New research suggests there could be 3 million injecting drug users worldwide who are HIV positive.
In an article published early Online and in an upcoming edition of The Lancet, Dr Bradley Mathers, National Drug and Alcohol Research Centre, University of New South Wales, Australia, said the number of countries reporting injecting drug users (IDUs) has increased over the last decade. A review in 1998 identified 129 countries with IDU, of which 103 reported HIV among IDUs. This latest research increases these numbers to 148 countries with IDUs and 120 of those reporting HIV among IDUs.
Dr Mathers called for better data from around the world in view of the increasing importance of injecting drug use as a mode of HIV transmission in many regions.
This systematic review showed huge discrepancies worldwide. For example, in the UK, 0·39% of 15–64 year-olds are IDUs, of which 2·3% are thought to be HIV positive. In Spain, this proportion of IDUs is lower (0·31%), but the proportion of IDUs with HIV is many times higher (39·7%).
Dr Mathers said the findings represented a major challenge for global public health.
“People who inject drugs have the right to enjoy the highest standard of health attainable,” he said, “There is a clear mandate to invest in HIV prevention activities such as needle and syringe programmes and opioid substitution treatments.
“The magnitude of this risk has not been met with an equally concerted investment in research to accurately quantify the problem.”
In an accompanying comment, Dr Kamyar Arasteh and Dr Don C Des Jarlais of the Beth Israel Medical Centerin New York, said: “The one optimistic aspect of this rather gloomy situation is that, if HIV-prevention efforts are implemented on a large scale when prevalence is low in injecting drug users, it is possible to avert HIV epidemics in users. Thus it should be an imperative—for both resource-constrained countries and international donors—to implement large-scale evidence-based programmes for HIV-prevention whenever there is an indication of a developing injecting-drug-use problem.”