Intravenous drug users at the International AIDS Conference say their particular needs have been overlooked in broad efforts to stem the spread of the virus.
But that has changed this year, as a group of drug users has been allowed space in the venue. They hope their presence and their voices will lead to greater progress in the fight against AIDS.
Ruth says she has heard every argument against her longtime heroin use.
“People who use drugs aren’t aliens. They aren’t bent on self-destruction or interested in punching your grandmother for her TV,” Ruth said. “We’re just all making our way in this world as best we can, and some people find that drugs help them do that, and some people don’t. And I really don’t think it should be the business of those who don’t to mess with the business of those who do.”
Ruth asked us to leave her surname out of this story because heroin is illegal in her native Australia.
IV drug users
Most people view so-called recreational drugs as potentially deadly addictions. But, Ruth argues, that does not mean that regular IV drug users like her deserve to be marginalized in discussions about their elevated risk of acquiring HIV.
And so, for the first time, after years of lobbying, a small booth in the corner at this year’s conference hall proclaims: People Who Use Drugs. A member of the community also addressed the conference during the closing ceremony.
The drug users’ stand is adorned with eye-searing paintings of the five-pointed cannabis leaf, the rounded coca leaf and a splotch of bright pink something that Ruth says is a type of opium poppy.
The booth, she is quick to point out, does not dispense any illegal drugs.
But, she says, it provides visibility for a large segment of the HIV-positive community - one that was among the epidemic’s first victims, but which remains nearly silent in discussions about the illness.
Ruth says that the medical community should consider the particular circumstances of drug users, instead of flatly condemning drugs. She says the AIDS community is slowly coming around to this idea.
“I think it’s becoming more and more difficult for the international HIV and AIDS community to exclude drug users. It’s just becoming silly to do so if we’re going to tackle this epidemic, we need to be looking at the environments that allow HIV to flourish, and certainly criminalization of both sex work and drug use are the best friends of HIV,” she says.
Susie McLean, a senior adviser on HIV and drug use at the International HIV/AIDS Alliances, agrees, noting that if you exclude data from sub-Saharan Africa, 30 percent of all new HIV infections worldwide are among drug users.
“They’re not a marginal group in terms of the HIV dynamics,” McLean says. “They’re a primary group. But one of the issues that concerns us that we have tried to get across at this conference, certainly the amount of funding that those populations receive and that the organizations that are serving those populations.”
That may change following a new recommendation from the World Health Organization on the use of Naloxone, a lifesaving drug that can reverse overdoses of drugs like heroin and methadone. But the drug is controversial: some critics argue that drug users will view the antidote as an insurance policy of sorts, and become more reckless.
McLean says her group supports Naloxone, and also wants people to change the way they see drug users.
“Drug users are people like us. They’re our brothers and our sisters, our mothers and our fathers, our sons and our daughters. And we think that a lot of the problem that goes on in public policy is what I tend to call “othering” -- in which we say that people who use drugs are other people over there, and that they’re bad,” McLean says.
“And so what we try to stress is that people who use drugs are people like us. Sometimes they need help and support, always they need human rights. And the more we respond in that kind of way that’s about health and rights, the more possible it is to end HIV,” she adds.
Ruth says she wants, as her ultimate goal, the decriminalization of some illegal drugs - she argues that the criminalization of drugs is driven by politics. And like many other drug decriminalization advocates, she says oversight and regulation will make drugs safer to use and decrease the impact of illegal drug syndicates.
That is a fight that she may or may not win - but for the first time ever at a major AIDS conference, she has been welcomed into the fight against AIDS.