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  • Title: Turning the tide.
    Author: Kahane T.
    Journal: WorldAIDS; 1993 Jul; (28):2. PubMed ID: 12286593.
    Abstract:
    It is estimated that 120,000-800,000 people in Vietnam out of a population of 67 million use injectable drugs for recreational purposes. Concurrently, HIV is spreading rapidly in the southern provinces of the country. The sharing of HIV-contaminated needles and injection equipment facilitate the dissemination of HIV so that more than 90% of the 332 cases of HIV infection officially notified by May 1993 are drug related. The most common injected drug is liquid opium. Large quantities of the drug are needed for the user to feel any effect, so large veins must be punctured with large needles. To realize this objective, each group of 20 IV-drug users (IVDU) tends to have its own skilled, yet untrained person who is paid to find and inject the opium in large veins in the leg or thigh. The same needle is used for everyone without sterilization. Funded by a group of American Vietnam war veterans, Jon Stuen-Parker, founder of the Boston-based National AIDS Brigade which provides AIDS information and runs needle exchange programs, visited Vietnam in March 1993 to establish a needle exchange program in the main areas of Ho Chi Minh City frequented by drug users. Unlike in the US, he was warmly received by officials and the program was implemented without controversy. Since IVDUs in this population do not self-inject, the report notes the need to educate only those who inject others about sterile needles and clean paraphernalia. Taking a different approach in recognition of the fact that needles are more expensive than liquid opium, CARE International proposes cleaning needles with bleach for both medical use and IVDUs. Accordingly, the Health Information and Education Center in Vietnam has produced literature promoting the bleach strategy which awaits approval for release. Stuen-Parker warns, however, that needles must soak for at least 30 seconds in 100% bleach to become sterile. He has planned a 2nd trip in July with the founder of the Vietnam Veterans with AIDS Committee to train Vietnamese workers in needle exchange programs to continue the program and to convince the authorities to support the approach.
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