Injection Drug Use and HIV/AIDS

1. Global Progress in Controlling HIV-AIDS Related to Injection Drug Use

"The world is not on track to reduce HIV transmission among people who inject drugs by 50%, as recent evidence suggests little change in the HIV burden in this population. HIV prevalence among people who inject drugs remains high – up to 28% in Asia. HIV prevention coverage for people who inject drugs remains low, with only two of 32 reporting countries providing the recommended minimum of at least 200 sterile syringes per year for each person who injects drugs. Among 35 countries providing data in 2013, all but four reached less than 10% of opiate users with substitution therapy. In addition to exceptionally low coverage, an effective AIDS response among people who inject drugs is undermined by punitive policy frameworks and law enforcement practices, which discourage individuals from seeking the health and social services they need."

"Global Report: UNAIDS Report on the Global AIDS Epidemic 2013," Joint United Nations Programme on HIV/AIDS, Sept. 2013, pp. 5-6.
http://www.unaids.org/en/media...

2. Persons In The US Living with Diagnosed HIV Infection Ever Classified as Stage 3 (AIDS), by Transmission Method

"From 2010 through 2014, the number and rate of persons living with infection ever classified as stage 3 (AIDS) increased (Table 19a). At year-end 2014, 521,002 persons in the United States were living with infection ever classified as stage 3 (AIDS). The prevalence rate of infections classified as stage 3 (AIDS) was 163.4."
Click here for the complete datatable of Estimated Number of Persons Living with Diagnosed HIV Infection Ever Classified as Stage 3 (AIDS), by Race/Ethnicity, Gender, and Transmission Method at Year-End 2014 - United States and 6 Dependent Areas

Centers for Disease Control and Prevention. HIV Surveillance Report, 2015; vol. 27, Table 21b, p. 9 and pp. 97-98. Published November 2016. Last accessed March 3, 2017.
http://www.cdc.gov/hiv/library...
https://www.cdc.gov/hiv/pdf/li...

3. Estimated Prevalence of People Who Inject Drugs (PWID) in the US

"Overall, the number of PWID per 10,000 persons aged 15–64 years varied from 31 to 345 across MSAs [Metropolitan Statistical Areas], median 104.4 (mean 127.4; standard deviation 66.7; percentile range 76–162) in 1992 and from 34 to 324 across MSAs, median 91.5 (mean 103.6; standard deviation 56.4; percentile range 61–125 ) in 2007 indicating an overall decline in PWID prevalence across MSAs.

"Figure 5 shows the overall trajectory of the PWID prevalence rates based on the multilevel model. Trend analysis of the overall results is consistent with a decline in the early study period, followed by an increase in 2000–02, and then remaining stable thereafter over time. On average there has been very little change since 2002 (mean 105.0) to 2007 (mean 103.6). Overall, across the 96 MSAs the mean PWID prevalence mostly decreased during our study period, as did the dispersion of estimates over time."

Tempalski B, Pouget ER, Cleland CM, Brady JE, Cooper HLF, et al. (2013) "Trends in the Population Prevalence of People Who Inject Drugs in US Metropolitan Areas 1992–2007." PLoS ONE 8(6): e64789. doi:10.1371/journal.pone.0064789
http://www.ncbi.nlm.nih.gov/pm...

4. Prevalence of Diagnosed HIV Infection in the US by Method of Transmission

"Sex (at birth) and transmission category: From 2014 through 2018 in the United States and 6 dependent areas, the annual percentage of diagnoses of HIV infection among adults and adolescents attributed to male-to-male sexual contact accounted for over 65% of diagnoses (Figure 5 and Table 1b). From 2014 through 2018 in the United States and 6 dependent areas, among male adults and adolescents, the annual number of diagnosed HIV infections attributed to injection drug use increased (Table 1b). The number of infections attributed to male-to-male sexual contact and heterosexual contact decreased. The number of infections attributed to male-to-male sexual contact and IDU remained stable. The perinatal and “Other” transmission categories accounted for less than 1% of cases. Among female adults and adolescents, the number of infections attributed to IDU increased. The number of infections attributed to heterosexual contact decreased. The perinatal and “Other” transmission categories accounted for less than 1% of cases."

Centers for Disease Control and Prevention. HIV Surveillance Report, 2018 (Updated); vol. 31.
http://www.cdc.gov/hiv/library.... Published May 2020. Accessed June 8, 2020.
https://www.cdc.gov/hiv/librar...

5. Estimated Worldwide Number of People Who Inject Drugs

"The UNODC/WHO/UNAIDS/World Bank joint estimate of the number of PWID in 2016 is 10.6 million (range: 8.3 million to 14.7 million), corresponding to 0.22 per cent (range: 0.17 to 0.30 per cent) of the global population aged 15–64 years. This estimate is based on the most recent and highest quality information currently available to UNODC. It does not imply that there has been a change in the global number of PWID compared with those published in previous editions of the World Drug Report. Based on data from 107 countries, the estimate covers 88 per cent of the global population aged 15–64 years.

"The extent of injecting drug use is less certain or unknown in some subregions due to the paucity of data: in the Caribbean, information is available only for Puerto Rico; for all of Oceania, there are data for Australia and New Zealand only; while for Africa, data are available for countries comprising 58 per cent of the population aged 15–64 years, and for the Near and Middle East, only 17 per cent of that population.

"The subregions where the largest numbers of PWID reside are Eastern and South-Eastern Europe, with 17 per cent of the global total number of PWID and where the prevalence of injecting drug use is highest at 3.8 times the global average; North America, with 17 per cent of the global total of PWID and where the prevalence of injecting drug use is 2.5 times the global average; and East and South-East Asia, with 30 per cent of the global total of PWID, but where the prevalence of injecting drug use is relatively low
and is below the global average.

"Almost half of all PWID worldwide in 2016 were estimated to reside in just three countries: China, the Russian Federation and the United States. Although these three countries combined account for just 27 per cent of the global population aged 15–64 years, together they are home to 45 per cent of the world’s PWID, an estimated 4.8 million people."

World Drug Report 2018. United Nations publication, Sales No. E.18.XI.9.
https://www.unodc.org/wdr2018/
https://www.unodc.org/wdr2018/...

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