Stimulant drugs use and HIV: there is still much to do
03 February 2012 - In 2009, some 14 to 20 million people used cocaine and between 13 and 56 million consumed some kind of amphetamine type stimulant. The use of stimulant drugs, especially ATS, has increased in the past decade and new patterns of consumption are emerging.
Stimulant drugs are available in diverse forms and purities, and the groups of users are also diverse. Cocaine, for instance, can be snorted, smoked, and injected. Methamphetamine or amphetamine can be found in powder, tablet, paste or crystalline form, while ecstasy is usually available in tablet or powder form.
In Latin America, for instance, the use of smoked cocaine/crack cocaine is spreading in some countries of the region. Street population has been a group specially affected by this trend. Practically made invisible in society, the use of stimulant has increased among specific sub-populations such as sex workers, men who have sex with men and travesties, and so far there are limited strategies to increase availability and access to prevention and treatment services.
At the same time, there is not necessarily more need to break the law to take stimulants. Prescription stimulants have considerably increased in North and South America possibly as a way regular people found to respond to social patterns that constantly require, for instance, weigh lost, sexual and working higher performances, less time off or less sleep.
Concerned about the use of stimulant drugs and the vulnerabilities to HIV, a high level group of academics, researchers, and experts gathered in São Paulo, Brazil, during the Global Technical Meeting on Stimulant drugs use and HIV. The meeting was organized by UNODC and hosted by the Government of Brazil.
The group had as a main objective to discuss and review recent studies and intervention experiences concerning the use of stimulant drugs - including crack cocaine and ATS - and HIV, and formulate a set of recommendations for countries regarding HIV interventions within stimulant drugs users.
The meeting´s attendance of specialists from 10 countries, including Brazil, India, Russia, South Africa, Thailand and the United States, revealed that HIV and the use of stimulant drugs is a global concern and marked an extensive and comprehensive literature review undertaken by UNODC, bringing to light possible responses on how to prevent and treat HIV among people who use, both injecting and non-injecting, stimulant drugs.
"We still need to learn much more on the patterns of use of stimulant drugs, about the different groups that are using these drugs and how to make sure people are aware of the risks regarding the drugs they use, and their vulnerability to HIV. It is also fundamental that people have access to treatment and care", says Bo Mathiasen, regional representative for UNODC in Brazil and the Southern Cone.
Although the meeting only marked the beginning of a deeper process of investigations, data collection, and analysis, some points are already consensual.
Vulnerabilities of stimulant drugs users to HIV come mainly from unprotected high risk sexual practices and unsafe injecting practices.
Already forgotten or among the most stigmatized groups of people, they are in general not targeted by HIV programs and have little access to adequate drug dependence and antiretroviral treatments, as well as prevention of drug use.
"We must deal with a wide range of additional vulnerabilities such as homophobia, homelessness, self-medication, comorbidities, and so on. Interventions must be based on human rights, be culturally sensitive, and demand attention not only to drugs but also to settings", says Christian Kroll, UNODC Global Coordinator for HIV/AIDS.