CAMBODIA: Rising drug use jeopardises AIDS success

Photo: Vinh Dao/IRIN

Crystal methamphetamine is usually smoked but sometimes injected

PHNOM PENH, 30 October 2008 (PlusNews) - Evidence of the large-scale use and manufacturing of methamphetamine in Cambodia could pose a new challenge to the fight against HIV/AIDS, warned non-governmental organisations (NGOs).

In the capital, Phnom Penh, 14 percent of injecting drug users were found to be HIV positive in 2006, rocketing to 35.1 percent in 2007, according to statistics from the National Authority for Combating Drugs (NACD), a government body.

Studies have found that crystal methamphetamine - commonly known as "crystal meth" or "ice", and usually smoked but sometimes injected - is also associated with high-risk sexual behaviours that can lead to HIV transmission and could inhibit the body's ability to suppress the HIV viral load.

The potent central nervous system stimulant is highly addictive, causing paranoia, delusions and hallucinations. Studies at this point have obtained mainly preliminary data, but indicate that methamphetamine may also accelerate the onset of HIV-related dementia and interfere with treatment effectiveness.

"Though there are conflicting findings regarding methamphetamine ... for HIV infection," said Frederick Curtis, senior technical officer for drug use at Family Health International (FHI) in Cambodia, "a rise in crystal meth use in Cambodia looms as a threat to reversing the HIV-prevalence trend."

HIV infection levels in Cambodia declined from 3.7 percent in 1997 to 0.9 percent in 2006, according to UNAIDS figures.

Street children and sex workers, two groups at high risk of HIV, are especially prone to crystal meth addiction as they abandon the once popular yama, a local slang name for amphetamines.

Data gathered by the NACD revealed that treatment admissions for crystal meth addiction increased by 18 percent during the first six months of 2008, compared to the previous six-month period, while yama admissions fell by 15 percent.

The trend reflects similar data from Thailand and Malaysia, reported at the First Global Methamphetamine Conference in September 2008 in Prague, Czech Republic.

"We've also seen that users will turn to methamphetamines because they think it will help them overcome heroine addictions," Curtis told IRIN/PlusNews.

Addiction dangers and HIV

Crystal meth - with 80 percent purity - is more addictive than other drugs and could pose problems to HIV prevention services in Cambodia.

Curtis noted that the effects of the drug, described as an intense rush of pleasure, were experienced almost immediately; Yama pills were not as pure, and the effects only kicked in after 40 minutes when taken orally.

"This intense euphoria is not lost on youth looking for new thrills," Curtis said. Ice also seemed to be favoured by an ever younger population of users, replacing ecstasy as the drug of choice in nightclubs and bars.

Cham Sopheap*, 25, a male clubgoer in Phnom Penh, agreed, and didn't think meth would put him at risk of HIV as other drugs did. "The NGOs teach us not to inject drugs, so we don't," he said. "I don't understand how smoking a drug would spread a disease."

He was more likely to hire sex workers when using the drug. "I've done it maybe four times, and every time I call a prostitute at the end of the night to lay with me," he commented.

"Meth doesn't make me feel energised like I want to have a lot of sex, but just that I want to lay around with a girl. I think this leads to sex."

gc/kn/he