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Injecting Drug Use and Infectious Diseases: Implications for the Global HIV/AIDS Response (An IAS/IDSA Partnership) |
TUSY06 |
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| Venue: |
SR 3 (550) |
| Interpretation: |
None |
| Time: |
14:30 - 16:00, 05.08.2008 |
| Code: |
TUSY06 |
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Co-Chairs: |
Arlene Bardeguez, United States
Pedro Cahn, Argentina (Chairperson)
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The Panel Discussion will bring leading researchers and clinicians to outline comprehensive services for injecting drug users and to highlight key infectious diseases affecting injecting drug users and define implications for the HIV/AIDS response. Discussions will provide insights into policy implications for planning, service delivery and monitoring, and will provide a framework for further research and state-of-the-art for action in the most affected regions.
Nearly one third of all new HIV infections outside of sub-Saharan Africa are attributed to injecting drug use. The world's fastest growing epidemic is in Eastern Europe where more than 70% of the infections are driven by injecting drug use. It is well known that levels of hepatitis B and hepatitis C infection are extremely high among injecting drug users. Studies show that injecting drug users also face higher risks of contracting TB and are more likely to develop it in multiple organs and sites; they have high incidence of other sexually transmitted infections; commonly develop skin infections at the site of injecting with resulting consequences including ulcers, abscesses, stroke, botulism, tetanus and destruction of heart valves; and have associated bacterial / viral systemic infections.
The information from the session will provide an update to researchers and will help clinicians, people living with HIV and advocates better understand the complex challenges associated with injecting drug use and HIV. This session will also highlight recommendations for policy, provide guidelines for clinical management and establish a platform for continued critical dialogue on injecting drug use and infectious disease in the context of HIV/AIDS.
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Presentations in this session:
14:30
TUSY0601
Powerpoint (340 KB) | Comprehensive care for injecting drug users: Syringe exchange, methadone and HIV care and treatment
Eric Goosby, United States
| 14:45
TUSY0602 | TB and IV drug use in Eastern Europe: Clinical and epidemiological aspects and implications for public health
Daria Podlekareva, Denmark
| 15:00
TUSY0603
Powerpoint (1.67 MB) | Staph infections in intravenous drug users
Frederick Altice, United States
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Rapporteur report
Track D report by Martin Donoghoe
All three presentations in this symposium highlighted the disproportionate burden of disease borne by injecting drug users (IDUS). These diseases include not only HIV/AIDS, but also: hepatitis (in particular hepatitis C); tuberculosis; sexually transmissible infections; and a wide range of other conditions, notably endocarditis (which is often overlooked) and, as eloquently presented by Dr. Altice, staphylococcal infections, that cause abscesses and soft tissues infections.
Tuberculosis co-infection in IDUs is high, particularly in the countries of Eastern Europe and, as reported by Dr. Podlekareva, this is the region with the highest rates of MDR TB in the world. Political and economic change in countries in the region contributed to reduced TB control and consequent increases in TB mortality from 1991 in part as a consequence of disinvestment in state run health care systems.
Critical barriers to providing care to IDUs identified by Dr. Goosby and Dr. Podlekareva, included poor provider patient interactions; stigma, discrimination and criminalization of drug users; and poor coverage of targeted interventions for IDUs notably opioid substitution therapy and other harm reduction measures sure as needle and syringe provision.
All presenters pointed to the need for integration of services for IDUs and a minimum package of services that includes prevention, treatment and care for HIV, tuberculosis, hepatitis and substance dependence. Questions and discussion pointed to high levels of untreated mental illness in IDUs; the need for vigilant surveillance of these conditions and the recent policy guidelines for collaborative HIV and TB services for injecting and other drug users developed by the World Health Organization and launched at this conference.
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