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Drug users, HIV and TB

4th August 2008

Drug users who are also HIV positive face barriers to life-saving treatments, amid stigma and discrimination, according to the World Health Organisation (WHO).

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WHO called on health and criminal justice authorities around the world to provide targeted services to drug users, especially those who inject drugs, to prevent and treat HIV and tuberculosis (TB), a major cause of death for people living with HIV.

In a new set of guidelines, the WHO called for better access for drug users to antiretroviral drugs and to isoniazid, a drug which significantly reduces the risk of TB disease in people living with HIV, but which is not widely used.

TB and HIV care should be pro-actively included in any support or outreach programmes to drug users, it said.

Drug users are often marginalised by homelessness, poverty, imprisonment, and by public and political hostility, factors which in themselves contribute to the transmission of both HIV and TB, and at the same time are barriers to treatment.

The new guidelines are an attempt to promote coordination and planning across all sectors that have dealings with drug users, especially those who inject.

Drug users are a high-risk group for transmission of HIV, and unsafe injecting practices are now a major route of infection for the virus.

All drug users, including those in prison, should benefit from TB and HIV prevention, treatment support and care, according to the guidelines compiled by WHO, UNAIDS and the UN Office on Drugs and Crime.

The guidelines call for national plans outlining the roles and responsibilities of service providers, staff training and operational research on TB and HIV services for drug users.

Nearly a third of new HIV infections outside Africa are acquired through unsafe injecting drug use, with that proportion rising to two-thirds in eastern Europe and central Asia.

Without proper treatment, the majority of people living with HIV die within two to three months of becoming sick with TB. The combination of diseases killed an estimated 231,000 people globally in 2006.

The guidelines also call for improved TB infection controls where large groups of people live together, including prisons, and ways to identify drug users either with the diseases or who are at risk of getting them.

They identify problems with access to HIV and TB prevention services and drug treatment services as major barriers to improvement, as well as low quality medical services for prisoners.

WHO urged stronger support measures to help drug users stick to treatment regimes, and warned that other infections such as hepatitis might being preventing access to HIV and TB treatments.

 

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