Work Group Reports on
Demand Reduction --
Summary of Overview,
Discussion, and
Recommendations
HIV/AIDS
Facilitators:
- Ms. M. Valerie Mills, USA
- Associate Administrator for AIDS Policy and Coordination,
Substance Abuse and Mental Health Services Administration
- Ms. Nora Gallegos Vázquez, Mexico
- Underdirector of Technical Development,
National Council on Addictions Ministry of Health
Presenters:
- Dr. Antonio Estrada, USA
- Assistant Professor,
Mexican American Studies and Research Center,
University of Arizona
- Dr. Carlos Magis, Mexico
- Director of Research,
National Council of Prevention and Control of AIDS
Ministry of Health
Overview:
Dr. Estrada began by noting that the conference participants have a unique opportunity to target HIV/AIDS prevention among several at-risk groups in the border area. These include not only injection drug users but also drug users whose drug use affects their ability to practice safe sex, including gay and bisexual males who may or may not use drugs as well as those engaged in the sex trade.
We have a unique opportunity to target HIV/AIDS prevention among several at-risk groups in the border area.
Dr. Estrada indicated that his center looked at HIV risk from a qualitative and quantitative perspective. He showed a series of slides of shared injection and drug-use paraphernalia to illustrate the ease with which infection can be transmitted. As he explained, use of any kind of bleach disinfectant is a rarity among drug injectors in the border area. For example, only one-sixth of the Mexican users interviewed had ever actually used bleach to disinfect their needles and syringes. Moreover, needles discarded where drug users congregate were also a hazard to others in the area, and contaminated paraphernalia markedly increase the risk of hepatitis and other infections. The risks of infection for non-drug-using sexual partners is also a serious public health problem, he stated.
Despite these obvious risks, Dr. Estrada pointed out that there is a critical lack of a drug-treatment infrastructure to treat intravenous drug users in the border areas; and there are only a few agencies, mostly under religious auspices, that provide HIV/AIDS intervention. He also reported seeing increasing intergenerational addiction and drug dealing in rural areas as well as increasing addiction among previously drug-free individuals from the interior of Mexico who migrate to the border area where drugs are more readily available. Dr. Estrada concluded by stating that the present is a critical time to develop comprehensive, theory-based interventions that target injection drug users, their sexual partners, and others at risk for HIV in the border areas.
Dr. Magis began by noting the 423 Mexican AIDS cases associated with injected drug use (IDU) since 1983. He identified the cities of Guadalajara, Mexico City, Tijuana, and Mexicali as the places with the most such cases in the nation. He also referred to a special study conducted at treatment centers and prisons in the northern city of Tijuana, Baja California, the purpose of which was to estimate the drug use prevalence among their populations. The results showed that 36 percent of the prison population use drugs. The drug most frequently used during the last 12 months was heroin by 96.2 percent of the population in treatment centers, and by 94.3 percent of those in prisons. The HIV prevalence was of 0.94 percent in treatment centers and 2.27 percent in prisons. Dr. Magis added that sentinel studies conducted in 18 Mexican states reported an increase in HIV prevalence among the IDU group.
Dr. Magis recommended sharing information with colleagues from the U.S. as well as exploring different settings, such as prisons, to continue with specific research targeted at the border region.
