1. The HIV Epidemic among People who Inject Drugs
Thomas Kerr
Director, Urban Health Research Initiative,
BC Centre for Excellence in HIV/AIDS
St. Paul’s Hospital, Providence Health Care
Associate Professor, Division of AIDS
Department of Medicine, University of British Columbia 1

2. People who Inject Drugs: The Global Situation
million PWID in 151 countries
0.8 – 6.6 million PWID living with HIV/AIDS
Growing epidemics in former Soviet Union/Eastern Europe & Southeast Asia driven primarily by PWID and transmission to their partners
Mathers et al., Lancet 2008; Mathers et al., Lancet 2010; UNAIDS, 2012

3. Injection Drug Use & HIV/AIDS
49 countries with HIV prevalence among PWID
22-50% greater than the in general population (UNAIDS, 2012)
Mathers et al., The Lancet, 2008

5. Access to Evidence-based HIV Prevention & Treatment
57 countries reporting: 37% of PWID receiving an HIV test annually
NEP in 82 countries: 5% of injections covered by sterile syringes
OST in 71 countries: 8 per 100 PWID covered with OST
Mathers et al., Lancet, 2010
Degenhardt et al., 2010; UNAIDS, 2012

7. Access to Evidence-based HIV Prevention & Treatment
57 countries reporting: 37% of PWID receiving an HIV test annually
NEP in 82 countries: 5% of injections covered by sterile syringes
OST in 71 countries: 8 per 100 PWID covered with OST
47 countries reporting ART for PWID: 4 per 100 PWID receiving ART
Mathers et al., Lancet, 2010
Degenhardt et al., 2010; UNAIDS, 2012

9. AIDS & Behavior, in press

10. The Lancet, 2010

11. Journal of Infectious Diseases, 2011

13. Global heroin supply increased by 380% from 1980-2010
Price of heroin in Europe decreased by 79%

14. Conclusions PWID suffer from high rates of preventable HIV infection
Evidence-based interventions exist but access remains low
Enforcement and incarceration have failed to reduce the use and supply of drugs and have contributed to the spread of HIV infection and treatment failure
The barriers to scale-up of prevention and treatment programs are social and structural in nature