Review of Global Policy Architecture and Country Level Practice on HIV/AIDS and Drug Treatment

51 Pages Posted: 11 Mar 2009

See all articles by Robert Ali

Robert Ali

University of Adelaide - WHO Collaborating Centre for Research in the Treatment of Drug & Alcohol Problems

David Burrows

AIDS Projects Management Group

Linda Gowing

WHO Collaborating Centre for Research in the Treatment of Drug & Alcohol Problems at the University of Adelaide

Robyn Vial

University of Adelaide - WHO Collaborating Centre for Research in the Treatment of Drug & Alcohol Problems

Nick Walsh

Southern Health

Pacifica Onyancha

Mathari Mental Hospital

Erin Finnerty

affiliation not provided to SSRN

Date Written: March 11, 2009

Abstract

This review, funded by the U.K Department for International Development, provides an understanding of the gaps and opportunities for improving access to drug treatment, in particular opioid substitution treatment (OST), for drug users affected and infected by HIV. OST is effective in treating opioid dependency, reducing its individual and social costs. For HIV-infected, opioid-dependent injecting drug users, consistent participation in OST is associated with a higher probability of antiretroviral treatment and, amongst antiretroviral users, more consistent use of antiretrovirals.

At the global policy level, there are few barriers to the introduction and expansion of OST with both methadone and buprenorphine now on the WHO Essential Drugs List, and all relevant international organisations approving and encouraging the use of OST for HIV prevention, treatment, care and support in countries where injecting drug use and HIV are found. Unfortunately, there are huge disparities in access to drug treatment, with participation in treatment in Asia and Africa being disturbingly low. Country reports from Vietnam, Kyrgyzstan and Kenya provide examples of the barriers and successes on the ground. Recommendations for donors, international organizations and public health champions include:

1. Strengthen leadership at global level for access to drug treatment and, in particular, opioid substitution therapy as a key intervention in HIV prevention, treatment and care among injecting drug users.

2. Develop audit tools for donors to ensure that consideration of harm reduction interventions, prioritizing OST and needle-syringe programmes, becomes a standard part of all development work related to HIV/AIDS.

3. Support the implementation of drug treatment and, in particular, OST in country.

4. Integrate drug treatment and, in particular, OST with HIV treatment.

5. Establish comparable drug treatment programs within correctional institutions to those in the community.

Suggested Citation

Ali, Robert and Burrows, David and Gowing, Linda and Vial, Robyn and Walsh, Nick and Onyancha, Pacifica and Finnerty, Erin, Review of Global Policy Architecture and Country Level Practice on HIV/AIDS and Drug Treatment (March 11, 2009). Available at SSRN: https://ssrn.com/abstract=1357336 or http://dx.doi.org/10.2139/ssrn.1357336

Robert Ali

University of Adelaide - WHO Collaborating Centre for Research in the Treatment of Drug & Alcohol Problems ( email )

Adelaide, SA, 5005
Australia

David Burrows (Contact Author)

AIDS Projects Management Group ( email )

Unit 108, 1 Erskineville Road
Newtown, 2042
Australia

Linda Gowing

WHO Collaborating Centre for Research in the Treatment of Drug & Alcohol Problems at the University of Adelaide ( email )

Adelaide, SA, 5005
Australia

Robyn Vial

University of Adelaide - WHO Collaborating Centre for Research in the Treatment of Drug & Alcohol Problems ( email )

Adelaide, SA, 5005
Australia

Nick Walsh

Southern Health ( email )

246 Clayton road
Clayton
Victoria, 3168
Australia

Pacifica Onyancha

Mathari Mental Hospital ( email )

Kenya

Erin Finnerty

affiliation not provided to SSRN ( email )

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