The Challenge of Implementation of Preventive Programs in a Developing Country: Experiences, Situations, and Perspectives in Uruguay

Abstract

In recent years, Uruguay has seen an alarming increase in the percentage of persons with human immunodeficiency virus infection/acquired immunodeficiency syndrome who are injection drug users (IDUs) and their sex partners, which has consequently contributed to the rate of perinatal transmission. Development of preventive harm reduction and risk reduction strategies has become imperative. These strategies must be suitable for a developing country and focused on its population of IDUs. These strategies must include, as a preliminary step, a comprehensive analysis of the current local legal system and knowledge about the kinds of drugs used, the ways in which they are used, and their effects on public health. The conclusions of some studies and a pilot program that Institute of Social Research and Development, Instituto de Investigación y Desarrollo Social, Uruguay, implemented in 2001 have pointed to new avenues for the control of the epidemic spread among IDUs and to their social environment.

Human immunodeficiency virus, AIDS, and drug consumption in South America and the Caribbean: epidemiological evidence and initiatives to curb the epidemic

“…Further analyses pointed to an even more worrisome picture. Among those aged 15-19 years, infections among IDUs accounted for 81% of all AIDS cases in this age bracket (57). Precocious initiation into illicit drug use was corroborated by an empirical study in Montevideo in 1995-1996, which showed that most people started using drugs between the ages of 10 and 14 years (56).…”

“…In Uruguay the vast majority of drug treatment centers are private and strictly oriented toward abstinence (57). In 2001 the NGO Instituto de Investigación y Desarrollo Social (IDES) organized an intervention program that targeted injection and noninjection drug users and their sexual partners who frequented a high-risk neighborhood.…”

“…Until now Uruguay has not provided sterile syringes and needles to IDUs, although the IDU population accessed by researches is growing. Interventions so far have been aimed at the general drug-using population (57).…”

Exploring the links between drug use and sexual vulnerability among young female injecting drug users in Manipur

“…Moreover, the few available studies have largely focused on men, and programmes generally do not attempt to reach and work with female drug users. One reason why female injecting drug users are likely to be under-represented in surveys and programmes is because women are more likely to be sensitive to the stigma associated with drug use and consequently are more likely to conceal their drug use than men (Amin and Burrows, in press;Hunter and Judd, 1998;Osimani, 2003).…”

Fatores associados à soropositividade ao HIV em indivíduos atendidos em centros de testagem e aconselhamento de Goiás e Distrito Federal: estudo multicêntrico

“…Estima-se que a proporção de UDI infectados na Argentina e no Brasil possa chegar a 50% (KHALSA; FRANCIS; MAZIN, 2003;MERTENS et al, 1995;MONTANO et al, 2005;OSIMANI, 2003;PANDO et al, 2003;WEISSENBACHER et al, 2003). Na América do Norte, Europa Ocidental e Central, a oferta sistemática de terapia anti-retroviral tem diminuído consistentemente as taxas de mortalidade por aids (DRAGSTED et al, 2004;MOCROFT et al, 2000;MOCROFT et al, 2003;PEZZOTTI et al, 2003a;PODLEKAREVA et al, 2006).…”