HIV on the rise in Africa's youth and IDUs

Thursday, February 19, 2015

Two HIV-related stories were in the headlines yesterday, both out of Africa. The big one is the finding, released by UNAIDS, that AIDS is now the leading cause of death for adolescents in Africa, and the second leading cause of death among adolescents globally (behind injury and traffic fatalities):
About 120,000 people aged between 10-19 years died of AIDS-related illnesses in 2013, the eight international organizations said while launching a global campaign in Kenya to stem the spread among adolescents.

Adolescent girls, particularly in sub-Saharan Africa, are most affected, said the organizations which included UNAIDs, U.N. children's fund, World Health Organization and the U.S. President's Emergency Plan for AIDS Relief or PEPFAR, among others.

In South Africa in 2013, more than 860 girls became infected with HIV every week, compared to 170 boys, they said.

Girls are more vulnerable because of physiological factors that see them more susceptible to infection, said Dr. Lilian Otiso, director of services at LVCT Health, an NGO that deals with AIDs prevention and treatment across Kenya.

Social-economic factors that see girls having sex at younger ages than their male peers also play a major role, she said. They might date older men who can provide for them, she said. Others, such as the 16-year-old, are forced to fend for themselves at young ages and become victims of sexual exploitation, abuse and rape, Dr. Otiso said.
Most of the 2.1 million adolescents living with HIV in 2013 became infected at least 10 years ago, the organizations said. Their mothers were pregnant and delivered at a time when anti-retroviral medicines that can greatly reduce the possibility of HIV transmission were not available, the organizations said.

Adolescents often don't come forward for testing and drop out of treatment regimes because their emotional needs aren't targeted, said Dr. Otiso.
Meanwhile, HIV infections are on the rise among injecting drug users, a trend more typically seen in Eastern Europe and MENA in the past:
Rick Lines, head of Harm Reduction International, said unsafe injecting drug use is a major driver of HIV/AIDS worldwide.

“Traditionally, we’ve seen regions such as Eurasia and Asia and the Middle East and North Africa sort of be epicenters of a lot of injecting drug use and a lot of unsafe injecting drug use. And so we see very high rates of HIV amongst people who inject drugs in those countries. But in recent years, researchers and community health organizations in a number of sub-Saharan Africa countries have also begun to document an increase.”

He said there are “new and emerging patterns of injecting drug” use in such places as Tanzania, Zanzibar Uganda, Senegal and Kenya.
Lines said the increase in injecting drug use in sub-Saharan Africa is connected to a change in drug trafficking routes. The drugs pass through the continent on their way to Western Europe.

The Global State of Harm Reduction 2014 report calls for an increase in programs to help drugs users. One such program is called OST or opioid substitution therapy.
Another way to help stop the spread of HIV among injecting drug users is the needle or syringe exchange program or NSP. Lines said, it too, has been in use for decades.
[Lines] said needle exchange programs are widely credited with reducing HIV infection rates in Western Europe and Australia in the late 1980s. The Global State of Harm Reduction report says Malaysia, Iran and Australia have seen the “steepest increase” in needle and syringe exchange programs.

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