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special section on HIV aggressive efforts to stop the spread of HIV by injection drug use have avoided a disaster in Australia.
Shortly afterwards an HIV test came on the market in 1985, researchers from St. Vincent's Hospital in Sydney watched the virus in 0 people receiving treatment for addictions to heroin and other injectable drugs. At that time, the small but terrible AIDS epidemic was concentrated among gay men, and only one drug user has tested positive. But a closer examination of sexual contact and needle sharing this man, not in the initial study, told a disturbing story: Four of six people tested had the virus. "This study is a real call to action," said Alex Wodak, director emeritus of alcohol and drugs at the service of the hospital. "We knew we had to do something quickly and that we had to work ".
Wodak convened a meeting of people who injected drugs and professionals who have worked with them." Everyone in the room looked exactly the same goal and obsession, "says Wodak . "We all wanted to stop the epidemic. And we were all ready to do whatever it took" They agreed collectively on what was then a radical plan :. They initiate exchange programs for needles and syringes as widely as they could to provide own equipment to users. This was in violation of drug laws in the country, but they believed so passionately in what is now called harm reduction they decided to take the risk.
The program started in November 1986 and the vice squad soon Police called in Wodak, the public face of the effort, for a barbecue. "I spoke without taking breath and explains that this was a serious problem," recalls Wodak. He barraged the police statistics on how quickly HIV can spread among people who inject drugs, infecting 50% of syringe sharing population within 6 months and significantly speed up the sexual propagation. Contaminated needles and syringes, not drugs, transmit viruses, he said. A principal officer then shot Wodak aside and told him they would not be the urgent expenses. "I knew we had won," says Wodak.
If they ever.
Regarding HIV infections among people who inject drugs "We have the best graphic boring world," said epidemiologist John Kaldor of the Kirby Institute for Infectious Diseases and immunity in society, a branch of the University of New South Wales in Sydney. in many countries neighboring Australia, including Indonesia and Malaysia, people who inject drugs account for a high percentage of infection. But Australia only 17 of 340 injecting drug users who received annual HIV tests between 1995 and 2012 were infected, Kaldor and colleagues reported in January 14 issue of AIDS . the last annual HIV surveillance report of the Kirby Institute found that between 08 and 2012, only injection drug use accounted for 2% of new HIV diagnoses in Australia. the men who have sex with men represented to the most new diagnoses (67%), followed by heterosexual contact (25%).
In 1987, the state of New South Wales approved the needle and syringe programs, and in 1989 the first National Strategic Plan against HIV / AIDS said that it would be an element key to the country's response. Overall, the needle and syringe programs had prevented more than 57,000 HIV infections by 09, according to the Australian Department of Health and Aging. Between 00 and 09, investment of just over $ 0 million of the country would have saved $ 1.2 billion in health care costs.
Today, Australia has more than 3,000 sites that distribute some 30 million needles and syringes to drug users each year. The government of the United States, however, prohibits financing similar programs, although nearly 0 locations legally operate in different states. According to the Centers for Disease Control and Prevention, 16% of people living with HIV in the country were infected by sharing needles and syringes.
embrace at the beginning of Australia HIV harm reduction strategies was largely sparked by "national psychodrama" which played at that time, Wodak said: When the AIDS epidemic emerged in Australia, the daughter of the Prime Minister has been struggling with heroin. Other factors are entered as well. Neal Blewett, the health minister, rallied bipartisan support for a strong response to HIV / AIDS and included representatives of drug users in the community discussions. Wodak and believes the Australian history as a British penal colony has helped too. "Convicts are people they are not ideologues practices," he said.
The Australian government soon went beyond its support of needle and syringe programs, allowing the center to open in 01, hosted a church band, where users can inject drugs with clean equipment under medical supervision without fear of prosecution. Located near a busy subway station, the Sydney Medically supervised injecting Centre (MSIC) was the first facility of its kind outside of a few European countries, and customer feedback has been extremely positive, says the medical center director, Marianne Jauncey. "the only more striking, the most often repeated phrase is," I thank you for treating me like a human being, "said Jauncey.
Marianne Jauncey, a doctor overseeing a injection site where people can fix in a safe environment
PHOTO :. MALCOLM LINTON
A series of independent reviews found that MSIC kept his promise. The last, published by the accounting firm KPMG in 2010, found that the center had overseen over 0,000 injections, referring about a third of its customers to a drug treatment. He managed nearly 3,500 overdoses without a single death and saved the health care system about $ 0,000 per year. Since the opening of the site, the HIV infection rates have decreased in the neighboring districts, although the review was not enough data to connect MSIC down.
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Harm reduction in Australia http://scim.ag/hiv2014.
Australia's harm reduction efforts have been its limits, the hepatitis virus C (HCV) projectors. HCV is spread by needle and syringe sharing much more easily than HIV is, and he was already widespread when harm reduction efforts began for HIV. According to the Department of estimates of health and aging, liver-damaging virus had infected more than 80,000 people by 1986. This number increased to 0 000 in 00, despite the needle and syringe programs. Yet without these programs, the country would have faced greater HCV epidemic. The Ministry of Health estimates that they have prevented more than 100,000 new HCV infections
Harm reduction programs for HIV and HCV also neglected some marginalized for a while. A study published in the October 06 issue Addiction found few services were available for "ethnic minorities", a group that included Australians and immigrants from Vietnam and other countries in Asia South who injected drugs in Sydney and indigenous urban sites less around New South Wales. "It was a nightmare of harm reduction," says Lisa Maher, an epidemiologist at the Kirby Institute, who led the study. Over 3 years, 31% of ethnic minorities in the study of 368 people have been infected with HCV, rate three times higher than that observed in the non-ethnic minority. Needle and syringe programs and accompanying health services for people who inject drugs have since expanded to these communities.
Wodak emphasizes that harm reduction can only do what its name suggests. "We are pleased to make a bad problem less bad," says Wodak. "We must eradicate the problem in order to feel that we have succeeded."
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