Abstract: The Human Immuno-deficiency Virus (HIV) epidemic in Afghanistan is low and mainly associated with Injecting Drug Use (IDU).
Objective: This study aims to explore the HIV risk and vulnerability factors among Injecting Drug Users (IDUs) in Afghanistan in order to add to the existing knowledge and research and also to provide recommendations for improvement of the response and making contribution to halting the HIV epidemic among IDUs.
Method: This is a descriptive study based on literature review. The Modified Social Ecological Model (MSEM) developed by Baral et al.2013 used as conceptual framework for analyzing the HIV risk and vulnerability factors at five layers.
Findings: At the ‘individual layer’, the injecting risk behaviors of IDUs like sharing the injecting equipment, and their sexual risk behaviors like unprotected sexual contact with multiple partners identified as the HIV risk factors among them. At the ‘network layer’, lack of HIV knowledge, peer pressure and risky norms in the networks of IDUs, the presence of other Sexually Transmitted Infections (STIs), spending time in prison by IDUs, and low uptake of the harm reduction services are the factors that make the IDUs vulnerable to HIV. At the ‘community layer’, massive drug production and easy access to drug, armed conflict, massive internal and external migration, unemployment and poverty, the male gender of the majority of IDUs, high stigma and discrimination against IDUs, unsafe injecting locations such as under the bridges, and low coverage of harm reduction and drug demand reduction services are the factors that make the IDUs vulnerable to HIV. At the ‘public policy layer’, punitive drug use law, lack of protection for the human rights of IDUs, and weak national political response to HIV and IDU identified responsible factors that make the IDUs vulnerable to HIV. Ultimately, at the layer of ‘HIV epidemic stage’, the highest HIV prevalence in the country reported among IDUs that poses a potential risk to uninfected IDUs.
Conclusion: The IDUs in Afghanistan are highly at risk and vulnerable to HIV. An informed and multi-sectoral response is required to halt the epidemic among this group. A rapid expansion of the harm reduction services is needed.
Keywords: Afghanistan, HIV, vulnerability, risk, injecting drug users.
Title: HIV risk and vulnerability among injecting drug users in Afghanistan
Author: Ahmad Shekaib Rasikh
International Journal of Thesis Projects and Dissertations (IJTPD)
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