Abstract

PIP: Infection with the human immunodeficiency virus (HIV) is spreading rapidly among injection drug users (IDUs), particularly in countries of the Golden Triangle where Myanmar (Burma), Thailand, and Laos converge and the pure heroin China White is refined. Thailand, Myanmar, Hong Kong, Malaysia, Singapore, the southern provinces of China, and the northeastern states of Mizoram, Manipur and Nagaland in India are affected. Infection has reached 50% and more in some groups of IDUs in these countries. In Thailand, 63% of the 23,845 known cases of HIV infection are among an estimated 400,000 IDUs. It is estimated that Myanmar has 160,000 IDUs, of whom half are infected with HIV, and among 85,000 IDUs tested, 85% were infected. The Myanmar sector of the Golden Triangle produces double the amount of the mid-1980s, more than 2000 tons of raw opium a year impaction northeastern India and China's southwest Yunnan province. The HIV infection rate among IDUs tested in Manipur was 50% in 1991, and 40% of an estimated 10,000 IDUs in neighboring Nagaland carry the virus. In China 398 of the 493 registered HIV cases are among IDUs in Yunnan. In Malaysia, there are nearly 4000 cases of HIV infection, approximately 80% of which are IDUs. The epidemic of heroin injection swept over Asia in the last decade, since Afghanistan, Pakistan, and Iran were major heroin producers. An estimated is 10 of Karachi's 8 million population uses drugs. Criminal syndicates in Pakistan, Afghanistan, and India control production, manufacture and wholesale distribution of heroin using sophisticated systems. Addiction is punishable in only a few countries, as most countries distinguish between the selling of drugs and consumption. WHO placed the interdiction of IDUs and HIV in Asia on its agenda at a meeting in Thailand, in October 1991, to prevent a shift toward drug injecting in countries where drugs are still largely inhaled.