Avoiding Hepatitis C / HIV – Tips from your peers

An article based on a research paper

by Sam Friedman et al.

Looking at How Some IV Users Manage to

Become ‘Double Negatives’.

In some climates where disturbingly high rates of infection exist, what key things are people doing in their daily using lives that conspire to keep them free from infection when so many of our  peers become positive. Sam Friedman et al looked into this subject and found some consistent factors

A brief BP comment before we introduce Sams article; We are always focusing on just HOW we end up getting blood borne viruses, and many of us have ended up getting, if not HIV then much more commonly, Hepatitis C (or B) -in some countries or prisons Hep C rates can be as high as 70-90% of all injectors. Yet we all know people who have managed to inject drugs for decades yet have avoided becoming infected with anything. Sam Friedman et al has turned the usual research approach  on its head here and put our own drug using culture under the microscope – searching for the little gems -those habits or behaviours that WE have utilised to keep us safe from such  infections, regardless of how long one has been injecting.

This is not about focusing on what ‘they did right and you did wrong’. No, this is about pulling

Negative (Negative album)

Sam Friedman’s research into the ‘Double Negatives’

together the cultural threads and day to day choices one can make that helps to create the environment you need to protect your health. It is interesting to see how adopting a few strategies around your using lifestyle, can work to protect you from what can be extremely common infections. Of course in a world of prohibition, opportunities to choose a safer path can change dramatically overnight, such as a stay in prison. Sometimes, with all the knowledge and support in the world, you can just be damn unlucky, or have no control over transmission events.

However, it is worth looking at Friedmans research to see, against just such a prohibitionist backdrop,  with perils around almost every corner, how our negative peers manage to stay negative -leaving us with the thought; “Can I incorporate some of these tactics/strategies/principles/street codes into my using life? Well yes you can -and all of these ‘tips’ are just as relevant for a positive person as well – after all, who wants to get re-infected? So, enough of the prologue, take it away Sam! PS -BP has added the odd hopefully useful comment in italics.

Staying Safe: How you and others might

avoid becoming infected with hepatitis C or

HIV?

Most people who inject drugs get infected with hepatitis C within a few years (often their first few years of IV using). Some also get infected with HIV. This happens in spite of all the syringe exchange, pharmacy syringe distribution programs, drug treatment, and other harm reduction efforts they engage in—and all the ways they help each other to have safer and happier lives.

“Some people who inject drugs do NOT seem to

get infected with either virus.

What are their resources or strategies?

How might you, your friends or your children

learn from how they did it?”

To read the full article and pick up a few tips, click here.

Andrey Rylkov Foundation’s website shut down in Russia

Here is an article from our friends at Harm Reduction International, writing about a truly appalling situation (another one) to emerge from Russia -affecting our dear friends and peer activists at Andrey Rylkov Foundation.  This courageous HIV/AIDS, drug and human rights organisation has consistently raised their head above the parapet (in a country where it can be literally be beaten off), and given people much needed health and harm reduction information in a climate of fear and intimidation.  One can only imagine what that must be like, to work every day knowing that you could be arrested, imprisoned, fitted up on a trumped up charge (which has happened repeatedly to other HIV and human rights activists) while thousands upon thousands of people are desperate for the sterile syringes that you give out, and the HIV information you impart. Last World AIDS day, December 1st 2011, ARF were instrumental in supporting us at BP (and INPUD) to coordinate the global Russian embassy protest, an attempt to shame Russian officials about their inaction and lack of response to the HIV catastrophe unfolding in their country. We are deeply concerned at this latest attempt by the Russian government to silence anyone or any organisations that discuss methadone in what is an ” ongoing assault on HIV prevention” taking things to the “next level by moving to silence public health advocates whose only infraction has been to spread life-saving information online and to criticize the government for its own failures.” We will keep you posted of developments. Catch ARF on facebook, and join to keep up to date with what is looking to be a highly charged time in Russian life and politics.

 

 

 

Authors:  

Vladimir Putin wrote a recent column praising the potential for “internet-based democracy”. But the Russian government adopts rules allowing for websites to be shut down on a

Vladimir Putin

Vladimir Putin's iron grip on power continues to circumvent free speech in Russia, as yet again, HIV & drug organisations like ARF are targeted.

whim, and has used those rules to close down HIV prevention sites.

He talked about free medical care being one of the priorities of Russian citizens. But that care denied to millions of Russian people.

While Prime Minister Putin spoke glowingly of digital democracy, his anti-drugs agency is censoring websites for writing about WHO essential medicine.

“[It’s over] methadone, plain and simple” said Anya Sarang, President of the Andrey Rylkov Foundation, which had its website shut down over the weekend.

The government’s anti-drugs agency, FSKN Moscow Department demanded that the Andrey Rylkov Foundation’s service provider block their website, utilizing new rules adopted last year. The notification states it was due to “placement of materials which propagandize (advertise) the use of drugs, information about distribution, purchasing of drugs and inciting the use of drugs”

What the Foundation was doing was spreading the word about basic HIV prevention measures and commenting on the Russian government’s policies.

Amidst pro-democracy protests, the Russian authorities have taken what is an ongoing assault on HIV prevention to the next level by moving to silence public health advocates whose only infraction has been to spread life-saving information online and to criticize the government for its own failures.

Russia is home to one of the biggest populations of injecting drug users, and one of the fastest growing HIV epidemics in the world. It is estimated that there are just under two million injecting drug users in Russia. In some regions, more than 80 percent of people living with HIV in the country contracted the virus through injecting with contaminated equipment.

According to the World Health Organization, methadone is an essential medicine, for treating heroin dependence and for preventing HIV transmission by reducing the practice of injecting. Multiple scientific studies back this up.

But the Russian government’s ‘zero tolerance’ approach to illicit drugs is well known and has resulted in the outright denial of methadone (or ‘opioid substitution therapy’). It is illegal in Russia.

The net result of these policies is a massive increase in the number of people living with HIV in the country over the last decade.

According to UNAIDS, “In Eastern Europe and Central Asia, there was a 250% increase in the number of people living with HIV from 2001 to 2010. The Russian Federation and Ukraine account for almost 90% of the Eastern Europe and Central Asia region’s epidemic. Injecting drug use remains the leading cause of HIV infection in this region”.

“People all over the world take this medication for granted” says Sarang, “but here in Russia it’s central to our struggle against HIV and it’s banned. Now, even our speaking about it seems to be banned.”

This is not the first time Russia has attempted to censor civil society voices for public health. At the UN General Assembly talk on HIV last March the Russian delegation tried to stop a Ukrainian drug user from speaking about HIV prevention. Fortunately, others were not happy with such censorship and the effort failed.

“The right to information is essential to realizing the right to health,” said Agnes Callamard, Executive Director of ARTICLE 19, in a statement. “A government agency such as Federal Drug Control Service should not have the ability to ban websites at the whim of a bureaucrat. This is particularly so when considering the impact of censoring discussions relating to drug addiction or HIV/AIDS.”

For years, human rights advocates like the Andrey Rylkov Foundation have argued that Russia’s colossal failure to provide vital services is a breach of its obligation under international law to respect, protect and fulfill the right to health. The government’s latest crackdown against public health activists has turned the matter into an issue of freedom of expression.

Mr. Putin says that democracy needs “efficient channels for dialogue… communication and feedback,” while the government’s actions silence people fighting to raise issues the government is refusing to face. This silences the spread of information. It silences the democratic process.

Source of publication: http://www.huffingtonpost.com

Category Categories: Drug policy in Russia, Russia and OST | Tag Tags: , , , , , | Comments No Comments »

Dec 1st Russian Embassy Protest -Be there!

The Red ribbon is a symbol for solidarity with...

WORLD AIDS DAY

On Dec 1st, 2011, World Aids day, people in 8 countries around the world will descend on Russian Embassies -To protest at the criminal treatment of people who use drugs – in the biggest catastrophe in the history of HIV in recent times. (See below for where and when).

In Russia today, we are bearing witness to one of the biggest, avoidable catastrophes in the history of HIV – the lack of response to the epidemic in Russia. We must point directly to the specific responsibility that Russian medical and public health officials bear for creating and sustaining this disastrous situation. Of particular concern are Russia’s, brutalising drug policies and its recently revised Total War on Drugs, which has resulted in further pushing people who use drugs into hiding, prison, and enforced detention, and severely compromising efforts from the international community to revert the trajectory of HIV/AIDS. The world is approaching a crossroads; a strong and decisive downward trajectory in the epidemic is possible in all countries -but it will only happen if the people who are most vulnerable to infection are supported and their human rights realised. Governments have legal obligations to act. Indeed, the implementation of harm reduction measures is consistant with and required by states obligations under international human rights law. 1,2.

Injecting drugs with contaminated equipment is driving Russia’s HIV epidemic, now the fastest growing in the world and it is reflected in the numbers; as many as 80% of new infections are occurring amongst people who inject drugs (PWID), in a total HIV positive population of approx 1million. With this in mind, recent projections forecast an additional 5 million people could become infected with HIV in the near future, unless Russia transforms the way it is dealing with its HIV pandemic.6

Russian authorities have repeatedly come in for fierce international criticism over their policy towards the treatment of drug dependence, which relies almost completely on the promotion of abstinence to the exclusion of harm reduction.  Russian officials claim, incorrectly, that the effectiveness of opiate substitution therapy (such as providing methadone and buprenorphine) has not been adequately demonstrated, and as such it is prohibited by law. Yet, despite the addition in 2005 of these two drugs to WHO’s list of essential medicines, and multiple position papers by international experts calling for substitution treatment as a critical element in the response to HIV (IOM, 2006; UNODC, UNAIDS, and WHO, 2005), methadone or buprenorphine remain prohibited by law in Russia and promotion of its use – punishable by a jail sentence.
Compare this legitimate injection kit obtained...

Sterile needles and syringes are proven ways to prevent the spread of HIV

With over 30,000 people dying from drug overdoses every year, numbers that can be shown to markedly reduce with the implementation of OST, and 150 becoming infected with HIV each day (2/3rds of which are injecting drug users), also evidenced to drastically reduce with the roll out of Needle and Syringe Programmes (NSP), it is upon everyone who cares about humanity, to demand an immediate transformational shift in Russia’s approach to HIV prevention and its treatment of drug users.  Access to NSP and OST is in itself, a human right;  UN Ruman Rights Monitors have specifically stated harm reduction interventions as necessary for states to comply with the right to health. 5)

Consistent evidence from around the world shows that treatment for opiate dependence works most effectively when the exclusive goal of abstinence is widened to foster multiple outcomes – including reduction in use of illicit opiates, exposures to blood-borne infections such as HIV and hepatitis, reduction in drug overdoses, better management of existing health problems etc. Evidence has repeatedly shown the clear benefits to the individual and society as a whole when drug dependence is viewed as a public health issue, as opposed to a criminal one. Evidence also shows OST, combined with a range of harm reduction measures such NSP, leads to a drastic reduction in the spread of new HIV infections in countries across the globe; none of this more clearly demonstrated today, than in Netherlands, a world leader in harm reduction where in 2010, only ONE injecting drug user contracted HIV. In the UK, another country that has harm reduction at the centre of its HIV prevention strategy, prevalence of HIV amongst drug injectors is at 1.5%, this against a Russian HIV prevalence backdrop of 30-35%. The evidence on harm reduction has been in for years. Why does Russia continue to turn its back?
The Russian government‘s estimated annual expenditure related to drug law enforcement) equal approx 100 million US  dollars. 7. This amount does not include the money spent on detention and imprisonment. In stark comparison, only 20 million US dollars was allocated to HIV and hepatitis B and C  prevention combined, among all population groups in 2011. By 2013, amounts spent will be three times less. Considering the context and tendencies in the development of the HIV epidemic in Russia, clearly such policies are not leading to any positive results. No money at all is allocated towards HIV prevention among the injecting drug using population.6Such punitive and torturous approaches to tackling drug use are not only fuelling the HIV epidemic in the region, but also the stigma, hate and ignorance of drugs, and of people who use drugs.  The insistence by both the Russian government and medical profession to treat drug users as criminals that need imprisonment at worst, and at best – enforced detention, has meant harm-reduction programs, including needle exchange, are officially accused of propagandizing drug use and activists have been arrested, harrassed and imprisoned for promoting harm reduction measures. Demonstrators who have protested and spoken out against the Russian response to HIV/AIDS are also regularly arrested and detained, including HIV positive people calling for access to ARV’s (drugs to treat HIV) and an end to treatment interruption fuelling drug resistant strains of HIV.This World Aids Day, December 1st 2011, we will echo the urgent voices of Russian drug users who are living and dying in the grip of an HIV and TB pandemic with almost no recourse or chance to engage in or promote an effective response.  . We will gather at Russian embassies around the world to demand Russia to change it current course towards death and disease. We want to see inappropriately aggressive, state sponsored hostility to drug users replaced by enlightened, scientifically driven attitudes and more equitable societal responses” 3 We demand our own countries to apply pressure wherever and whenever they can, voicing publicly our concerns about human rights abuses in the Russian response to drug use and HIV.
Sound, evidenced based and cost effective harm reduction solutions stand at the forefront of what has been shown to effectively prevent HIV infection in the drug using community. The personal narratives of people who use drugs and their allies on the front line of human right struggles must be recognised and remain a key part of today’s growing evidence base. People who use drugs must be seen as central players in the search for solutions rather than being framed and targeted as the problem.
Nothing About Us Without Us  www.inpud.net
Dec 1st at Russian Embassies in London, Stockholm, Berlin, Bucharest, New York, Sydney/Canberra, Spain (?), and Toronto. Dec 1st
 for times and locations follow updates at http://russianembassyprotest.wordpress.com or (add your email/website)

1) UNIDCP Flexibility of Treaty positions as regards harm redcution approaches, decision 74/10 Geneva UN 2002 ,
2) UNODC World Drug Report Vienna 2009
3) Lancet July 2010 HIV in people who use Drugs
4) The right to the highest attainable standard of health; Article 12, comment 14  International Covenent on  Economic, Cultural and Social Rights 2000
5) Barrett D et al;  Harm Reduction and Human Rights, the Global response to drug related HIV Epidemics. London, HRI, 2009
6) News Release, Oct 7th 2011, Risk of HIV Hitting Catastrophic Levels; from the Canadian HIV/AIDS Legal Network; Eurasian Harm Reduction Network; Harm Reduction International;
7) Articles 228-233 of the Russian Criminal Code

Clean Needles Save Lives – Drugreporter

A concise piece from the terrific HCLU on Needle Exchange Programmes and why they are so important, interviewing New Yorks finest at the organisation run by the Harm Reduction Coalition, who have been serving the needs of NYC’s injectors for decades, preventing HIV and HCV from escalating on a massive scale, why oh why are we still having to argue the necessity of NEPs  in 2011???
Vodpod videos no longer available.

Different perspectives on the Political Declaration on HIVAIDS 2011

Estimated number of people in the world living...

Numbers of people living with HIV in 2008

New York’s user led Harm Reduction Coalition runs a weekly podcast on a range of interesting subjects and during the High Level Meeting in HIV/AIDs that occurred in New York early June, Allan interviews several people (including myself) and gains a few different perspectives on just how people felt about the declaration and their input into it. Over to you Allan (text taken from the HRC podcast website)

High Level Meeting on AIDS: A report back from New York. A new Political Declaration emerged from the recent United Nations High Level Meeting on AIDS. This week’s podcast features interviews with participants in the meeting – Erin O’Mara from the International Network of People Who Use Drugs, Pablo Cymerman of Intercambios and Rick Lines from Harm Reduction International. The final Political Declaration is available here
Click here for the Podcast – no 33 

(The Harm Reduction Coalition has an excellent website, highly recommended and with good activist roots and the organisation is a definate contact point for any person who uses drugs when looking for drug related support in New York)

A young Russian and a message you can’t forget.

The Red ribbon is a symbol for solidarity with...

Russia’s Aleksey Kurmanaevskiy speech delivered at the UN High Level Meeting on HIV and AIDS in New York – June 9 2011 by INPUD on Thursday, 09 June 2011 at 18:33:

INPUD is a global peer-based organisation that seeks to promote the health and defend the rights of people who use drugs. We will expose and challenge stigma, discrimination and the criminalisation of people who use drugs and its impact on our community’s health and rights. We will achieve this through processes of empowerment and international advocacy. Find us at: http://www.inpud.net, Facebook/INPUD, Twitter/INPUD. Blog at: http://www.inpud.wordpress.comThe following speech was delivered by Aleksey Kurmanaevskiy at A dialogue on HIV and Human Rights at: Universal Access for Key Affected Populations. This event was hosted by the United Kingdom and the Republic of South Africa together with the International HIV/AIDS Alliance and the International Federation of the Red Cross and Red Crescent Societies. This session took place at the High Level Meeting on HIV and AIDS at the United Nations in New York City.

Aleksey is from Russia and is 30 years old. He has been dependent on drugs for 15 years, and has been living with HIV for 11 years. He is a member of the International Network of People who Use Drugs (INPUD) and will speak with you today for people who inject drugs, those who are living with HIV\AIDS, and for the members of the drug using community who are no longer with us because of HIV\AIDS, Tuberculosis, Hepatitis, and drug Overdoses.

Text of Aleksey’s speech:

Q1 – Highlight key challenge or obstacle & successful action or approach:

I would like to call to attention the laws and practices that are based on the criminalization of people who use drugs and the consequences of these measures. In our opinion, the practice of imprisoning people who use drugs in order to deny them their freedom or subjecting them to coerced treatment for the personal use of drugs should be ended. Imprisonment and coerced treatment are clear breaches of human rights that undermine the public health of people who use drugs and the wider community.

The criminalisation of people who use drugs and the widespread stigma and discrimination against our community results in people hiding and living in fear and secrecy. This can cut people off from family support and drives people further into problem drug use. As such, punitive laws can dramatically reduce the effectiveness of HIV prevention strategies with my community and undermine access to and retention in services. As a result, punitive laws are costly and ineffective.

The introduction of science-based harm reduction interventions like needle and syringe programmes, opioid substitution therapy (OST), and overdose management programmes is saving the lives of my community in many countries in the world. We have the experience, the evidence and tools to end concentrated epidemics of HIV among people who inject drugs. 30 years of evidence demonstrates that OST radically improves the health and wellbeing of people who take drugs and supports our engagement in HIV and TB treatment. Significantly OST gives people who are dependent on heroin and other opiate drugs an alternative to crime and allows us to fully participate in and contribute to society. History has shown that when people who use drugs are involved in the design, development and delivery of HIV prevention interventions, the reach is greater, the quality is higher and there is better value for money.

Q2 – 1 or 2 key recommendations to HLM on practical way forward:

I am a husband and father of two sons and very much want peace and mutual understanding within my family. I learned that it is absolutely critical to listen to my loved ones. Before agreeing on a solution, we consider all of the possible alternatives. The very welfare of our family depends upon this process of open dialogue.

I have drawn this analogy deliberately. The family can be viewed as a microcosm of society. We are all members of one global family. Though we all have unique worldviews, customs, and ways of life, there is no doubt that we have to deal with the HIV epidemic together. The foundation of such mutual understanding through dialogue is the first step in this process.

Around the world people who inject drugs are giving sterile injecting equipment to their friends, are sharing education and knowledge and supporting service access. At a global and regional level drug user organisations are supporting consultation and contributing to policy development. At a country level we can provide a community watch dog function helping donors to spend money wisely and programmers to deliver services effectively.

Our challenge to all countries is meaningfully involve people who use drugs in the design, implementation and monitoring of the HIV response. If you are serious about engaging us as true partners then this has include the resourcing of our organisations and the meaningful participation of our representatives. This is key to reversing the trajectory of the HIV epidemic and bringing under control the spiraling costs of HIV. It is time to stop framing my community always as the problem and instead to recognise that we are a key part of the solution to HIV.

Your views on HIV and Drug Use

The Red ribbon is a symbol for solidarity with...

Image via Wikipedia

Some news to encourage input from you – the community of people who use drugs!

In June 2011, the world will come together to review progress and chart the future course of the global AIDS response at the 2011 UN General Assembly High Level Meeting on AIDS from 8 –10 June, in New York.

The High Level Meeting will comprise plenary meetings and up to five thematic panel discussions. An informal interactive hearing with civil society will take place two months beforehand in April 2011. The one day informal interactive hearing with civil society will be chaired by the President of the General Assembly and organized with the active participation of people living with HIV and broader civil society.The objective of the hearing is to create a space where civil society, NGOs and the private sector can interact with Member States and offer input to the comprehensive review process.

To facilitate civil society involvement in the high-level meeting and ensure an open, transparent and participatory process, the President of the General Assembly, in partnership with UNAIDS and upon nominations by Civil Society Selection Committee the Civil Society Task Force comprises representatives from civil society and the private sector (yours truly is one of them). The Task Force will, among other things, help determine the format, theme and programme of the civil society hearing, as well as help identify speakers for the civil society hearing and HLM plenary and panel discussions.

We have an INPUD representative (International Network of People who Use Drugs) on the Civil Society Task Force to bring the voice of people who use drugs to the group which will act as a mechanism to facilitate input of civil society and the private sector in the 2011 Review, including the preparatory process.

ICASO has worked hard to ensure the CSTF is representative of the various world regions and constituencies (such as women, sex workers, people who use drugs, men who have sex with men etc, ) and balanced in gender and ethnicity. (INPUD also had a member on the Selection Committee). It is important as well as challenging that INPUD has a member on these committees as it continues to forge ahead with bringing the voice of the drug using community into global HIV discourse.

For the vast majority of people who inject drugs (but also other users such as snorters of drugs) HIV/AIDS still lives large. Significant HIV transmission factor in many regions of the world, driving fast-growing epidemics that affect users, particularly in in Eastern Europe & Central Asia, Asia & the Pacific, Latin America and North Africa. We know what prevents HIV, and we have a good handle on treating it these days, yet we still continue to see obstacle after obstacle put in place by the governments of the world who refuse to see people who use drugs as worthy of essential harm reduction and HIV and drug treatment. Cost-effective interventions, including needle and syringe exchange programmes, opioid substitution therapy, and expanded access to HIV treatment and care, are supported on public health and human rights grounds; however, only around 10% of people who use drugs worldwide are being reached, and far too many are imprisoned for minor offences or detained without trial and/or are suffering from horrific human rights violations -because they use drugs and/or have HIV and use drugs. To change this situation takes commitment, advocacy, and political courage to advance the ‘action agenda’.

The coming blogs that will appear on the INPUD blog (and some links here) on this issue should be an interesting account on how the drug using community is able to assert its voice on the UN community but by having a voice on committees such as these can only be a step forward.

Stay tuned and please, if you have any views or comments on HIV and how you see it affecting people who use drugs, I urge you to comment here and I will do my best to incorporate your thoughts into the views I bring forward to the Task Force, and through them, to the United Nations.

To read this article in its entirety, please click here.

%d bloggers like this: