DURBAN, July 22 (ANA) – Drug control measures in South Africa have failed to reduce availability as drug trafficking on the continent increased, a HIV prevention researcher from the University of Cape Town told the International AIDS Conference 2016 in Durban on Friday.
Dr Andrew Scheibe said the availability of heroin had increased in South African and the continent, and that South Africa was now a global exporter of methamphetamine.
“Africa plays a central part in drug trafficking. Opiates are coming in through East Africa and cocaine destined for Europe makes its way through West Africa,” Scheibe said.
He was speaking at the last day of the conference in a session that focused on hotspots in Africa for alcohol, drug use and sexual risk behaviour.
Under examination was a series of concentrated epidemics of HIV in four settings in Africa where risk behaviour was being driven by “a confluence of geographical, cultural, social and economic realities” underpinned by alcohol and/or drug use.
Reasons for drug use were varied, he said, and there was still misinformation, stigma and social exclusion for users.
Gang activity, unemployment, limited education and violence were some of the reasons for drug use.
He said drug users were treated disrespectfully and experienced human rights violations and possible arrest. When this led to incarceration, it increased their chances of exposure to criminal networks and contracting diseases such as HIV.
“South Africa is currently the only place on the continent with opioid replacement therapy,” he said. But it remained “problematic” that almost all interventions were based on abstinence.
He noted that opioid replacement therapy was done under medical supervision, using prescription opioids to replace illegal opioids to give drug users a less painful alternative to stop drugs than simply stopping, which could be dangerous.
There was a lack of funding for health services for drug users in South Africa, and he noted the difficulty of collecting data due to criminalisation.
“Criminalisation of drug users limits the potential effectiveness of the HIV response, and law reform is essential for sustainable change.”
Worldwide, it was estimated that one in three people using drugs had started to inject heroin.
Scheibe said one in seven people in South Africa were at risk of developing a substance disorder, and drug users had increased injections of cocaine and methamphetamine.
According to an integrated bio-behavioural survey in Cape Town, Johannesburg and Durban it was estimated that HIV prevalence amongst drug users was between nine and 17 percent.
One in two people were re-using needles and one in four had shared their injecting equipment.
“Heroin and methamphetamines are a big problem in South Africa,” Scheibe said.
He noted that while government did have a National Drug Master Plan, it did not offer guidelines on intervention.
Diverting funding towards evidence-based prevention, treatment and services was necessary he said.
“[This] is a better investment of resources than efforts to arrest and detain people who use drugs.”
He said there was an intersection between drug use and sex, particularly in high-risk populations.
It was estimated, he said, that between one and four percent of people in the country engaged in same sex practices.
HIV prevalence here was estimated to be at between 13 and 15 percent. Injecting drugs, using chem-sex, GHB and methamphetamines were often used by men who had sex with men, he said. Alcohol use was also frequently and was often used in the context of sex.
Chem-sex involves unprotected sex while under the influence of drugs and was often done in groups.
There was also a strong association between transactional sex and alcohol use, particularly amongst women who were binge drinkers or who had alcohol disorders.
Hazardous drinking amongst sex workers was highest in Johannesburg, (81.5 percent), followed by Cape Town (58.4 percent) and Durban (43 percent).
Scheibe said in the past year, sex workers had used varying levels of drugs, with the highest being in Cape Town at 47.9 percent. The most commonly used drugs were methamphetamine (18.7 percent) and heroin (9.7 percent).
About two percent of sex workers in Cape Town said they had injected drugs, and less than one percent in Durban and Johannesburg.
– African News Agency (ANA)
