141st APHA Annual Meeting

In This section

292787
HIV and drug policy reform: The cost of a slow learning curve

Tuesday, November 5, 2013 : 11:50 AM - 12:10 PM

Laura Thomas, MPH, MPP , DPA, Drug Policy Alliance, San Francisco, CA
Issue: The global war on drugs is jeopardizing the fight against AIDS. Criminalizing drug use drives HIV not just among people who use drugs but also among their families and communities. The U.S. can learn from other countries, where different approaches have led to significantly lower HIV incidence among people who use drugs. Description: Throughout the world, research has consistently shown that repressive drug law enforcement practices force people who use drugs away from public health services and into hidden environments where HIV risks become markedly elevated. Health-centered programs such as sterile syringe access programs are effective and cost-efficient. They also link people to health care, connect people to addiction treatment, and can reduce overall drug use. Lessons learned: In 2001, Portugal decriminalized drug possession and scaled up their harm reduction programs. HIV cases among people who use drugs plummeted by 34 percent between 2000 and 2008. Switzerland has implemented public health approaches such as syringe access, supervised injection facilities, and replacement therapy programs,. As a result, new HIV cases fell by 82 percent between 1990 and 2002. In Australia, by 2001 syringe exchanges had prevented 25,000 HIV infections and 21,000 hepatitis C infections, and had prevented 4,500 AIDS deaths. Recommendations: In countries where addiction is treated as a health issue, the fight against HIV is being won. New HIV infections there have been nearly eliminated among people who use drugs, These global best practices should be adopted in the U.S. to achieve our goal of an AIDS-free generation.

Learning Areas:
Advocacy for health and health education
Public health or related laws, regulations, standards, or guidelines
Public health or related public policy

Learning Objectives:
Compare drug policy approaches across multiple countries. Describe the impact of those drug policy approaches on HIV incidence.

Keywords: Drug Use, Law

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have worked in HIV policy and programming in San Francisco for 25 years, with a focus on federal HIV legislation and appropriations, passing state legislation on syringe access and overdose prevention, and local efforts to increase access to services for people living with HIV.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.