See also:

 
 
Resources
 
Phasing out drug detention centres in East and South East Asia: Poster presentation at Harm Reduction Conference, Lithuania, June 2013
Overview of epidemiology of injection drug use and HIV in Asia: Poster presentation at Harm Reduction Conference, Lithuania, June 2013
   
Projects
 
UNODC Partnership for the Reduction of Injecting Drug Use, HIV/AIDS and Related Vulnerability in Myanmar
Reducing the spread of HIV through HAARP Country Flexible Program in Myanmar
Reduce the spread of HIV harm associated with drug use amongst men and women in the Lao PDR: -HAARP Country Flexible Program Lao PDR (LAO/K18)
Drug abuse and HIV prevention among ethnic minorities in Nortwest Viet Nam
Project on Strengthening Comprehensive HIV/AIDS Prevention and Care among Drug Users and in Prison Settings
   
Stories
 
UN calls to close compulsory drug detention and rehabilitation centres without delay
(9 March 2012)
6 million people living with HIV in Asia: countries striving to achieve "Zero New Infections" by 2015
(1 March 2012)
World AIDS Day 2011: Getting to ZERO
(1 December 2011)

More...
 
Publications
 
AusAID HIV Strategy 2009
(1 May 2009)
 
Related Documents
 
MoU between UNODC and WHO
 
 
 

HIV and AIDS

 

Our commitment

The use of contaminated injecting equipment among injecting drug users is one of the major routes of HIV transmission in many countries, contributing up to 10 per cent of all HIV transmissions worldwide and to more than 30 per cent if sub-Saharan Africa is excluded.

In Asia, an estimated 3,000,000-4,000,000 people inject drugs.

In several countries in East Asia, a large proportion of reported HIV infections have been associated with injection drug use. Despite overall low rates of HIV, a high prevalence of HIV among people has been reported in Indonesia (57.1% of women and 52.1% of men), Thailand (38.7%), Myanmar (36.3%), Cambodia (24.4%), Malaysia (22.1%), Vietnam (18.4%) and China (9.3). Even countries that reported no HIV in this population during the 1990s, such as the Philippines, have since reported epidemic outbreaks among people who inject drugs.

The United Nations General Assembly's High-Level Meeting on AIDS in June 2011 adopted bold targets for 2015: to reduce the sexual transmission of HIV by half, cut HIV transmission among people who inject drugs by 50 per cent, provide treatment for 15 million people living with HIV, end stigma and discrimination, and close the AIDS funding gap.

UNODC, a co-sponsor of UNAIDS, and the UN family have embraced a new global vision: zero new HIV infections, zero discrimination and zero AIDS-related deaths, as detailed in the UNAIDS Strategy for 2011-2015.

UNODC advocates and supports governments and civil society organisations to scale up access to a comprehensive package of services for the prevention, treatment and care of HIV among people who inject drugs:

1. Needle and syringe programmes (NSPs)
2. Opioid substitution therapy (OST) and other drug dependence treatment
3. HIV testing and counselling (T&C)
4. Antiretroviral therapy (ART)
5. Prevention and treatment of sexually transmitted infections (STIs)
6. Condom programmes for IDUs and their sexual partners
7. Targeted information, education and communication (IEC) for IDUs and their sexual partners
8. Vaccination, diagnosis and treatment of viral hepatitis
9. Prevention, diagnosis and treatment of tuberculosis (TB).

These nine interventions are included in the comprehensive package because they have the greatest impact on HIV prevention and treatment. There is a wealth of scientific evidence supporting the efficacy of these interventions in preventing the spread of HIV in this population.

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Our main achievements in 2012

  • At a regional level, UNODC continued to compile, synthesize and share data on the epidemiology of injection drug use and HIV as well as coverage of key prevention services, specifically needle and syringe programme and opioid substitution treatment programme, among people who inject drugs in countries identified by UNAIDS as priority countries for intensified action in Asia. This information is being used to inform advocacy, policy making and programmatic responses at both regional and national levels.
  • In October 2012, the HIV/AIDS team, in partnership with the DDR team, ESCAP and the UNAIDS Regional Support Team for Asia and the Pacific, organised the Second Regional Consultation on Compulsory Centres for Drug Users (CCDUs) in Malaysia. Delegations of senior officials from nine Governments in East and Southeast Asia participated. The consultation resulted in the adoption of the meeting report in which countries committed to the expansion of voluntary community-based drug dependence treatment. While several countries expressed an intention to phase out compulsory centres, some countries acknowledge that such a transition will require time due to existence of a large number of centres.
  • In Indonesia, UNODC supported the Parliament by providing technical assistance to conduct of a one day seminar in the House of Representatives precinct. The seminar on Implementing the Right to Health for Drug Users to Receive Treatment and Rehabilitation as stipulated in Article 54, Act Number 35 of 2009 on Narcotics included speeches by senior government officials, including the Head of BNN, Chairmen of commission III (on law and security) and Vice Chairmen of Commission IX (on health), INP and MoH. Attend by 200 participants, mostly Representatives of Parliament, expert staff of Member of Parliament and community representatives.
  • In Lao PDR, with support from the AusAID funded HAARP project, harm reduction outreach and provision of primary health care to people who inject drugs has been taking place in 25 villages in four districts (one district of Phongsaly and three district of Houaphanh Province) bordering Vietnam. A needle syringe program (NSP) service delivery is now available in five fixed sites (health centres) and through outreach by 25 peer educators. As of December 2012, the number of PWID accessing HIV prevention services in the project target areas has reached 149 persons who inject drugs, or 324% from the original 46 people who inject drugs, identified by the RAR in 2010.
  • In Myanmar, UNODC continued to make a direct contribution to increasing access to and coverage of HIV prevention and harm reduction services for drug users and their sexual partners. In 2012, UNODC supported services reached a total of 18,094 individual clients at nine project sites across the country with a package of prevention and care services. According to reports by the National AIDS Programme (NAP) these services have directly contributed to declining HIV prevalence among people who inject drugs in the project areas.
  • Viet Nam, ongoing advocacy efforts through a study visit, workshops and trainings has increased openness of the government to implementing evidence based HIV prevention work in prison settings. Such evidence-based responses are now included in the government's draft strategic national response to HIV/AIDS, whereas in the past they were not. Places of detention have been included in the new decree on substitution treatment of opioid dependence (MMT Decree), approved in November 2012, whereas in the past they were not included (prisons and pre-trial detention centers, juvenile schools and education centres).

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Our main achievements in 2011

  • At a regional level, UNODC has continued to help ensure that data on HIV prevalence and access to core HIV services (particularly among its core target group of people who use drugs) is generated, analysed and shared. This information is being used to inform policy making and programmatic responses at both regional and national levels.
  • In Myanmar, UNODC has made a direct contribution to increasing access to and coverage of HIV prevention and harm reduction services for drug users and their sexual partners. In 2011, UNODC supported services reached a total of 2,347 individual clients with a package of prevention and care services. According to reports by the National AIDS Programme (NAP) these services have directly contributed to declining HIV prevalence among people who inject drugs in the project areas.
  • In Lao PDR, the linkage between injecting drug use and HIV was only officially accepted in 2010 based on the findings of a Rapid Appraisal and Response survey supported by UNODC. Subsequent to this shift in understanding and policy, and following a high-level visit to Viet Nam in 2011 by senior government officials from Lao PDR, the piloting of needle and syringe programmes began in two pilot provinces in that country.
  • In Indonesia, a series of fact-finding missions went to Australia to review the policy, public and community sector response to drug dependence. The Head of the National Narcotics Bureau (BNN) led the first of these missions and a key outcome has been the expansion of treatment approaches to be supported by BNN and an increase in the role of community-based treatment services.
  • In Indonesia, data on HIV and syphilis prevalence and risk behavior in 24 prisons and detention centres became available through a national study supported by UNODC. The study findings are now being used to improve harm reduction and treatment services in Indonesian prisons.

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Our main achievements in 2010

  • Finalization of a Strategy to Halt and Reverse the HIV Epidemic among People who Inject drugs in Asia and the Pacific 2010-2015, involving WHO, UNODC, UNAIDS, GFATM and ANPUD.
  • In Myanmar, UNODC has made a direct contribution to increasing access for injecting drug users (IDUs) to treatment and harm reduction services. This occurs both at specific project sites and in terms of overall national coverage. According to national figures, IDUs accessing drop-in-centre (DIC) services increased by 14% in 2010 as compared with the same figure for 2008. National needle-syringe distribution also increased to more than 5 million from a figure of 3.5 million in 2008. There is a direct correlation between these results and UNODC operations through its two main HIV projects in country.
  • Availability of up-to-date strategic information in the areas of national policies, financial and human resource availability and coverage of HIV prevention and treatment interventions for people who inject drugs in 15 countries in Asia. This has been made available through the Baseline Assessment of Policies, Resources and Services for People who Inject Drugs, a survey commissioned by the UN Regional Task Force on Injecting Drug Use and HIV/AIDS for Asia and the Pacific.

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Our main achievements in 2009

  • Design and implementation of the AusAID-funded HIV/AIDS Asian Regional Programme (HAARP) in Myanmar and Lao PDR.
  • Support to the development of an opioid substitution treatment programme in Cambodia.
  • Provision of recommendations to Chinese authorities on an effective response by law enforcement to HIV/AIDS in closed settings and among injecting drug users.
  • Improved access to HIV/AIDS treatment services in four provinces in the northwest of Viet Nam.
  • Development and dissemination of strategic information on scaling-up effective responses to HIV.
  • Monitoring progress towards universal access, specifically the extent to which opioid substitution therapy and needle/syringe programmes are available in 15 countries in Asia.

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