54 HIV Epidemics Driven by Injecting Drug Users: Observations from the former Soviet Union Kasia Malinowska-Sempruch Intl Harm Reduction Prgm, Open Society Inst, New York, NY, USA

A number of countries known as the former Soviet Union are now struggling with significant HIV infections attributed to injecting drug use.  The presentation will explore the social, economic and political reasons for these epidemics.  It will provide available data on HIV and injecting drug use in this region.  It will discuss necessary strategies for intervention in the areas of prevention -- harm reduction and sexual care for drug users; and care and treatment -- availability and obstacles for treatment, issues of adherence among drug users, necessity for substitution therapy to accompany HIV treatment efforts.  Finally, it will discuss relevant international and national policies obstructing HIV prevention and treatment efforts designed for drug using communities.  Lessons learned from the former Soviet Union are applicable to other parts of the world where HIV is attributed to injecting drug use and those parallels will be explored.