along with his wife Joyce, works
as a consultant on HIV/AIDS and addiction, referred to HIV
infection and drug addiction as a 'real nightmare'.

"Both of them (HIV/AIDS and drug addiction) are already found
here in Indonesia ... and if we want to be real honest to
ourselves, we're not ready to face them...," he told the
seminar's participants.

In his 42-years of experience working with drug addicts, he
has noticed that many drug addicts often share needles with other
addicts.

"None of them care about the cleanliness of the needles and
almost none of them know how to clean needles properly," said
Gordon, who was a drug addict himself for 15 years.

In his paper, he cited the confessions of a drug addict under
his treatment:

"I usually clean it (the needle) with water. What's wrong with
it? If it's dirty, it will only cause a bit of swelling. With
sakaw (pain) and pakaw (wanting) to use the drug, I don't have
time to think. The most important is, pakaw... in keeping the
needles clean, I don't do much. Sometimes, I just put it on the
dashboard without a plastic cover. While with friends, we use it
(the needle) together. The most important thing is, I have the
needle and it's not blunt..."

Although it is difficult and takes time, drug addiction can be
treated. The detoxification process to cleanup addicts takes
around six to 10 days. Then, it is up to the addicts themselves,
whether they want to stop or continue with their habits.

"But the key to success, to completely stop addiction is:
ongoing counseling...," said David.

Unfortunately, he said, there were only a small number of
rehabilitation centers to treat drug addiction here. Also, there
are no needle-exchange programs here, he added.

According to HindarAIDS bulletin, in the United States, after
long debate, the government finally gave official support in
April of this year to sponsor needle-exchange programs. These
programs distribute free needles to intravenous drug users to
prevent the spread of HIV and other infections through
contaminated needles.

He also pointed out the absence of any survey of drug addicts.
A survey's results would provide a clear picture of drug abuse
here and the real number of drug addicts, he added.

"We in Indonesia never perform a study of HIV and drug
addicts, because just like HIV/AIDS, addiction in Indonesia is
still considered to be nonexistent," David said.

However, such surveys and programs, along with skilled
experts, are important factors in dealing with drug-related HIV
infections in the future, he said.