The spread of HIV among injecting drug users across Europe – outside of sub-Saharan Africa one in three new cases of HIV area among users – will be high on the agenda at the International AIDS Conference in Vienna, Austria, which starts on Sunday.
In Eastern Europe and Central Asia, injecting drug use is the “primary cause” of the rapid spread of new infections.
Ahead of the 18th AIDS meeting, experts from across the world have released the “Vienna Declaration” calling on governments and the UN to promote rational drug policies that promote human rights and public health.
“As scientists, we are committed to raising our collective voice to promote evidence-based approaches to illicit drug policy that start by recognizing that addiction is a medical condition, not a crime,” they stated, warning that the criminalisation of illicit drug users fuels HIV.
Yesterday three former Latin American presidents from Brazil, Mexico and Columbia yesterday signed the declaration, along with Brazilian writer Paulo Coelho, Peruvian writer Mario Vargas Llosa and Nicaraguan writer Sergio Ramírez.
“The war on drugs has failed,” said former Brazilian president Fernando Henrique Cardoso.
“In Latin America, the only outcome of prohibition is to shift areas of cultivation and drug cartels from one country to another, with no reduction in the violence and corruption generated by the drug trade.”
AIDS 2010 Chair Dr. Julio Montaner, president of the International AIDS Society (IAS), said: “I hope that the Vienna Declaration will inspire many more political leaders to cast aside the drug war rhetoric and embrace evidence-based policies that can meaningfully improve community health and safety.”
The International AIDS Society, the International Centre for Science in Drug Policy, and the BC Centre for Excellence in HIV/AIDS initiated the declaration.
HIV activists need better protection the International AIDS Society declared today, calling for the release of Maxim Popov, who has been imprisoned for seven years in Uzbekistan for his HIV prevention work.
This week 9 activists were detained in Tanzania, after handing over a memorandum calling on political leaders to fund universal prevention and treatment for HIV/AIDS, and then deported.
Popov is in prison for promoting effective, evidence-based ways to prevent HIV, the IAS stated.
“Popov, 28, is the author of ‘HIV and AIDS Today,’ a brochure that discusses the use of condoms in HIV prevention, the need for sterile needles for injecting drug users, and education on HIV prevention within same-sex relations,” said IAS executive director Robin Gorna.
“In his training workshops with school teachers, Popov, used a text-book ‘Healthy Lifestyles, The Guidance for Teachers, published in Kyrgyzstan and Kazakhstan with support of USAID and UNDP, which advises using condoms to protect oneself from HIV.
“The Uzbek government said that the book constituted an ‘assault on minors without violence’ and ordered the book incinerated and barred from circulation. Izis, the AIDS NGO founded by Popov, with support from a wide array of donors including USAID and DfID, has shut down since his jailing.
“Imprisoning Maxim Popov is not only a violation of human rights, but it has hurt public health efforts in Uzbekistan,” said Gorna. “In most countries around the world the work done by Maxim Popov would be drawing praise and support.”
Uzbekistan has one of the world’s fastest-rising HIV infection rates, the UNAIDS reports.
About 16,000 cases of HIV were reported in 2009 – more than an eleven-fold increase from 1,400 cases in 2001.
IAS president Julio Montaner said: “I urge all influential political and public health leaders to join IAS in calling for Maxim Popov’s release from prison.”
Homosexuality is a crime in Uzbekistan and the Popov verdict obtained by Eurasia.net, shows he was also convicted of distributing copies of a UNAIDS publication, “HIV and Men who have Sex with Men in Asia and the Pacific”, according to a report on the International Lesbian, Gay, Bisexual, Trans and Intersex Association website.
“Studies in several nations show that treating people before they fall ill can curb the spread of disease,” writes Erika Check Hayden, in an article in the journal Nature this week.
Research in Africa, the US and Canada seems to provide more evidence in favour of “treatment as prevention”, Hayden reports.
* The African research involving seven countries and data from 3 408 discordant couples (Deborah Donnell) showed that “HIV-positive individuals who were receiving treatment almost never passed the virus on to their partner, whereas many untreated individuals did”.
* The American study found that “as ‘community viral load’ — the amount of virus in the blood of all HIV-infected individuals tested in San Francisco (Moupali Das) — declined from 2005 to 2008 because of drug treatment and increased awareness, the number of new infections in the city also dropped”.
* The Canadian study involving intravenous drug users had similar results, with new HIV infections dropping by around 50% when treatment was expanded to intravenous drug users with HIV throughout British Columbia(Julio Montaner).
But the results – presented at the annual Conference on Retroviruses and Opportunistic Infections in San Francisco, California – do not prove that antiretroviral treatment itself reduces the spread of HIV as there were many confounding factors.
Dr Anthony Fauci, director of the US National Institute of Allergy and Infectious Diseases, said in the article: “Rather than saying it’s an all-or-nothing phenomenon — that we’re going to eliminate the epidemic without anything else but test and treat — what I argue for is, why don’t we let test and treat be part of a more aggressive prevention armamentarium.”