IDU Reference Group

Regional estimates are the sum of country level IDU populations size estimates. For those countries where injecting drug use was reported but no prevalence estimates were available, the population-weighted mean regional IDU prevalence was used to estimate the number IDUs. For countries where injecting drug use has not been reported the number of IDUs was assumed to be zero. Source: Mathers et al (2008)

Regional estimates based on sum of country level estimates of the number of HIV positive IDUs. Country level estimates were derived by applying HIV prevalence estimates to the estimated number of IDUs for that country. For those countries where injecting drug use was reported but no HIV prevalence estimates were available, the IDU-population-weighted mean regional HIV prevalence among IDUs was used to estimate the number HIV positive IDUs. Source: Mathers et al (2008)

Needles and syringe programs provide sterile injecting equipment to injecting drug users. NSPs may operate from fixed sites, mobile services or through outreach workers. Here we consider NSPs as those services where injecting equipment are provided for free. In many countries injecting equipment may be purchased from pharmacies – these are considered separately here. More information... http://www.who.int/hiv/topics/idu/needles/en/

Numerator: total number of individual IDUs who accessed an NSP in a 12 month period (from program data)
Denominator: estimated number of IDUs
Source: Mathers et al (2010)

Numerator: total number of needles-syringes distributed from NSPs in a 12 month period (from program data)
Denominator: estimated number of IDUs
Source: Mathers et al (2010)

Opioid substitution therapy involves the provision, under medical supervision, of opioids such as methadone, buprenorphine and diamorphine (pharmaceutical heroin) to people who are opioid dependent. Both methadone and buprenorphine for the treatment of opioid dependence are included in the WHO list of essential medicines. More information... http://www.who.int/hiv/topics/idu/drug_dep...

Numerator: total number of OST recipients at a single point in time; including both IDUs and drug users who do not inject (from program data)
Denominator: estimated number of IDUs
Not all IDUs use opioids and not all OST recipients are IDUs. Because data on the number of opioid injectors and the number of IDUs receiving OST were available for very few countries it was not possible to report on the percentage of opioid IDUs who were recipients of OST. In order to gain some sense of the scale of OST programs relative to the size of the injecting population the ratio of all OST recipients to the total number of IDUs was calculated.
Source: Mathers et al (2010)

In this section we considered psychosocial and medical treatments for the drug use other than opioid substitution treatment (OST) including: drug detoxification services (both inpatient and outpatient); short to long term residential rehabilitation programs; services that offer psychosocial support such as individual or group counselling or therapy; peer-based support groups such as narcotics anonymous; in some cases data were only available for multiple types of treatment counted together or for treatment modalities not otherwise specified. More information... http://www.who.int/substance_abuse/en/

A paucity of consistently reported data on the provision of drug treatment (other than OST) prevented regional estimates being derived.

HIV testing and counselling may be client initiated (voluntary testing and counselling), or in some circumstances provider initiated. HIV testing and counselling is an important gateway to HIV treatment and care. More information... http://www.who.int/hiv/topics/vct/en/

A paucity of consistently reported data on the provision of HIV testing and counselling prevented regional estimates being derived.

Antiretroviral therapy (ART) consists of the use of a combination of antiretroviral drugs to suppress the HIV virus and stop the progression of HIV disease. Huge reductions have been seen in rates of death and suffering when use is made of a potent ARV regimen. More information... http://www.who.int/hiv/topics/idu/care/en/

Numerator: total number of IDUs receiving ART at a single point in time (from program data)
Denominator: estimated number of IDUs living with HIV
Estimating the coverage of ART to those in need requires estimates of the cumulative number of people how have injected drugs and become infected with HIV and meet criteria for the initiation of ART as well estimates of those who are receiving it. Because such estimates were not available in order to gain some sense of the scale of ART provision for IDU relative to the number of IDUs infected with HIV the ratio of all IDUs receiving ART at a single point in time to the estimated number of IDUs living with HIV was calculated. It is important to note that not all IDUs living with HIV will meet criteria for initiation of ART, criteria which themselves may differ in different settings. In addition the estimates of IDUs living with HIV used here are for current IDUs and the former IDUs infected with HIV may be excluded from these estimates. Further, counts of IDUs receiving ART are commonly taken from ART registries reporting likely HIV exposure category and may not accurately reflect the number of all IDUs receiving ART.
Source: Mathers et al (2010)

Distribution of condoms to injecting drug users and their partners is an important component of the HIV prevention response. More information... http://www.who.int/hiv/topics/condoms/en/

A paucity of consistently reported data on condom programs for IDUs and their partners prevented regional estimates being derived.