Columbia International Affairs Online: Working Papers

CIAO DATE: 07/2010

HIV Prevention among Injection Drug Users: Strengthening U.S. Support for Core Interventions

Richard H. Needle, Lin Zhao

April 2010

Center for Strategic and International Studies

Abstract

In 2008, the United States agreed to extend and expand its historic global HIV/AIDS program, authorizing up to $48 billion over five years to combat global HIV/AIDS, tuberculosis, and malaria.1 In its first phase (2004–2008), the President’s Emergency Plan for AIDS Relief (PEPFAR) concentrated most of its resources and attention on countries in sub-Saharan Africa, with a priority focus on expanding access to treatment with antiretroviral therapy (ART).2 Among the primary accomplishments of the initiative in its first phase was to demonstrate the feasibility of mass provision of life-saving ART treatment in low-income African countries hardest hit by the HIV pandemic.3 But despite the major gains in ART access since 2003, it is estimated that for every two people starting HIV treatment today, another five are newly infected. PEPFAR’s second phase (2009–2013) continues and expands treatment scale-up and prevention with the intent of transitioning from an emergency program to a sustainable country-driven and -managed response. The program will be judged, in large part, on the progress it makes in halting the further spread of HIV.