Research shows HIV prevalence and vulnerable context among drug users in Uruguay
Montevideo, 13 June 2014 - A study to determine the prevalence of HIV/AIDS and practices among users of pasta base, crack and other designations of smokable cocaine in Montevideo and its metropolitan area showed that, out of every 100 people who use this type of drug, six have HIV. Most of them live in contexts of high vulnerability, although they have access to health care systems due to their problematic drug use.
Presented earlier this month, the study was conducted by the Uruguayan Drug Observatory of the National Drug Council of Uruguay, the Ministry of Public Health and the United Nations joint team on AIDS, with the support of Equipos Mori. The survey was conducted because of the need for updated information on drug use practices, HIV prevalence and sexual practices and attitudes among smokable cocaine users living in Montevideo and its metropolitan area.
The final sample had 318 cases for a population between 18 and 64 years old, who had used drugs for at least 25 days during the past six months. The survey was conducted between 5 September and 30 November 2012.
HIV prevalence among users of smokable drugs or inhalants is 6%, while among those who inject drugs the number rises to 10%. However, authorities warned that consumption patterns have changed in Uruguay, moving away from injectable drugs.
The presentation was attended by the Sub Secretary for Public Health, Leonel Briozzo; the Secretary-General of the National Drug Council, Julio Calzada; the Program Officer for HIV/AIDS of the UN Office on Drugs and Crime (UNODC), Carola Lew; the Advisor on HIV/AIDS of the UN Population Fund (UNFPA) in Uruguay, Juan José Meré; and the Director of the MSP Program for Sexually Transmitted Infections and HIV/AIDS, Susana Cabrera.
Cabrera presented the main results of the study, emphasizing the vulnerable context of the population, formed mostly by young men with low access to education.
Almost 64% of the pasta base users have never studied or have received only primary education; their housing situation is precarious (about 40% live on the streets, in shelters or in some kind of precarious housing); only 16% have formal employment and many are scavengers or have informal jobs. Theft, drug sales and sex work also appear as alternative ways to make money, but at a relatively low percentage.
Another main conclusion is that these highly stigmatized populations, even if they are hidden and are not represented in public surveys, are able to access the health care system due to drug use.
"We have to work with an emphasis in training and raising awareness in the health system. This is a victimized population and the health system has all the tools to offer them, such as the promotion of condom use and access to diagnosis", said Cabrera.
One of the recommendations is to increase access to condoms by installing distribution programs in all community centers identified as places of use among drug users.
It is also suggested that training should be provided for health professionals about the vulnerability of drug users to HIV.
Both Calzada and Briozzo emphasized the importance of this research, which will allow the development of specific programs for this population.
"If these people can't go to the health system, the system has to go to them", Briozzo said, referring to the experience of this study, which was conducted at the fishing club Belvedere, which offered its structure for the research.
The study showed that, despite the fact that these populations attend health services or receive treatment for drug use, only 44% of health care centers provide free condoms, 43% offer HIV testing at the same place and only 4% provide syringes to injectable drug users as a harm reduction policy.
Briozzo recognized the lack of preparation of the health system to address this highly vulnerable and stigmatized population.
"That's why we have been considering for the past year the fact that, among health and sanitation workers, it should be clear that the stigmatization of drug users and people living with HIV is an issue of patient safety and that whoever fails to act accordingly can be punished", he said.
Source: National Drug Council of Uruguay