Crack and HIV: a new challenge for health systems

30 August, 2012 - New consumption patterns, new challenges. The use of crack cocaine is spreading in some countries of Latin America and the vulnerabilities of users to HIV and other infectious diseases such as tuberculosis, hepatitis and sexually transmitted infections, in a general, are worrisome. To date, strategies to increase the availability and access to prevention services and treatment are limited.

In order to broaden the knowledge about the relationship between the use of crack and vulnerabilities to HIV and help building more efficient public policies for prevention and treatment of users, experts, policy makers, and services users presented studies and experiences during the IX Brazilian Congress of Prevention of STDs and AIDS, the II Brazilian Congress of Prevention of Viral Hepatitis, the VI Latin-American and Caribbean HIV / AIDS and STDs Forum, and the V Community Forum.

Under the title "Crack: what we know, what we have and what we will do?", the roundtable was formed by the advisor to the Mental Health Technical Area of the Ministry of Health, Leon Garcia; the regional UNODC Coordinator of the Health and Development Unit, Nara Santos; the technical area coordinator of the Mental Health Program of São Paulo, Rosangela Elias; the collaborator to the Aids Prevention Support Group - GAPA/RS, José Nadir Ramirez, and the coordinator for Management of STD/AIDS and Viral Hepatitis Department of Health of the Federal District, Fernando Marques.

During the roundtable, international, national and local responses that address issues such as the stigmatization of crack users, the fight against the barriers to integrated and comprehensive health care services and the perception of services users discussed.

Forgotten or among the most stigmatized groups of people, generally, crack users are not targets of programs for HIV prevention and have restricted access to drug abuse and antiretroviral treatments, as well as to drug use prevention programs. Among them, street populations are the most affected groups.

The situation is worsened by the lack of attention guidelines for crack users. Myths about the user's ability to adhere to treatment and to adopt preventive practices, for instance, make it difficult to conduct research, as well as to implement appropriate public policies.

Violation of people who use drugs' rights, through practices such as imprisonment, coercive and abusive treatment, police harassment, arbitrary arrests, cruel treatment, and torture, in turn, deepen the vulnerabilities to HIV infection.

According to Nara Santos, the focus mustn't be on the substance itself but rather on the user through actions to fight the stigma and prejudice that represent major barriers in promoting this populations' access to health services.

"We need to deal with an additional range of vulnerabilities such as homophobia, homelessness, comorbidities, among others. Interventions should be based on human rights, have cultural sensitivity, and require attention not only on drugs, but in different contexts of use," she says.

Another recommendation is the inclusion of chemical dependency treatment in broad health-oriented strategies, focused on people in most vulnerable situations, considering the different practices and contexts of use.

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For press information:

Department of STD, AIDS and Viral Hepatitis

Tel: (+55 61) 3315-7616 / 7624/7651

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