An injection Drug User

As many as 3 million (19 percent) of about 15.9 million people in the world using self-injecting drugs may be infected with HIV/AIDS, according to a study recently published in The Lancet.

There were 148 countries with significant populations of injecting drug users (IDU) and 120 of them (82 percent) had HIV positives among their IDUs.

This marked an increase from a similar study in 1998 which identified 129 countries having IDUs and 103 of them (79 percent) having HIV infected individuals among the IDUs.

The study was carried out by international experts affiliated with the United Nations reference group on HIV and Injecting Drug Use. The experts systematically analyzed the data and findings from various peer-reviewed studies covering people aged 15-64 years.

The results showed great variation among countries.

There were nine nations where the proportion of HIV infected people to the total number of IDUs exceeded 40 percent: Estonia (72.1%); Argentina (49.7%); Brazil (48.0%); Kenya (42.9%); Myanmar or Burma (42.6%); Indonesia (42.5%); Thailand (42.5%); Ukraine (41.8%); and, Nepal (41.4%).

Other observations noted in the study:

* The United States had 0.96% of its population aged 15-64 classified as IDUs and 15.6% of this group had tested positive for HIV.

* Argentina had a lower 0.29% of IDUs but 49.7% of the group were HIV positive.

* The United Kingdom had 0.39% of IDUs but showed a very low 2.3% of them as HIV positive.

* Spain also had a lower 0.31% of IDUs but 39.7% of them had HIV; this was the highest figure in Western Europe.

The researchers believe that of the 15.9 million IDUs worldwide, the largest numbers are in China, the U.S. and Russia.

However, the areas of concern are places in Africa where little data is available and the countries in Eastern Europe, Southeast Asia and Latin America with high rates of infection.

HIV infections have spread rather quickly among injecting drugs users in recent years. Used syringes become the medium to spread the disease. IDUs also have greater tendency to follow risk-laden behavior such as engaging in unprotected sex.

This trend is highlighted by Estonia. In the 1998 review, Estonia was not even included in the list of nations with IDUs. A decade later, it shows a 72% HIV-positive group of people in a sample of IDUs.

The study believes these findings show:

* Programs like needle exchanges and drug substitution treatments are effective. Needle exchange programs are cited as one key factor for the low infection rate in the UK. In contrast, HIV prevalence is higher in countries against needle exchanges because of misguided beliefs that the programs encourage use of drugs.

* Information programs can help prevent the spread of HIV. This is especially helpful in countries where use of injecting drugs is common but HIV infections are not yet widespread.