Harm Reduction News: Access to HIV Treatment

The AIDS epidemic in Central and Eastern Europe and the former Soviet Union (CEE/FSU) is especially challenging since it is overwhelmingly associated with a criminalized and severely stigmatized behavior: injection drug use. Effective control and treatment of HIV in this region will require contributions from many sectors in society—perhaps most critically from the people and communities most directly affected.

In this issue of Harm Reduction News, contributors from CEE/FSU and elsewhere elaborate on these challenges and begin to provide outlines for effective solutions. Comprehensive prevention efforts across the region—from the Balkans to the Baltic states—reflect local, regional, and international collaborations.

For example, in St. Petersburg, painstaking efforts are underway to develop access to medical care resources; in Moldova, an NGO coalition generates palliative care for AIDS patients; in Odessa, a self-help movement prepares its constituents for large-scale antiretroviral treatment. Also in this issue, physician experts from Poland and France describe mature programs delivering comprehensive services to injection drug users. They provide a powerful weapon to those just beginning to build such resources: a concrete response to the complaint that drug users cannot be engaged in care effectively.

Support from international organizations for equitable and comprehensive treatment for HIV-infected or at-risk drug users is growing dramatically as can be seen from perspectives as varied as the European AIDS Treatment Group, the U.K. Department for International Development, the Global Fund to Fight AIDS, Tuberculosis, and Malaria, and the World Health Organization. Finally, there is a reminder from South Africa that progress against AIDS is intricately bound up in the progress toward (or retreat from) open and democratic societies.

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