       Document 0833
 DOCN  M9640833
 TI    Operating needle exchange programmes in the hills of Thailand.
 DT    9604
 AU    Gray J; National Centre for HIV Social Research, School of Behavioural;
       Sciences, Macquarie University, Sydney, New South Wales,; Australia.
 SO    AIDS Care. 1995;7(4):489-99. Unique Identifier : AIDSLINE MED/96119355
 AB    Injecting drug use is increasingly markedly amongst the ethnically
       distinct Hilltribe peoples of northern Thailand in the notorious 'Golden
       Triangle'. This paper reports on the establishing of needle exchanges in
       three remote Hilltribe villages, examining the success and the failure.
       Up to 60% of adult males and a smaller percentage of adult females in
       these villages are habitual users of opium and/or heroin. Overcoming
       initial concern that needle distribution would encourage increased use,
       the villagers themselves have assumed responsibility for much of the
       needle exchange operation. Prior to the introduction of the needle
       exchanges all the injecting drug users were sharing needles. This
       behaviour changed significantly with the introduction of the exchanges.
       Reluctance on the part of locally-based government officials to
       participate fully in the programme created difficulties in maintaining
       needle supplies which saw some resumption in needle sharing. HIV
       seroprevalence rates amongst the tested injecting drug users remained
       fairly stable at 33% in February 1993 and 32% in February 1994. The
       conclusion can be drawn that needle exchange programmes are operable in
       the Hilltribe context and that they are the best means of limiting
       HIV/AIDS transmission amongst injecting drug users and the wider
       community. The success of needle exchange programmes, however, is
       dependent upon co-operation from various government agencies and
       non-government agencies, in addition to the local communities. To this
       end mechanisms ensuring co-operation, training, monitoring and
       evaluation need to be developed alongside the introduction of needle
       exchanges.
 DE    Adult  Consumer Participation  Female  Health Policy  Heroin
       Dependence/EPIDEMIOLOGY  Human  HIV Infections/*PREVENTION & CONTROL
       HIV Seropositivity/EPIDEMIOLOGY  Male  Narcotic Dependence/EPIDEMIOLOGY
       Needle Sharing/ADVERSE EFFECTS  Needle-Exchange
       Programs/ECONOMICS/*ORGANIZATION & ADMIN  Opium  Program Evaluation
       *Rural Health  Substance Abuse, Intravenous/EPIDEMIOLOGY  Support,
       Non-U.S. Gov't  Thailand/EPIDEMIOLOGY  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

