Pubdate: Fri, 12 Jul 2002
Source: Honolulu Star-Bulletin (HI)
Copyright: 2002 Honolulu Star-Bulletin
Contact:  http://www.starbulletin.com/
Details: http://www.mapinc.org/media/196
Author: Sabin Russell
Note: Sabin Russell is the Medical Writer for the San Francisco Chronicle
Bookmark: http://www.mapinc.org/heroin.htm (Heroin)

GLOBAL HEROIN USE FUELS AIDS EPIDEMIC

BARCELONA, Spain -- From the jungles of southeast Asia to the streets of 
Moscow, the AIDS virus is riding on the back of a global heroin epidemic 
and taking root among the most populous nations on Earth.

The link between HIV infection and injection drug use was one of the 
earliest discoveries of the epidemic. But it is only recently that disease 
trackers have detected signs of a rapidly spreading drug-related outbreak 
in Eastern Europe and Asia that threatens to reach into the general population.

"Central Asia is a bomb waiting to explode," said Kasia 
Malinowska-Sempruch, a native of Poland who directs a drug-related AIDS 
program for the Open Society Institute, which urges that the world adopt 
"harm reduction" tactics such as needle exchange programs that are credited 
with rolling back an outbreak of HIV among drug users in San Francisco.

The highest increases in the rate of HIV infections are in the former 
Soviet Union. As many as 840,000 Russians are estimated to have the AIDS 
virus, the great majority drug-related cases.

A quarter-million Ukrainians are HIV-positive, the highest infection rate 
in Europe. Three out of 4 infections are among drug users or their sexual 
partners, and rates of pregnant women with HIV are rising.

Malinowska-Sempruch delivered a spellbinding speech Tuesday at the 14th 
International AIDS Conference, warning of the growing menace of AIDS.

"The world celebrated with us when the Berlin Wall fell and then left us 
alone to deal with the consequences. AIDS and drug use are the issues that 
will define whether or not we reverse the tide of economic and social 
disruption in this generation. If the world is unable or unwilling to turn 
its attention to this region and offer help, the consequences will be 
horrific."

Estimates are that 1 percent of the population of the Commonwealth of 
Independent States, which includes most of the former Soviet Union, uses 
injection drugs.

"More than 90 percent of new HIV cases in Moscow are related to injection 
drug use," said Ilona van de Braak of the AIDS Foundation East-West. Young 
people in Moscow are experimenting with drugs, and there is little aversion 
to injecting drugs because Russian medicine has often favored the syringe 
over the pill, she said.

"Drug use started with the Soviet Union collapse," said Lily Hyde of the 
International HIV/AIDS Alliance.

Drug-related AIDS epidemics are turning up along the heroin trade routes 
from Afghanistan to Burma. Already, at least 4 million are believed 
infected in India.

In China, pockets of drug-driven outbreaks have turned up in seven 
provinces, with infection rates among heroin users approaching 70 percent.

Indonesia, which had seemed immune to the epidemic, is now seeing high 
rates of HIV in urban areas where drug use thrives.
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