Harm Reduction Policies and Interventions for Injection Drug Users in Thailand

Tyndall, Mark

World Bank, Washington, DC

关键词: ABSTINENCE;    ACCESS TO TREATMENT;    ADDICTION;    ADDICTION SERVICES;    ADDICTIONS TREATMENT;   

RP-ID  :  64642

学科分类：社会科学、人文和艺术（综合）

来源: World Bank Open Knowledge Repository

【 摘 要 】

The World Bank initiated a review of HIVprevention among injection drug users in Thailand, with theobjective of providing technical assistance to strengthennational capacity to develop state-of-the-art injecting druguse harm reduction interventions. Thailand has receivedinternational recognition for its successful interventionsto reduce the transmission of HIV among female sex workersand military recruits. It is looked upon as a role model forHIV education and awareness campaigns that include theextensive promotion and wide acceptance of condoms as an HIVprevention strategy. Thailand has the most progressive andcomprehensive antiretroviral program in the region with areported coverage of over 80 percent of eligibleindividuals. In 2001, it embarked on a progressive universalhealth care program that provides free access to a widearray of health care diagnostics and therapeutics for thepeople of Thailand. With these impressive achievements, itis remarkable how poorly Thailand has responded to the HIVepidemic among injection drug users (IDUs). From availabledata, it appears that the HIV prevalence rates among IDUshave remained high and stagnant over the last decade.Failure to provide effective interventions to reduce HIVtransmission among drug users has resulted in unnecessarysuffering, and for many, HIV-related death. Continuedinaction threatens to undermine successful HIV preventionefforts in the country through ongoing HIV transmissionamong injection drug users and their sexual partners. Thecurrent focus on enforcement and punishment, along with thereliance on compulsory drug treatment centers, has donelittle to control drug use in Thailand. The unintendedconsequence of this approach has been to push drug usersinto precarious and dangerous environments that havedirectly led to risky drug using patterns and persistentlyhigh rates of HIV transmission. Adopting a harm reductionapproach to deal with injection drug use could have a majorimpact on reducing HIV transmission as well as engaging drugusers into better health care and effective drug treatment.This will require strong leadership in key governmentMinistries and related agencies so that the centralstakeholders can roll out harm reduction programs. Thailandhas the potential to greatly reduce the transmission of HIVamong injection drug users and become a regional leader inharm reduction.