Over 3 Million Injection Drug Users Worldwide Are HIV-Positive

Of the approximately 15.9 million injection drug users (IDUs) throughout the world, three million are likely HIV-positive, according to a new study.

Researchers at the at the University of New South Wales (UNSW, Sydney, NSW, Australia) reviewed injection drug use and the prevalence of HIV/AIDS among IDUs in 148 countries, using a systematic search of peer-reviewed database (Medline, EmBase, PubMed, and BioMed Central), internet, and gray literature databases. Data requests were also made to UN agencies and international experts. A total of 11,022 documents were reviewed, graded, and catalogued by the Reference Group to the UN on HIV and IDU.

The researchers reported that prevalence estimates of IDUs could be ascertained for 61 countries, containing 77% of the world's total population aged 15-64 years. China has the largest number of IDUs, with a midrange estimate of 2.35 million and an HIV prevalence of 12.3% among the group. The United States has the second highest caseload with about 1.85 million IDUs and an estimated HIV prevalence of 15.6% among them. The researchers also noted potentially high HIV prevalence among IDUs in Ukraine and Russia, which could be 42% and 37%, respectively. According to the study, HIV prevalence among IDUs is more than 40% in eight countries: Argentina, Brazil, Estonia, Indonesia, Kenya, Myanmar, Nepal, and Thailand. Australia and New Zealand have low HIV prevalence among IDUs despite high numbers of users, which the researchers attributed to quick introduction of needle-exchange programs in the 1980s. About 1.5% of IDUs in Australia are HIV-positive, and New Zealand has an HIV prevalence of 1.6% among IDUs. The researchers noted, however, that a lack of data from Africa, the Middle East, and Latin American could be masking a larger issue worldwide. The study was published in the September 23, 2008, issue of the Lancet.

"Injection drug use occurs in most countries and HIV infection is prevalent among many populations of injecting drug users, representing a major challenge to global health,” concluded lead author Bradley Mathers, MS.D, MB.Ch.B, of the drug and alcohol research center at UNSW. "There is a clear mandate to invest in HIV prevention activities such as needle and syringe programs and opioid substitution treatment; more research is needed to accurately measure the scale of the problem.”

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