A report by the UK-based NGO, Harm Reduction International (HRI) says new patterns of injected drug use in sub-Saharan Africa call for an increase in preventative efforts among this population which is at risk of HIV infection, according to a Mail & Guardian report.
HRI said in its Global State of Harm Reduction report that although injected drug use has been documented in more than 150 countries, it is difficult to establish an accurate number for people who inject drugs. Globally, this form of drug consumption is estimated to be between 8.9m and 22.4m people. The number of people in this population group and living with HIV ranges from 900,000 to 4.8m.
The organisation, which advocates for the “prevention of harm (from drug use) rather than on the prevention of drug use itself”, estimates that HIV prevalence among people who inject drugs in Tanzania is 33.9%, 16.7% in Uganda, 9.1% in Senegal and 19% in South Africa.
A small number of sub-Saharan African countries have taken up harm reduction policies. Kenya and Tanzania, for example, have increased the number of places that provide drug users with clean needles and syringes. The aim of these needle syringe programmes is to prevent HIV or hepatitis C infection through the use of dirty needles.
Tanzania has also scaled up opioid substitution therapy services – the medical procedure of replacing illegal opioid with a longer-acting opioid. The World Health Organisation says both these methods are effective in reducing HIV infection and HIV risk behaviour among drug users who inject themselves.
Although awareness programmes are planned in three South African cities – Pretoria, Cape Town and Durban – there is only one needle-syringe programme site in the country. The Cape Town initiative focuses on men who have sex with men who inject drugs.
The HRI report states that more of these services are needed – especially in light of the increase in high-risk practices such as flashblood, where one user draws blood back into the syringe after injecting heroin and then passes the syringe on to a peer, who injects the blood.