About 99% of people who inject drugs are at high risk of HIV infection because they do not have enough access to harm reduction services and could face harsh punishments for using drugs, UNAIDS, the global agency combatting HIV/AIDS, said.
New HIV infections among adults worldwide declined by 14% between 2011 and 2017, but there has been no decrease in the annual number of new HIV infections among people who inject drugs. (They were 1.4% worldwide in 2017.)
In a new three-year report, it said, “People who use drugs have been the biggest casualties of the global war on drugs. Vilified and criminalized for decades, they have been pushed to the margins of society, harassed, imprisoned, tortured, denied services, and in some countries, summarily executed.”
“Billions of dollars spent, a considerable amount of blood spilt and the imprisonment of millions of people have failed to reduce either the size of the drug trade or the number of people who use psychoactive substances.”
The report follows on a 2016 UNAIDS study that showed how the world was failing to protect the health and human rights of people who use drugs and provided a road map for countries to reduce the harms that are associated with drug use.
In today’s report, UNAIDS chief Michel Sidibé noted: “As a result of the current global approach, persistently high rates of HIV, viral hepatitis and tuberculosis continue among people who inject drugs.”
There is compelling and comprehensive evidence that harm reduction, including opioid substitution therapy and needle–syringe programs, improves the health of people who inject drugs, the report said.
When people who use drugs have access to harm reduction services, they are more likely to take an HIV test, and if found to be living with HIV, enroll in and adhere to HIV treatment.
Decriminalization of drug use and possession for personal use reduces the stigma and discrimination that hampers access to health care, harm reduction and legal services.
“People who use drugs need support, not incarceration… If we are to end AIDS by 2030, we can’t leave anyone behind. And that includes people who use drugs,” Sidibé added.
He was referring to a globally agreed goal to end the AIDS epidemic as a public health threat by 2030. To achieve this after three decades of the most serious epidemic in living memory, the number of new HIV infections and AIDS-related deaths will need to decline by 90% compared to 2010.
In his 2019 State of the Union address, President Donald Trump appeared to endorse this goal when he pledged to eliminate HIV transmission within 10 years. “We have made incredible strides, incredible,” Trump said. “Together, we will defeat AIDS in America and beyond.”
If the global fast-track strategy to end the AIDS epidemic works, about 28 million HIV infections and 21 million AIDS-related deaths will have been averted between 2015 and 2030.
The economic return is expected to be 15 times expenditures and US$ 24 billion of additional costs for HIV treatment will have been averted.
While the incidence of HIV infection globally (all ages) declined by 25% between 2010 and 2017, HIV infections among people who inject drugs are rising.
People who inject drugs and their sexual partners account for roughly one quarter of all people newly infected with HIV. In eastern Europe, central Asia, the Middle East and North Africa, people who inject drugs accounted for more than one third of new HIV infections in 2017.
Brij Khindaria