Harm reduction policies and interventions for injection drug users in Thailand

Thailand is looked upon as a role model for HIV education and awareness campaigns that include the extensive promotion and wide acceptance of condoms as an HIV prevention strategy. It has the most progressive and comprehensive antiretroviral program in the region with a reported coverage of over 80% of eligible individuals. In 2001, it embarked on a progressive universal health care program that provides free access to a wide array of health care diagnostics and therapeutics for the people of Thailand.

With these impressive achievements, it is remarkable how poorly Thailand has responded to the HIV epidemic among injection drug users (IDUs). The HIV prevalence rates among IDUs have remained high and stagnant over the last decade. Failure to provide effective interventions to reduce HIV transmission among drug users has resulted in unnecessary suffering, and for many, HIV-related death. Continued inaction threatens to undermine successful HIV prevention efforts in the country through ongoing HIV transmission among injection drug users and their sexual partners.

At the root of this failure has been the pursuit of an aggressive drug enforcement policy to reduce drug supply and provide “compulsory treatment” to illicit drug users. This “abstinenceat-any-cost” approach has effectively silenced repeated calls to provide effective interventions that could actually reduce HIV transmission, improve health outcomes, and engage drug users into effective treatment and recovery programs.

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