Meeting the challenge of Injection drug use and HIV in Armenia

Injection drug use (IDU) rates and HIV rates in some countries of the former Soviet Union (FSU) are skyrocketing.

The epidemic of injection drug use is an epidemic of the young. These young people deserve attention and care, irrespective of how society feels about drug use. Stigmatizing them could risk the survival of a generation on which the promise of transition depends. Their drug use, the reasons behind it, and its consequences must be addressed with effective evidence-based methods - even if those methods may make some people uncomfortable.

Compared to the known prevalence of HIV in other countries in the region, such as Russia and Ukraine, that in Armenia is not high. Between 1988 and November 1, 2005, 375 people with HIV were registered in the country, and the estimated HIV prevalence rate in 2002 was less than 0.1%.

This relatively low rate may not be enough alone to justify an immediate effort to develop an HIV prevention program.

Armenia's socio-economic crisis, however, in addition to other factors such as poverty, mass unemployment, and a considerable population of internally displaced persons and refugees, makes the HIV/AIDS epidemic a real danger for this small country of approximately three million people. As declared at the Caucasus Area Meeting on National Responses to HIV/AIDS, ". . . the alarming situation and experience of Ukraine, Belarus and Russia demonstrate that the number of HIV cases can increase from hundreds to thousands within a year. Tomorrow can be late. We have to act today. . . ."

Official statistics show that the HIV epidemic in Armenia, as in other countries of the FSU, is driven mostly by injection drug use (54.5% of all registered cases). In recent years, a significant increase in the number of cases of infection resulting from the injection of drugs has been observed. So far, all of the individuals infected via IDU in Armenia have been men, the majority of whom were living temporarily in the Russian Federation (Moscow, St. Petersburg, Irkoutsk, Surgut, and Rostov) and Ukraine (Odessa, Mariupol, and Kiev).

Studies have demonstrated that when an HIV epidemic is driven by IDU, early intervention becomes critical: once HIV has been introduced into a local community of injection drug users, there is a possibility of extremely rapid spread. Moreover, once HIV prevalence exceeds 5-10% among injection drug users, overall infection rates can climb as high as 50% in fewer than five years. The potential for the rapid spread of HIV among injection drug users means that any delay in implementation of HIV prevention interventions carries particularly serious consequences.

Data on the prevalence of drug use in Armenia are scarce and vary widely at times. According to the operative data of the Ministry of the Interior, the number of drug users in Armenia in 2000 was about 20,000 (50% residing in the capital city, Yerevan), with 2,000 of them using injection drugs.