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.