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Thursday, April 24, 2014
- In contrast to the rest of southern Africa, intravenous (IV) drug users have become the group most vulnerable to the transmission of the HI virus in Mauritius. This has led the Mauritian government to introduce a syringe and needle exchange programme in a bid to stem HIV infection among Mauritian drug users.
Sexual transmission among heterosexuals is the most common way of HIV infection in southern Africa, the region which has become the centre of the international HIV/AIDS pandemic in recent years.
Mauritius is unusual in the region as the HIV prevalence rate among its population of 1.2 million people is less than 0.5 percent. Since 1987, 162 Mauritians have died from AIDS-related illnesses. Currently, some 2,345 Mauritians are living with HIV/AIDS according to official figures but some social workers estimate the number to be around 10,000.
Another unusual characteristic of the epidemic in Mauritius is that drug injection with shared needles has since 2003 been the main mode of HIV transmission. The sharing of contaminated needles was responsible for 92 percent of new HIV infections in 2005 and 85.2 percent of new infections in 2006.
Social worker Cadress Runghen ascribes the increased vulnerability of drug users to HIV/AIDS to the fact that anti-AIDS messages focussed on sexual behaviour only.
Sensitisation campaigns helped to ensure that the population was made aware of the risk of HIV infection through sexual means, leading to a drop in such infections during the 1990s.
But, says Runghen, ‘‘nobody kept a check on the drug addict community’’. In the meanwhile the HI virus has been spreading like wildfire among the members of this marginal group.
To address this and other issues, the Mauritian parliament adopted the new HIV and AIDS Act at the end of 2006 which introduced a syringe and needle exchange programme and methadone treatment. Methadone is used to alleviate withdrawal symptoms during the rehabilitation of drug addicts.
In just a few weeks, 2,000 syringes used by drug addicts have been taken out of circulation and replaced by new ones. A few hundred addicts are now being treated with methadone.
Social workers have started this programme in the capital Port Louis and on the outskirts of the capital at Baie-du-Tombeau, Roche Bois and Batterie Cassée where a large number of drug addicts live or come to have their daily dose of heroin or other drugs.
They meet in places which are not generally frequented by other members of the public. Social workers visit these places to hand out new syringes and condoms. The used syringes and needles are collected in a plastic box and destroyed.
Social workers use this contact to sensitize drug users to HIV/AIDS issues. ‘‘It is not only a programme to exchange syringes. It is not a mechanical exercise. We are doing it to reach out to drug addicts and convince them to go to one of our rehabilitation centres,’’ says Runghen.
Drug addicts hide themselves from the public eye for fear of being arrested by the police. The social workers have to win their confidence. ‘‘This is a long process. Drug addicts want to talk to people. They want to feel the warmth of people who listen to them. They do not want to be rejected,’’ Runghen adds.
One female drug addict, Nalah (not her real name), told IPS that she is now more aware of HIV/AIDS. She and her friends used to share one syringe for days on end because pharmacists would not sell them new ones.
‘‘That is why we come to exchange our syringes. When an addict suffers because you cannot take your daily dose, you will take any syringe you find to shoot up with,’’ Nalah explains.
Another social worker, Imran Dhannoo, is adamant that the programme should be directed at those thousands of drug addicts who are vulnerable and who do not know about the programme. ‘‘We should reach out to them. We should not wait for them to come and see us.’’
The syringe exchange programme is one of a number of initiatives in the comprehensive HIV/AIDS legislation introduced last year.
According to health minister Satish Faugoo, the law provides an effective national framework with prevention and care programmes that will get people involved in curbing the spread of HIV/AIDS while protecting people’s human rights.
Emphasis is placed on confidentiality and human rights. Thus, no HIV test can be undertaken without prior consent of the person being tested, and the results of tests must be made available to the person. The law also allows a minor to undergo an HIV test without the consent of her or his guardian.
The law determines that HIV-positive people be referred for treatment. Information about the HIV status of an individual is protected from unauthorised collection, use or disclosure in health care and other settings.
In a bid to stem stigmatisation and discrimination against people with HIV, penalties have been introduced to protect their pension rights and employment conditions, and to prevent prejudice or ill-treatment of any kind.
Faugoo has said that HIV positive people should be guaranteed equal rights to employment and heath care as are accorded all other members of Mauritian society. The law makes it illegal to impose HIV testing as a pre-condition for employment or continued employment.
It is also an offence for a doctor not to provide treatment to a person who is or perceived to be HIV positive. Testing facilities will be introduced in specific public health institutions, as well as pre- and post-test counselling. Testing will happen in accordance with strict guidelines and protocols to ensure the reliability of results.
Nicolas Ritter, spokesperson for a nongovernmental HIV/AIDS organisation, welcomed the new legislation. According to him, many people are living with HIV without knowing it.
Meanwhile, religious leaders are warning people about their sexual behaviour. Catholic priest Jocelyn Grégoire has appealed to Mauritians, saying: ‘‘The house is on fire and we cannot save it. But we should save the furniture. You are being told to use condoms. If they cannot protect you from pregnancy, how can they protect you from HIV?’’
‘‘Better be faithful,’’ added Homa Mungapen, spokesperson for the Council of Religions.