Intravenous drug use on rise in SE Asia, says WB

Intravenous drug use on rise in SE Asia, says WB

BANGKOK (Agencies): Intravenous drug use is on the rise in Southeast Asia, helping fuel an explosion in the region's HIV- AIDS epidemic, according to a World Bank study released on Friday.

Cheap heroin supplies, deepening poverty and social desperation in the wake of the economic crisis, as well as a lack of effective law enforcement, are responsible for the trend, officials said.

With the exception of Cambodia, "virtually all the other countries in Southeast Asia are seeing sustained rising high rates of intravenous drug use," said Chris Beyrer, director of the U.S.-based John Hopkins University AIDS Training Program.

Beyrer, who contributed to the World Bank study on Thailand's HIV/AIDS crisis, told AFP that "intravenous drug use is a major problem but has not been recognized in many Southeast Asian states."

In Bangkok, HIV infection rates rose from two percent of IV drug users a decade ago to over 40 percent today, the World Bank's study said.

In the south of Thailand, more than 50 percent of IV drug users are infected with HIV, and that number seems likely to increase in the next year, Beyrer said.

The World Bank said that Thailand must spend more money to build on the success of its globally-acclaimed fight against AIDS, even as it faces a fresh wave of HIV infections among housewives and children. It also urged the Thai government to control the "new sources of infection ... if future generations are to be spared the threat of HIV/AIDS."

The government spent $37.9 million on its national AIDS program in 1999, a decline of 27.8 percent since the Asian economic crisis of 1997, the report said. It spent $86 million in 1996.

The hardest hit has been HIV prevention expenditure, which dropped by half since 1997. The government says it is spending the money more efficiently without compromising the campaign.

HIV infection rates among IV users, most of whom inject heroin, are also rising in Vietnam, Bangladesh, Malaysia and Myanmar, Beyrer said.

The World Bank researchers attributed growing HIV rates among Southeast Asian drug users to a lack of government intervention in the health crisis and the continued practice of needle- sharing.

"Injecting drug users' HIV problem has not been addressed in most of Southeast Asia," Beyrer said.

World Bank Senior Economist Martha Ainsworth said injecting drug users have poor access to free heroin substitutes, clean needles or treatment for opportunistic infections which prey on HIV-positive people.

If nothing is done, injecting drug users will remain "a reservoir for transmission (of HIV) to the rest of the population," she said.

Southeast Asian governments, some of which have made strides towards addressing HIV among sex workers, must undertake major new initiatives among injecting drug users, the researchers said.

"The same pragmatic policy toward prevention of HIV among illegal commercial sex workers needs to be extended to injecting drug users" by providing them with clean needles, counseling and education, Ainsworth said.

Thailand, which has had some success in decreasing HIV rates, could take the lead on this issue, she said. "Thailand can show the region what can be done to fight HIV among drug users."

Beyrer said the HIV transmission cycle among IV drug users would not be broken unless the same effort to effect change among sex workers was used on this problem.

"HIV prevalence among IV drug users is not a hopeless problem. Strong government action has proven successful in Sydney, Glasgow, Scotland and other cities," he said.