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Abstract
Addressing HIV/AIDS among IDUs: lessons learned from Thailand
L. Khondkar
Freelance consultant, Dhaka, Bangladesh
Issues: In sharp contrast to other groups at risk of HIV such as sex workers and military recruits, HIV prevalence among injecting drug users (IDUs) in Thailand never dropped. Thailand has failed to implement scientifically proven policies and international guidelines to prevent HIV/AIDS among them. State imposed barriers to harm reduction programs for IDUs violate their human right to health.
Description: Using the link between health and human rights as theoretical framework this study examines Thai response to HIV/AIDS among IDUs. Literature review, visits to intervention sites, in-depth interviews with key stakeholders from academia, government, NGOs, international organizations, and activist groups were conducted in different parts of Thailand during September 2004-May 2005.
Lessons learned: Thailand’s drug policies emphasize criminalization over humane treatment and harm reduction. There are no conceptual and operational linkages between drug control and HIV prevention and intervention policy. War on drugs drove numerous IDUs into hiding and away from the few services existed to help protect them from HIV. Findings of the study suggest that major challenges faced by IDUs include criminal justice approach taken by government, limited prevention coverage, ineffective treatment interventions, discriminatory practices in society and health care facilities, lack of opportunities to take part in decision making process etc.
Recommendations: Better inter-sectoral collaboration needs to be promoted between the drug control and HIV/AIDS agencies. It is crucial to change laws and policies that prevent IDUs from accessing services. Stigma and discrimination that drive them underground and undermine prevention efforts must be eliminated. Government should ensure their meaningful participation in developing national AIDS plans and implementing HIV prevention and treatment programs. Public health rationale based on scientific evidence must prevail against moralistic arguments and judgmental attitudes. Instead of victimization, criminalization, and marginalization protecting human rights of IDUs should be central while addressing HIV/AIDS among them.
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