The growing problem of HIV, HCV and other blood-borne viruses among drug users and in particular injecting drug users is recognized as a major threat to public health. Given this situation, this Working Group will endeavour to produce a best practice document to outline the role of drug dependency treatment and rehabilitation services in the prevention and care of HIV/AIDS and HCV. The project will identify good treatment practice as outlined in the research literature and list good practice examples to demonstrate what can be done to impact HIV and HCV prevention and care.
There are a number of core treatment components that have been demonstrated to be effective in HIV/AIDS prevention and care. The core components identified are:
* Accessible pharmacotherapy treatments for drug dependence (methadone, buprenorphine and others for substitution and withdrawal)
* HIV and HCV (and other?) testing is available
* HIV/AIDS (and other?) education (such as safe sex and safe drug use) is routinely provided
* Withdrawal services (residential and non residential) are accessible Psycho-social treatments of demonstrated efficacy (brief interventions, motivational interviewing, CBT, relapse prevention and others) are provided
* Support (wrap-around) services (eg. Vocational training, housing, financial support)
* Policy advice and advocacy.
* Access to affordable ARV’s and other relevant medications
* Access to clean needles and syringes
* Outreach services targeting high-risk groups (eg. Commercial sex workers)
From a clinical perspective, although medicine was best positioned to help contend with disease processes, it was the rehabilitation community (e.g., physical therapists, occupational therapists, speech-language pathologists and physiatrists) who brought expertise in dealing with the life-related consequences of the illnesses. Furthermore, it was rehabilitation and disablement frameworks to which scholars and activists turned for insight into how to reconceptualize HIV beyond the level of disease.
The World Health Organization’s (WHO’s) International Classification of Impairments, Disabilities and Handicaps (which was updated in 2001 and renamed the International Classification of Functioning, Disability and Health, or ICF) provided a framework that could highlight the challenges related to living with HIV at the level of the body structure or function (e.g., painful knee or congested lungs), the level of the individual (e.g., difficulty walking or getting dressed), and the level of involvement in life situations (e.g., difficulty with one’s job or in parenting roles). This reframing provided the basis for both programming and policy advocacy.
Tags: AIDS, Conditions and Diseases, Health, HIV, Immune Deficiency, Immune Disorders, Substance dependence, World Health Organization