Asia must tackle HIV in injecting drug users

Asian countries must adopt strategies to slow the spread of HIV among injecting drug users, urge researchers in this week's BMJ.

More than 60% of injecting drug users in many Asian countries are HIV positive. China alone is estimated to have almost 900,000 injecting drug users and disturbingly large pockets of HIV infected injecting drug users exist in other populous Asian countries, such as India and Pakistan.

Although strategies to prevent the spread of HIV infection among and from injecting drug users can be effective, an unwarranted fear exists that these strategies will conflict with current drug policies.

Encouragingly pragmatic approaches to HIV infection among injecting drug users are being adopted. For example, Indonesia, Vietnam and China have recently shown promising signs of increasing interest in developing outreach, syringe exchange, and drug substitution programmes.

But the frightening fact remains that HIV continues to spread among and from injecting drug users much more rapidly than these programmes are adopted and expanded, say the authors.

HIV/AIDS is probably the most serious global health problem since the Great Plague more than half a millennium ago, they write. For the next few decades, the health and wellbeing of the most populous region of the world will depend a lot on the speed with which Asian countries adopt, adapt, and fully implement harm reduction interventions, especially needle and syringe programmes and drug substitution treatment for heroin users.