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Growing Pains: a first look at drug use in a post-conflict country

Growing Pains: a first look at drug use in a post-conflict country

In February 2013, Fundasaun Timor Hari’i (FTH) commissioned a Rapid Assessment and Response (RAR) among the People Who Inject Drugs (PWID) in Dili and Bobonaro Districts. Timor-Leste is still considered to have a low-level epidemic, with an estimated national HIV prevalence of approximately 0.1845%, which is non-generalized. Most HIV infections would appear to have been acquired through heterosexual contact, with other routes of transmission likely to occur less often. The RAR aimed at assessing the nature and extent of injecting drug use, types of drugs used, sexual practices and demographic characteristics of drug users.

Research methods included: • Stakeholder meetings, discussions with organisations working in the field • Literature review  • Key informant interviews with drug users • Drug user questionnaires • Focus group discussions
Social observation results: • 61% of drug users interviewed were aged 18-26 years old with over 45% of all interviewees having begun using drugs before the age of 19. • 43% of interviewees had used drugs intravenously within the last 3 months. • Most common illicit drugs used were methamphetamine, heroin, cannabis and MDMA. • 61% of PWID’s reported sharing needles, with 32% reporting they share all the time. • Three quarters of those men interviewed had sex with a sex worker and 68% of all interviewees had sex with someone who was not their regular sexual partner.  • 84% of those individuals interviewed had never been tested for HIV although 36% believed they were at high risk of infection.
The next step for FTH is to develop a HIV prevention program for PWID based on harm reduction principles. This program will be multi-layered, including political advocacy, further research and a peer education program and condom distribution. FTH will continue to work closely with the MoH to advocate for drug services as well as developing organisational referral pathways to other services available.

Areas of Interest / Categories: AIDS 2014, Drug Use, HIV

AIDS 2014

Immune Control of the HIV reservoirs

Prevalence of Sexually Transmitted Infections (STIs) and patient characteristics of older men over 60 years of age attending a public STD clinic in South Australia

Background: STI prevalence is changing. With society aging, life expectancy increasing and changes in sexual practices, STIs in senior citizens are of interest from economic, health related and social burden perspectives. Few studies on STIs in older men greater than 60 years of age exist, hence, a need to obtain further information about this subpopulation.

Conducting clinical audits to improve sexual health service delivery in primary health care services: Successes, challenges and lessons learnt

Conducting clinical audits in the context of continuous quality improvement (CQI) programs in Aboriginal Community Controlled Health Services (ACCHS) has provided valuable information regarding what factors facilitate or create challenges to improving outcomes in sexual health service delivery.

High prevalence, incidence and clearance of anal high-grade squamous intraepithelial lesions (HSIL) in homosexual men: early evidence from the Study of the Prevention of Anal Cancer (SPANC)

Homosexual men are at increased risk of anal cancer. Screening and treatment of the precursor, HSIL, has been advocated by some, but screening is not recommended in widely-accepted guidelines. We aimed to describe the prevalence, incidence, and clearance rates of anal HSIL, and association with human papillomavirus (HPV) status, in a community-recruited cohort of homosexual men.

HIV and syphilis co-infections and re-infections: trends from Victoria

Since 2009, the Victorian syphilis enhanced surveillance system has been collecting HIV status and syphilis re-infection status for infectious syphilis cases. Baseline data from 2009 showed that 31% of the infectious syphilis cases were HIV positive and 18% reported were re-infections. This suggested that syphilis transmission among a pool of HIV positive MSM was making a considerable contribution to the syphilis epidemic in Victoria. We analysed the data from 2009 to 2012 to determine whether this pattern of transmission is continuing. Notification data for infectious syphilis between 2009 and 2012 were reviewed by HIV infection status, syphilis re-infection status and risk factor exposures.

Efficacy and acceptability of a combination intervention for smoking cessation in HIV positive individuals: a pilot study

HIV positive gay men have high rates of cigarette smoking. The risks of smoking in addition to the elevated risk of cardiovascular disease and some malignancies in people with HIV means smoking cessation interventions should be prioritised.

Is the stage of the menstrual cycle related to chlamydia detection?

We investigated the association between chlamydia detection and stage in the menstrual cycle to investigate whether chlamydia detection was higher at different stages of the cycle. Electronic medical records for women attending Melbourne Sexual Health Centre March 2011 - 31st December 2012, who were tested for chlamydia by nucleic acid amplification of high vaginal, cervical, or urinary samples, and who recorded a date of last normal menstrual period (LNMP) between 0-28 days were included in the analysis. Logistic regression was used to calculate OR (95%CI) for the association of chlamydia with menstrual cycle adjusted by demographics and behavioural variables.