Report on injecting drug use in Bali (Denpasar and Kuta): results of an interview survey

Autor: I.Pt.G.Terryl Adnyana, I Made Agus Setiawan, Steve Yulianto, Moh Arif, Jane H Patten, Agus Triadi
Rok vydání: 1999
Předmět:
Zdroj: International Journal of Drug Policy. 10:109-116
ISSN: 0955-3959
DOI: 10.1016/s0955-3959(98)00071-1
Popis: The number of reported HIV cases in Indonesia is growing every year, although few are officially attributed to IDU transmission. Bali has the fourth highest number of reported HIV infections among Indonesia's 27 provinces. Specific data among drug users from a public health perspective is needed to develop intervention and prevention programs. Currently management of the issue is limited to police action, high school based lectures and hospital based rehabilitation. This questionnaire study set out to gather baseline information on the knowledge, attitudes, behaviours and social background of substance abusers (mainly heroin) in the Kuta and Denpasar areas of Bali, particularly relating to public health problems, specifically AIDS and other STDs. Subjects were recruited based on prior contacts and information gained during preliminary informal observation and mapping and word-of-mouth information from key informants. Our final sample was 34 respondents (30 male and only four female), 30 of whom were currently using by injecting. It is estimated that there are up to 1000 IDUs in Bali. The young age of initiation into use of narcotics and injecting drug use is a key concern. Half of the respondents began their drug use before age 18, almost 80% before age 20. Low use of sterilised needles and high needle sharing behaviour clearly places IDUs in this sample at high risk of disease infection. This problem has recently been worsened due to the increasing price of needles and heroin with the event of the economic crisis. Sexual behaviour patterns among these IDUs further increase the risks of HIV/STD infection, including sex with sex workers (26.5%), sex with foreigners (17.6%), multi-partner (26.5%), and under the influence of drugs (70.7%) and with low condom use. Of the 34 respondents, 10 perceived that they probably or possibly were infected with HIV. There is a need for public health oriented initiatives here to balance the police action currently used to manage this issue. Development of appropriate written educational materials targeted at IDU and urban youth is necessary. A local foundation with a staff team including IDUs could undertake core programs applying the philosophy of harm reduction, involving a drop-in center for peer counselling and information distribution plus outreach. In the longer term, needle exchange and rehabilitation programs should be considered.
Databáze: OpenAIRE