In the two weeks before and after June 27, the highest number of positive diagnoses are made around National HIV Testing Day. This draws attention to the many ways people become infected, but more importantly, demonstrates what is being done to prevent the rise in infections.
In 2010, eight percent or 3,900 of the estimated 47,500 new HIV infections in the U.S. were attributed to injection drug use, according to the Centers for Disease Control and Prevention. Studies reveal that two out of five people who inject drugs have contracted the disease without knowing it. More than 90 percent of new HIV infections can be avoided, says the CDC, by getting tested and diagnosed earlier.
But most injection drug users avoid seeking testing, care, and treatment as there is a stigma related to substance abuse. It is often viewed as a criminal activity rather than a medical issue that requires counseling and rehabilitation.
Harm Reduction Decreases the Risk of HIV
Sharing needles is one of the most common and most dangerous ways to transmit HIV. Resources in the form of harm reduction or substitution therapy have become more available as the response to HIV and AIDS is on the rise again. Harm reduction focuses on decreasing the consequences of drug use, as opposed to practicing and teaching abstinence.
This new harm-reduction strategy for treating drug addiction in the U.S. has been used in countries like Portugal and Switzerland for more than a decade: not until recently did this become an American trend.
People who advocate for harm reduction believe that illegal drug use will always occur, no matter what. The concept is to give drug users a safe environment rather than advocate for harsher drug penalties or abstinence.
At this point, needle-exchange programs seem to be working in the U.S. They allow people to anonymously trade used needles in for clean needles. There are approximately 200 needle exchange programs in 33 states and the District of Columbia, according to the North American Syringe Exchange Network.
HIV infections among drug users in Washington D.C., for example, dropped by about 70 percent in 2008, according to a report by The Washington Post. On average, the amount of HIV cases dropped from 19 new infections per month to fewer than six new infections. This decline can be attributed, in part, to a shift in society’s perspective about addiction and a drug user’s right to proper treatment.
Some of the most reputable drug and alcohol rehabilitation centers in the U.S. are located in New York and California. When people make the choice to get treatment for substance abuse they are more likely to start and remain in HIV medical care, adopt safer behaviors, and take their HIV medications correctly than those not receiving such treatment.
While there may not be a plethora of rehabilitation centers abroad, the U.S. supports a wide range of activities – from research and development to technical assistance and financial support to other nations still struggling to combat the global HIV and AIDS pandemic.
Safe Injection Sites Have Gained National Attention
Only one safe injection site exists in North America. Insite opened in Vancouver, British Columbia in 2003. Ottawa, Ontario is working to create a second safe injection facility this year.
There have been more than three million visits since opening 13 years ago, according to a Vancouver Coastal Health report. There are more than 18,000 people registered with Insite. The site takes nearly $3 million a year to operate, and includes a detox facility known as Onsite.
A 2010 study by The Journal of Global Drug Policy and Practice illuminated how these safe injection sites were working around the globe. The study reveals that no one has ever died of an overdose inside of a safe injection site and “the available research is overwhelmingly positive.”
Still, the study makes clear that it’s difficult to decide if these facilities are truly effective because of a lack of evidence. Safe injection sites currently lack proper controls and long-term data. There isn’t enough evidence to say if safe injection facilities are causing positive changes in communities. “They are too often credited with generating positive effects that are not borne out by solid empirical evidence,” according to the study.
Insite is viable at this point. The federal department, Health Canada, approved a four-year exemption from federal law following what they described as a “rigorous, evidence-based review that included an assessment of the center’s application, an inspection of the facility, and the establishment of terms and conditions to protect public health and safety.”
As drug overdose rates continue to pose a problem in cities across both Canada and the U.S., supporters of harm reduction will continue to advocate for their own supervised injection sites in response. Despite political setbacks, recent talks show promise for the future of harm reduction. Luxury rehabilitation centers and other addiction treatment centers are beginning to provide specialized treatment for HIV and AIDS, as well.
The Future of HIV and AIDS
The International AIDS Conference in Durban, South Africa, July 18-22, is the premier gathering for those working in the field of HIV, as well as policy makers, persons living with HIV and other individuals committed to ending the pandemic. It is a chance to assess where we are, evaluate recent scientific developments and lessons learnt, and collectively chart a course forward.
The AIDS 2016 program will present new scientific knowledge and offer many opportunities for structured dialogue on the major issues facing the global response to HIV. A variety of session types – from abstract-driven presentations to symposia, bridging and plenary sessions – will meet the needs of various participants. Other related activities, including the Global Village, satellite symposia, the Exhibition and affiliated independent events, will contribute to an exceptional opportunity for professional development and networking.
Also featured will be the latest developments on tools for prevention, diagnosis and treatment of HIV co-infections. The program will share research results, important clinical developments and updates on ongoing and new studies in the field of HIV and co-infections, particularly tuberculosis and viral hepatitis.
For more information, visit http://www.aids2016.org/.