[Introduction] [Agenda] [Abstracts] [Recommendations] [Biographical Sketches] [Participants]

Introduction

The conference was planned, organized and conducted by Jag H. Khalsa, Ph.D., and Henry Francis, M.D. of the Center on AIDS and Medical Consequences of Drug Abuse (CAMCODA), of the National Institute on Drug Abuse (NIDA), a part of the U.S. National Institutes of Health (NIH), and Rafael Mazin, M.D. Armando Peruga, M.D. and Fernando Zacarias, M.D. of the Pan American Health Organization (PAHO), World Health Organization (WHO), and Dr. Mercedes Weissenbacher of the National Center for AIDS Research, Buenos Aires, Argentina. The objectives of the conference were: (a) to facilitate the exchange of experiences, lessons learned and "best practices" between experts in the United States of America, Spain, and Latin America and the Caribbean who work in the area of blood-borne infections and sexually transmitted infections (STIs) among intravenous drug users and their partners; (b) to discuss medical, behavioral and other relevant public health consequences of injecting drug use, as well as the current situation and trends of it in both the U.S.A. and Latin America and the Caribbean; and (c) to review successful behavioral, medical and public health interventions implemented both in the U.S.A. and in Latin America and the Caribbean that may be adopted/adapted by each other.

A group of 32 participants (clinicians, scientists, and other health care providers) from the United States of America, Latin America, the Caribbean, and Spain discussed the state-of-the-art information on infections among injection drug users and their partners. The topics discussed included: (a) epidemiology of HIV/AIDS and drug abuse and associated health and psychosocial consequences in the Western Hemisphere, (b) political and cultural determinants of transmission of infections in HIV-infected drug abusers, with special emphasis on underserved populations including incarcerated and homeless and their sexual partners; (c) obstacles for the development of interventions (prevention and treatment) for HIV and drug abuse associated consequences; (d) health effects and health care issues (cost-effective interventions). In addition, the participants shared their experiences and lessons learned so that each country could design strategies for future research and develop policies/guidelines applicable to their respective countries. The participants also made excellent recommendations for future research on the subject.

Recommendations for Future Research

The recommendations included the study of: (a) incidence and prevalence of drug abuse and co-occurring infections (including HIV, hepatitis, STDs and TB) in Latin America and the Caribbean; (b) medical/health and psychosocial consequences of infections among IVDUs, their partners, with emphasis on under-served populations such as incarcerated and homeless men and women; (c) health care issues such as: recruitment/enrollment, adherence and compliance to treatment protocols, access to health care facilities and related issues; (d) interventions (prevention and treatment) that have been found effective and that can be exchanged between the countries; (e) effective collaborations among treatment centers/hospitals and basic research scientists to be able to exchange experiences and lessons learned; (f) attitudes and motivational items to measure the reasons for drug use or risk behaviors, tailored to each culture; g) risk behavior measurement and development of instruments applicable to culturally-divergent populations; (h) relationship indicators (e.g., closeness and relationship type: spouse/family member/drug partner) that influence drug use behaviors among HIV-infected populations. Support a surveillance system adopting multi-tiered measuring instruments and recruitment protocols for HIV-infected drug users. These are further elaborated below under Recommendations.