Treatment and scale up access TV, ART OST treatment for people who

use drug sin SEA

Ekta

Why integration • My friend is HIV positive he comes to

methadone clinic everyday.• He increase his dose up to 300mg per day.• Because there is no doctor

HIV Prevelance among IDU in SEA

• the percentage of IDUs with HIV ranges from 11.5 per cent in India

• 41.5 per cent in Nepal • 42.5 per cent in Indonesia. • SEA amongst IDUs is around one-third

Although the majority of prevalent and incident cases of hepatitis C are related to injection drug use, drug users often are co infected with HIV and Hep c they find it difficult to access treatment services because of concerns about adherence and treatment entry ..Ajit karki activist for hep C

IDU and TB

• The risk of IDUs acquiring tuberculosis (TB) is equally high. Studies show that IDUs have 10 to 30 times more chance of becoming infected with TB.

• In prisons, this risk can be up to 50 times. • which is the case in large number of IDUs dying

within one year of contracting TB bacilli. Multiple drug resistance among IDUs with TB and HIV is another significant phenomenon in SEA countries

Integration ??

Create point of contact between treatment services and HIV infected PUDs

resource limited setting

Receive HIV care less comparing to other Risk groups

Greater difficulties accessing HIV treatments like enrollment being diagnosed, prescription of ART med.

Available but not accessible because mistrust, fear of prosecution, stigma, and unmanageable life style

• Most of the countries in South east Asia ,HIV/ AIDS epidemic are being driven by IDUs. Treatment services and access to care

and support programs is limited in resource limited settings like ours. Access to these existing service to IDU is further complicated.

Advantages of integrated services

• Convinient • Effictive treatment• Improve relapse cases.• Better use of resources• Increase possibilities for overall checkups and required

medical services. • Service provider will be more capacited • Decrease duplication of services • Improve health out comes in specific community.

Conti…

• Reducing this gap and strengthening the link will play an important role in the integrated approach.

• WHO agrees that there have been practical problems at the ground level in implementing its policy because of lack of coordination, suppressive national policies and local environments.

The need of working with a collaborative approach on TB,OST and HIV among IDUs is urgent.

• integrated approach is a useful strategy for engaging high-risk drug injectors with serious medical conditions, and that offering combined treatment services in a single setting that addresses multiple comorbidities can yield high levels of engagement and treatment success, even in the most challenging patients with active addictive disorders.