Harm Reduction Policies and Interventions for Injection Drug Users in Thailand

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作者：

Tyndall, Mark

来源地址：

http://hdl.handle.net/10986/26868

关键词：

ABSTINENCE;  ACCESS TO TREATMENT;  ADDICTION;  ADDICTION SERVICES;  ADDICTIONS TREATMENT;  ADOLESCENTS;  ADVERSE HEALTH;  AIDS TREATMENT;  ALCOHOL USE;  AMPHETAMINES;  ANAL SEX;  ANTIBIOTICS;  ANTIBODY;  AWARENESS CAMPAIGNS;  BACTERIAL INFECTIONS;  BLOOD SAMPLES;  CAPACITY BUILDING;  CARE PROVIDERS;  CARE SERVICES;  CENTRAL NERVOUS SYSTEM;  CITIZENS;  CLEAN NEEDLES;  CLINICAL OUTCOMES;  CLINICS;  COHORT STUDIES;  COMA;  COMMERCIAL SEX;  COMMERCIAL SEX WORK;  COMMUNITY HEALTH;  COMMUNITY INTERVENTIONS;  COMPLICATIONS;  COMPREHENSIVE CARE;  CONDOM;  CONDOM DISTRIBUTION;  CONDOM USE;  CONSENSUAL SEX;  DANGERS;  DEPRESSION;  DETOXIFICATION;  DIAGNOSES;  DIAGNOSIS;  DIAGNOSTICS;  DIET;  DIRTY NEEDLES;  DISEASE;  DROPOUT;  DRUG;  DRUG COMBINATIONS;  DRUG DEPENDENCY;  DRUG INJECTING;  DRUG INJECTORS;  DRUG INTERACTIONS;  DRUG MISUSE;  DRUG SUPPLY;  DRUG TOXICITY;  DRUG TRAFFICKING;  DRUG TREATMENT;  DRUG USE;  DRUG USER;  DRUG USERS NEED;  DRUGS USERS;  DURATION OF TREATMENT;  ECSTASY;  EMERGENCY RESPONSE;  ENDOCARDITIS;  EPIDEMIC;  EPIDEMIOLOGIC DATA;  EPIDEMIOLOGY;  EQUAL ACCESS;  FAMILIES;  FEMALE SEX WORKERS;  GENITAL ULCERS;  GOVERNMENT PROGRAMS;  GRASS-ROOTS;  HARM REDUCTION;  HARM REDUCTION INTERVENTIONS;  HEALTH AUTHORITIES;  HEALTH CARE;  HEALTH CARE PROFESSIONALS;  HEALTH CARE PROVIDERS;  HEALTH CENTERS;  HEALTH CONSEQUENCES;  HEALTH FACILITIES;  HEALTH INTERVENTIONS;  HEALTH OUTCOMES;  HEPATITIS;  HEPATITIS C;  HEROIN USE;  HERPES;  HIGH-RISK;  HIV;  HIV EDUCATION;  HIV INFECTION;  HIV POSITIVE;  HIV PREVENTION;  HIV PREVENTION INTERVENTIONS;  HIV TESTING;  HIV TRANSMISSION;  HIV/AIDS;  HOSPITAL;  HUMAN RIGHTS;  ILLEGAL DRUGS;  ILLICIT DRUG USE;  ILLICIT DRUGS;  IMMUNOSUPPRESSION;  INFECTION RATES;  INFORMATION CAMPAIGNS;  INFORMED CONSENT;  INJECTING DRUG USE;  INJECTING DRUG USERS;  INJECTION DRUG;  INJECTION DRUG USE;  INJECTION DRUG USERS;  INJECTION EQUIPMENT;  INTERVENTION;  ISOLATION;  LEVELS OF KNOWLEDGE;  LIVER;  LIVING CONDITIONS;  LONG-TERM CARE;  MEDICAL CARE;  MEDICAL FACILITIES;  MEDICAL PROFESSIONALS;  MEDICAL SERVICES;  MEDICAL STAFF;  MEDICATION;  MEDICINE;  MENTAL;  MENTAL ILLNESS;  METABOLISM;  METHADONE;  METHADONE PROGRAM;  MORBIDITY;  MORBIDITY AND MORTALITY;  MORTALITY;  MOVEMENT DISORDERS;  NATIONAL AIDS;  NATIONAL CAPACITY;  NATIONAL HEALTH;  NEEDLE SHARING;  NEEDLE STICK;  NEEDLE USE;  NEEDLES;  NEGATIVE EFFECTS;  NUMBER OF PEOPLE;  NURSE;  NURSING;  OPPORTUNISTIC INFECTION;  OSTEOMYELITIS;  OUTREACH WORKERS;  OZONE;  PARANOIA;  PATHOGENS;  PATIENT;  PATIENT EDUCATION;  PHARMACEUTICALS;  PHARMACY;  PHYSICAL ABUSE;  PILL;  PILOT PROJECTS;  PLASMA VIRAL LOAD;  POLICY MAKERS;  PREVALENCE;  PREVALENCE RATES;  PREVENTION EFFORTS;  PREVENTION STRATEGIES;  PRISONS;  PRIVATE CLINICS;  PROGRESS;  PSYCHOACTIVE DRUGS;  PSYCHOACTIVE SUBSTANCES;  PUBLIC HEALTH;  PUBLIC HEALTH OFFICIALS;  REHABILITATION;  RISK GROUPS;  RISK OF EXPOSURE;  RISK OF TRANSMISSION;  RISK TAKING;  SANITATION;  SCREENING;  SERVICES FOR PEOPLE;  SEX TRADE;  SEX WORKERS;  SEXUAL ENCOUNTERS;  SEXUAL EXPOSURE;  SEXUAL PARTNERS;  SEXUAL PARTNERSHIPS;  SEXUAL PRACTICES;  SEXUAL RISK;  SEXUAL TRANSMISSION;  SEXUALLY TRANSMITTED INFECTIONS;  SKIN INFECTIONS;  SOCIAL FACTORS;  SOCIAL RESEARCH;  SOCIAL SERVICES;  STAPHYLOCOCCUS;  STERILE EQUIPMENT;  STERILE SYRINGES;  STIMULANTS;  STIS;  SUBSTANCE ABUSE;  SUBSTITUTION THERAPY;  SYMPTOMS;  SYPHILIS;  TB;  TB CONTROL;  TECHNICAL ASSISTANCE;  THERAPEUTICS;  THERAPIES;  THERAPY;  TOLERANCE;  TREATMENT SERVICES;  TUBERCULOSIS;  UNAIDS;  UNSAFE SEX;  USE OF ALCOHOL;  USE OF DRUGS;  USE OF HEROIN;  VACCINE;  VICTIMS;  VIRAL LOADS;  VIRUS;  VIRUSES;  VOCATIONAL TRAINING;  VOLUNTARY COUNSELING;  VULNERABLE POPULATIONS;  WAR;  WORLD HEALTH ORGANIZATION;  YOUNG PEOPLE;  YOUTH;  Report; 

年份：

2011

出版地：

Washington,USA

语种：

English

摘要：

The World Bank initiated a review of HIV prevention among injection drug users in Thailand, with the objective of providing technical assistance to strengthen national capacity to develop state-of-the-art injecting drug use harm reduction interventions. Thailand has received international recognition for its successful interventions to reduce the transmission of HIV among female sex workers and military recruits. It is looked upon as a role model for HIV education and awareness campaigns that include the extensive promotion and wide acceptance of condoms as an HIV prevention strategy. Thailand has the most progressive and comprehensive antiretroviral program in the region with a reported coverage of over 80 percent of eligible individuals. In 2001, it embarked on a progressive universal health care program that provides free access to a wide array of health care diagnostics and therapeutics for the people of Thailand. With these impressive achievements, it is remarkable how poorly Thailand has responded to the HIV epidemic among injection drug users (IDUs). From available data, it appears that the HIV prevalence rates among IDUs have remained high and stagnant over the last decade. Failure to provide effective interventions to reduce HIV transmission among drug users has resulted in unnecessary suffering, and for many, HIV-related death. Continued inaction threatens to undermine successful HIV prevention efforts in the country through ongoing HIV transmission among injection drug users and their sexual partners. The current focus on enforcement and punishment, along with the reliance on compulsory drug treatment centers, has done little to control drug use in Thailand. The unintended consequence of this approach has been to push drug users into precarious and dangerous environments that have directly led to risky drug using patterns and persistently high rates of HIV transmission. Adopting a harm reduction approach to deal with injection drug use could have a major impact on reducing HIV transmission as well as engaging drug users into better health care and effective drug treatment. This will require strong leadership in key government Ministries and related agencies so that the central stakeholders can roll out harm reduction programs. Thailand has the potential to greatly reduce the transmission of HIV among injection drug users and become a regional leader in harm reduction.