Mathers Bradley M, Degenhardt Louisa, Adam Philippe, Toskin Igor, Nashkhoev Magomed, Lyerla Rob, Rugg Deborah
National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.
J Acquir Immune Defic Syndr. 2009 Dec;52 Suppl 2:S132-42. doi: 10.1097/QAI.0b013e3181baf0c5.
The 2001 Declaration of Commitment from the United Nations General Assembly Special Session on HIV/AIDS (UNGASS) set the prevention of HIV infection among injecting drug users (IDUs) as an important priority in the global fight against HIV/AIDS. This article examines data gathered to monitor the fulfillment of this commitment in low-income and middle-income countries (LMICs) where resources to develop an effective response to HIV are limited and where injecting drug use is reported to occur in 99 (of 147) countries, home to 75% of the estimated 15.9 million global IDU population.
Data relating to injecting drug use submitted by LMICs to the Joint United Nations Programme on HIV/AIDS (UNAIDS) in the 2008 reporting round for monitoring the Declaration of Commitment on HIV/AIDS were reviewed. The quality of the data reported was assessed and country data were aggregated and compared to determine progress in HIV prevention efforts. For each indicator, the mean value weighted for the size of each country's IDU population was determined; regional estimates were also made.
Reporting was inconsistent between countries. Forty percent of LMIC (40/99), where injecting occurs, reported data for 1 or more of the 5 indicators pertinent to HIV prevention among IDUs. Many of the data reported were excluded from this analysis because the indicators used by countries were not consistent with those defined by UNAIDS Monitoring and Evaluation Reference Group and could not be compared. Data from 32 of 99 countries met our inclusion criteria. These 32 countries account for approximately two-thirds (68%) of the total estimated IDU population in all LMICs.The IDU population weighted means are as follows: 36% of IDUs tested for HIV in the last year; 26% of IDUs reached with HIV prevention programs in the last year; 45% of IDUs with correct HIV prevention knowledge; 37% of IDUs used a condom at last sexual intercourse; and 63% of IDUs used a clean syringe at last injection. Marked variance was observed in the data reported between different regions.
Data from the 2008 United Nations General Assembly Special Session reporting round provide a baseline against which future progress might be measured. The data indicate a wide variation in HIV service coverage for IDUs and a wide divergence in HIV knowledge and risk behaviors among IDUs in different countries. Countries should be encouraged and assisted in monitoring and reporting on HIV prevention for IDUs.
2001年联合国大会关于艾滋病毒/艾滋病问题特别会议（UNGASS）的《承诺宣言》将预防注射吸毒者（IDU）感染艾滋病毒列为全球抗击艾滋病毒/艾滋病的一项重要优先事项。本文研究了为监测低收入和中等收入国家（LMIC）履行这一承诺而收集的数据，在这些国家，用于制定有效应对艾滋病毒措施的资源有限，且据报告在147个国家中的99个国家存在注射吸毒现象，这99个国家的人口占全球估计1590万注射吸毒者总数的75%。
对低收入和中等收入国家在2008年报告周期内向联合国艾滋病毒/艾滋病联合规划署（UNAIDS）提交的与注射吸毒相关的数据进行审查，以监测《艾滋病毒/艾滋病承诺宣言》。评估所报告数据的质量，汇总并比较各国数据，以确定艾滋病毒预防工作的进展情况。对于每个指标，确定按各国注射吸毒者人口规模加权的平均值；还进行了区域估计。
各国报告情况不一致。在存在注射吸毒现象的99个低收入和中等收入国家中，40%（40/99）报告了与注射吸毒者艾滋病毒预防相关的5项指标中的1项或多项数据。许多报告的数据被排除在本分析之外，因为各国使用的指标与UNAIDS监测和评价参考小组定义的指标不一致，无法进行比较。99个国家中的32个国家的数据符合我们的纳入标准。这32个国家约占所有低收入和中等收入国家注射吸毒者估计总数的三分之二（68%）。注射吸毒者人口加权平均值如下：去年接受艾滋病毒检测的注射吸毒者占36%；去年接触到艾滋病毒预防项目的注射吸毒者占26%；具备正确艾滋病毒预防知识的注射吸毒者占45%；上次性交时使用避孕套的注射吸毒者占37%；上次注射时使用清洁注射器的注射吸毒者占63%。不同区域报告的数据存在明显差异。
2008年联合国大会特别会议报告周期的数据提供了一个可据此衡量未来进展的基线。数据表明，注射吸毒者获得艾滋病毒服务的覆盖范围差异很大，不同国家的注射吸毒者在艾滋病毒知识和风险行为方面也存在很大差异。应鼓励并协助各国监测和报告针对注射吸毒者的艾滋病毒预防情况。
