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PAKISTAN: New study suggests Afghan war has led to increase in HIV/AIDS

The Afghan war led to increased needle sharing in Pakistan
Islamabad, 15 July 2003 (PlusNews) - A recent US study has suggested that the war in Afghanistan in 2001 led to a higher HIV risk among drug users in neighbouring Pakistan and warns that immediate action is needed to prevent an epidemic.

The study's principal author, Dr Steffanie Strathdee, said the report highlighted how the effects of military action can be more far-reaching than initial casualty assessments show.

"Our study illustrates how complex emergencies like war can directly or indirectly exacerbate vulnerabilities to infectious diseases, in this case by leading to increases in needle sharing," Strathdee told IRIN from the John Hopkins Bloomberg School of Public Health in Baltimore, USA.

The report, entitled "The Rise in Needle Sharing Among Drug Users in Pakistan during the Afghanistan War" was published in the July issue of the "Journal of Drug and Alcohol Dependence". It was based on research by Strathdee's team from Baltimore and NGOs based in Pakistan.

The joint team reported that opiates, including heroin, became more expensive and scarce between August and October 2001, while military action took place, leading to increased numbers of addicts injecting, rather than smoking, the drug. In this three-month period alone, needle sharing increased more than three-fold.

The report explains that addicts tend to inject opiates more when supplies are restricted, because the method gives a more intense and immediate 'high' than smoking or ingesting the drugs. When injection rates increase, so does needle sharing. It is this practice that directly affects the rates of HIV and other diseases that can be transmitted through the blood.

Strathdee warns that ignoring this change in drug taking behaviour could have severe consequences for Pakistan. "Although HIV infection rates appear low in Pakistan, this could soon change," she said.

Dr Farrukh Ansari, Senior Progamme Officer for the UN Programme on HIV/AIDS (UNAIDS), agrees. "Timely action needs to be taken in Pakistan. This is classified as a low-prevalence, but high-risk country," he told IRIN in the Pakistani capital, Islamabad.

The country is vulnerable to a sharp increase in infection rates, Strathdee said, because there are few preventive safeguards in place. "Pakistan has very low levels of HIV/AIDS awareness and condom use, high levels of needle sharing, and a practice of some blood clinics to pay blood donors," she added.

Researchers found that 30 percent of injecting drug users in their study had been paid for donating their blood. The report criticises the practice of giving cash incentives for blood donations and raising the risk of transmission from injection drug users to the general public. Blood stocks in Pakistan are screened for HIV and other diseases, but Ansari notes that
there is a period of three months after infection where HIV cannot be detected.

Ansari said that Pakistan has approximately 2,000 known cases of HIV out of a population of 140 million, but the majority of cases are thought to go unreported. UNAIDS estimates that the true figure is between 70,000 and 80,000 people. The Pakistani government, UNAIDS and NGOs are currently working together to document the extent of the HIV/AIDS problem in Pakistan and to co-ordinate a strategy against it.

The UN Office on Drug and Crime (UNODC) puts the figure of heroin addicts in Pakistan at 500,000, and agrees that increasing numbers are injecting the drug.

The researchers recommend that in order to avoid an explosion of HIV rates, a wide range of risk factors should be addressed. "A dramatic scaling up of drug abuse prevention and treatment, needle exchange, and voluntary HIV testing and counselling is needed in Pakistan," Strathdee said.

Although the report indicates that the HIV/AIDS situation in Pakistan could decline drastically if action is not taken, Ansari is optimistic that the country can avoid an epidemic by working with vulnerable groups like injection drug users.

"What we have right now is a window of opportunity," Ansari said.

Theme (s): Other,

[This report does not necessarily reflect the views of the United Nations]

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