NCJ Number
171387
Journal
Substance Use & Misuse Volume: 33 Issue: 5 Dated: special issue (1998) Pages: 1075-1091
Date Published
1998
Length
17 pages
Annotation
Needle exchange programs have been implemented among intravenous drug users (IDUs) in nine Hilltribe communities of Northern Thailand in response to a rapid increase in HIV seroprevalence rates.
Abstract
The Hilltribe villagers of Mae Chan District, Chiang Rai Province, live on the lower trip of the Golden Triangle. They have a long history of using opium for social, ritual, and medicinal purposes. The decreased availability of opium has led to the increased availability of heroin, and injecting has become a more favored route of administration than smoking. Drug use in the villages is very high, with more than one user per household in some villages. Needle exchange programs were first established in November 1992 in three villages and involved 46 male IDUs; the programs were extended to six more villages in 1995. Needle exchange programs operate on a two-tiered level, direct exchanges and on a request basis. IDUs receive monthly health checks free of charge, and special attention is given to IDUs who are also HIV-seropositive. Needle exchange programs have been effective in limiting AIDS transmission in the nine communities. Major program constraints have been routine attendance, needle gauge, and high mobility of IDUs. Needle exchange programs are run by indigenous staff with the cooperation of the community and are a good example of the feasibility of establishing community-based harm reduction programs. The epidemiology of HIV among IDUs in Thailand and other parts of Asia is discussed, and drug policies that incorporate harm reduction strategies are recommended. 30 references and 2 tables