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The HIV Epidemic among People who Inject Drugs

The HIV Epidemic among People who Inject Drugs. Thomas Kerr Director, Urban Health Research Initiative, BC Centre for Excellence in HIV/AIDS St. Paul ’ s Hospital, Providence Health Care Associate Professor, Division of AIDS Department of Medicine, University of British Columbia.

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The HIV Epidemic among People who Inject Drugs

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  1. The HIV Epidemic among People who Inject Drugs Thomas Kerr Director, Urban Health Research Initiative, BC Centre for Excellence in HIV/AIDS St. Paul’s Hospital, Providence Health Care Associate Professor, Division of AIDS Department of Medicine, University of British Columbia

  2. 11 - 21 million PWID in 151 countries • 0.8 – 6.6 million PWID living with HIV/AIDS • Growing epidemics in former Soviet Union/Eastern Europe & Southeast Asia driven primarily by PWID and transmission to their partners People who Inject Drugs: The Global Situation Mathers et al., Lancet 2008; Mathers et al., Lancet 2010; UNAIDS, 2012

  3. Injection Drug Use & HIV/AIDS 49 countries with HIV prevalence among PWID 22-50% greater than the in general population (UNAIDS, 2012) Mathers et al., The Lancet, 2008

  4. 57 countries reporting: 37% of PWID receiving an HIV test annually • NEP in 82 countries: 5% of injections covered by sterile syringes • OST in 71 countries: 8 per 100 PWID covered with OST Access to Evidence-based HIV Prevention & Treatment Mathers et al., Lancet, 2010 Degenhardt et al., 2010; UNAIDS, 2012

  5. 57 countries reporting: 37% of PWID receiving an HIV test annually • NEP in 82 countries: 5% of injections covered by sterile syringes • OST in 71 countries: 8 per 100 PWID covered with OST • 47 countries reporting ART for PWID: 4 per 100 PWID receiving ART Access to Evidence-based HIV Prevention & Treatment Mathers et al., Lancet, 2010 Degenhardt et al., 2010; UNAIDS, 2012

  6. AIDS & Behavior, in press

  7. The Lancet, 2010

  8. Journal of Infectious Diseases, 2011

  9. Global heroin supply increased by 380% from 1980-2010 Price of heroin in Europe decreased by 79%

  10. PWID suffer from high rates of preventable HIV infection • Evidence-based interventions exist but access remains low • Enforcement and incarceration have failed to reduce the use and supply of drugs and have contributed to the spread of HIV infection and treatment failure • The barriers to scale-up of prevention and treatment programs are social and structural in nature Conclusions

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