Tuesday, August 15, 2006

Harm Reduction In a Long Overdue Spotlight

Harm reduction - a set of practical strategies that reduce negative consequences of drug use - is finally getting the attention it deserves at this year's International AIDS Conference. Eastern European and Central Asian Harm Reduction and Injection Drug User (IDU) advocates took center stage yesterday with more than 10 session being held on topics ranging from HIV/Hepatitis C to related human rights violations to on-the-ground tactics for reducing discrimination and stigma against IDUs. Outside of Africa injection drug use currently accounts for 1 in 3 new HIV infections; worldwide, 13 million people living with HIV were infected through injection drug use. In Eastern Europe and Central Asia harsh discrimination and stigma against IDUs continues to marginalize HIV + people while denying them critical medical care, treatment programs and social services. As of the end of 2004, 36,000 IDUs worldwide receive ARVs, 30,000 of whom reside in one country - Brazil.

Talking today with harm reduction advocates from Indonesia, Thailand, Russia and Ukraine, denial of medical services to IDU's consistently emerged as one of their major concerns. Stories abounded of doctors routinely turning away drug users from medical centers and hospitals. Ukraine is currently home to one of the world's fastest growing HIV epidemics. Yet HIV+ IDUs are routinely subject to human rights abuses by health practitioners and police, which force these highly vulnerable populations underground or "into the shadows" in their efforts to avoid criminalization, persecution and prison. A Ukrainian activists talked at length today about the forced testing which Ukrainians are subjected to in health care facilities. Once found to be positive, men and women are frequently forced to sign a statement acknowledging their criminal liability and then turned out to the streets without treatment.

HRW covered many of these issues in a report earlier this year entitled "Rhetoric and Risk: Human Rights Abuses Impeding Ukraine's Fight Against HIV/AIDS". You can find it online at: in at http://hrw.org/reports/2006/ukraine0306/.

IDU advocates, activists and PLHA's also highlighted the relationship between HIV and Hepatitis C, a disease which many claim has been ignored by doctors, scientists, and national governments. Around the world, more than 500 million people are infected with Hepatitis C (HCV) but treatment is available for one percent of infected people. And, even for those who are on treatment often critical information on interference between ARV and HCV drugs is limited or non-existent forcing many people who start the treatment to drop it once unexpected side affects begin. Tomorrow look for interviews with Russian AIDS activists from FrontAIDS, a dynamic movement fighting for access to treatment, adherence and community mobilization across Russia.

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