Abstract
BackgroundWithin a ten year period South Africa has developed a substantial illicit drug market. Data on HIV risk among drug using populations clearly indicate high levels of HIV risk behaviour due to the sharing of injecting equipment and/or drug-related unprotected sex. While there is international evidence on and experience with adequate responses, limited responses addressing drug use and drug-use-related HIV and other health risks are witnessed in South Africa. This study aimed to explore the emerging problem of drug-related HIV transmission and to stimulate the development of adequate health services for the drug users, by linking international expertise and local research.MethodsA Rapid Assessment and Response (RAR) methodology was adopted for the study. For individual and focus group interviews a semi-structured questionnaire was utilised that addressed key issues. Interviews were conducted with a total of 84 key informant (KI) participants, 63 drug user KI participants (49 males, 14 females) and 21 KI service providers (8 male, 13 female).Results and DiscussionAdverse living conditions and poor education levels were cited as making access to treatment harder, especially for those living in disadvantaged areas. Heroin was found to be the substance most available and used in a problematic way within the Pretoria area. Participants were not fully aware of the concrete health risks involved in drug use, and the vague ideas held appear not to allow for concrete measures to protect themselves. Knowledge with regards to substance related HIV/AIDS transmission is not yet widespread, with some information sources disseminating incorrect or unspecific information.ConclusionsThe implementation of pragmatic harm-reduction and other evidence-based public health care policies that are designed to reduce the harmful consequences associated with substance use and HIV/AIDS should be considered. HIV testing and treatment services also need to be made available in places accessed by drug users.
Highlights
Recent data demonstrates that drug-related health problems are increasing in South Africa
The implementation of pragmatic harm-reduction and other evidence-based public health care policies that are designed to reduce the harmful consequences associated with substance use and HIV/AIDS should be considered
The rapid assessment undertaken with drug using commercial sex workers in Cape Town, Durban and Pretoria by Parry et al in 2009 recognises the need for prioritising interventions recognising the role of drug abuse in HIV transmission, the issues of access to services, stigma and power relations [3]
Summary
Recent data demonstrates that drug-related health problems (such as HIV infections) are increasing in South Africa. Existing data are far from adequate, in both quality and quantity, particularity in view of the increasing importance of injecting drug use as a mode of HIV transmission in many regions such as South Africa [8]. The study by Dos Santos et al (2010) further discerns the need be make HIV testing and treatment services available in places accessed by vulnerable people as fear of stigma and discrimination often keep injecting users away from public health facilities [10]. This study aimed to explore the emerging problem of drug-related HIV transmission and to stimulate the development of adequate health services for the drug users, by linking international expertise and local research
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