Operating needle exchange programmes in the hills of Thailand
Gray, J.
Aids Care 7(4): 489-499
1995
ISSN/ISBN: 0954-0121 PMID: 8547363 DOI: 10.1080/09540129550126434Document Number: 294019
Injecting drug use is increasing markedly among the ethnically distinct Hilltribe people of northern Thailand in the notorious Golden Triangle. This paper reports on the establishment of needle exchanges in 3 remote Hilltribe villages. The needle and syringe exchanges were established in 3 villages: Anamai Village 1, 2, and 3, each with an average of 47 households and 5-6 people per household. Altogether there were 46 injecting drug users participating: 16 from Anamai Village 1; 12 from Anamai Village 2; and 18 from Anamai Village 3. Up to 60% of adult males and a smaller percentage of adult females in these villages were habitual users of opium and/or heroin. Through a series of meetings in the villages various means available to prevent the transmission of HIV/AIDS in an injecting drug use context were discussed. The villagers themselves have assumed responsibility for much of the needle exchange operation. The sharing of needles by injecting drug users changed significantly with the introduction of the exchanges. Reluctance on the part of local government officials to participate in the program created difficulties in maintaining needle supplies, which led to some resumption in needle sharing. The needle and syringe exchanges in November 1992 supplied 5000 1 cc needle and syringe fits, a 1-years' supply. HIV seroprevalence rates among the tested injecting drug users remained fairly stable at 5 cases (33%) of 15 IDUs tested in February 1993. In February 1994, 8 (32%) of 25 IDUs tested were found to be HIV seropositive. The 17 men found to be HIV negative in February 1994 despite their injecting behavior would seem to indicate that the needle exchange programs in the Hilltribe context are effective in limiting HIV/AIDS transmission among injecting drug users and the wider community. The success of needle exchange programs is dependent upon cooperation from various government agencies and nongovernment agencies as well as the local communities.