“HIV is principally transmitted by sexual intercourse in Mauritius.” This is what a lot of people seem to think, according to a recent survey commissioned by PILS. Maybe campaigns have not been properly carried out, maybe the media have not put enough emphasis on the facts, or maybe people are just not interested to know. However, last year, 87% of new cases were injecting drug users (IDUs), and this percentage is gradually increasing.

HIV is wreaking havoc among IDUs. According to the AIDS Unit, about one fifth of drug users on rehabilitation are HIV positive. But what about those who are not on rehabilitation? According to a NATReSA study, the number of drug users in Mauritius is around 17,000 and rehabilitation centres can cater for only some 300. What then is the situation for the 16,700 who, without any cure, are even more exposed to the virus?

Why is the virus on the rise among drug users? To answer this, one must understand the world of a drug user. Suffering is physical when withdrawal symptoms appear. When in this state, an IDU suffers from body pains that can only be soothed by an injection of “brown sugar”. He/she will thus do anything to relieve his pain and will not bother to find a clean needle, because, at this point, any needle will do.

Even if an IDU wanted to use a new needle, it is illegal to be in possession of a syringe without a prescription. Since needles are scarce, IDUs have no other choice than to share a needle. One HIV positive user can thus lead to five or six new cases within minutes. In March, out of 78 new cases, 74 were IDUs, thus bringing the rate to 95%.

However, this problem is not limited to the IDU community. HIV positive people who are sexually active, can just as easily spread the virus. This is indeed what is happening.

Most of us probably still think that commercial sex workers are the most affected among women. But housewives are just as concerned by the spread of HIV. Maybe we should say this out loud more and more. According to official figures, 44% of HIV positive women are housewives and only 40% are prostitutes…

And we might be far from reality… So opening our eyes could be the first step we can all take because we are indeed all concerned.

The coalition “HIV Urgency” made up of NGOs, rehabilitation centres and social workers, assumes the State spends more than Rs 142,000 per year for each HIV positive person for anti-retroviral treatment (ARV) and other treatment linked to his/her ‘serostatus/positivity’. With a total of 1,309 official HIV positives, the State thus has to spend more than Rs 186 million per year. And new cases of HIV positive people are increasing every day. We are thus talking about a national problem. And this implies taking national action… HIV is spreading among IDUs, so why not take action where the need is?

Maybe we should stop thinking that a needle exchange program will encourage drug use. Clean or not, needles will be used by IDUs when withdrawal symptoms appear. A risk reduction program might therefore be carried out in recognised centres in collaboration with the AIDS Unit. The latter, as well as other NGOs say they are ready to implement the program, but are still waiting for legal amendments from the highest levels. After all, this program is already part of the government’s action plan. Why not have the guts to implement it for the benefit of the country? Why not give them the opportunity to minimise the risk of HIV (as well as hepatitis) while waiting for the setting up of more rehabilitation centres?

If this program consists of needle exchange, not mere distribution, and if the AIDS Unit can control and follow up this program, why not try to consider its relevance? The whole world is talking about behaviour change to fight HIV/AIDS, Why can’t we start being realistic about the issues linked with HIV and IDUs?