| | Times: AIDS pandemic arrives in Afghanistan with refugees, drug users
According to a story in tomorrow's New York Times (reg. req.), the AIDS epidemic has now arrived in Afghanistan, although it remains almost entirely unacknowledged in this conservative, religious country.
The incidence of the disease is presently still low compared to Afghanistan's neighbors, but it is likely to become more common due to the return of refugees, Afghans going abroad to seek work, and the growing prevalence of intravenous drug use.
Excerpts:
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Geography and migration make Afghanistan particularly susceptible. It is surrounded by countries with the fastest-growing incidence of AIDS in the world -- Russia, China and India. Other neighbors, Pakistan and Iran, have high levels of drug addiction and a growing number of HIV infections, as does Central Asia to the north, experts say. AIDS can easily cross borders, carried by migrants or refugees who picked up drug habits or had sex with infected people in those countries and returned home. Rates of drug addiction are rising in Afghanistan, with its booming opium and heroin trade.
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"In Afghanistan, all the traditional risk factors for rapid spread of HIV exist concurrently," according to Dr. Fred Hartman of Management Sciences for Health, a Boston-based group working in Afghanistan. He has worked as technical director of Reach, an American-financed program to expand health care to Afghanistan's rural communities for three years, and has advised the government on HIV/AIDS.
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The return home of more than 2 million refugees is another way the disease is likely to spread, said Renu Chahil-Graf, regional coordinator for UNAIDS, the U.N. program, who was visiting Pul-i-Charkhi prison in Kabul, where a voluntary testing clinic has opened. Some of those returning to Afghanistan have drug habits, and they spread AIDS by sexual contact with spouses, prostitutes and street children.
Afghanistan, the biggest opium- and heroin-producing country in the world, has nearly 1 million drug users, according to U.N. estimates. Most users still smoke the drug, but five years ago, injectable heroin hit the streets of Kabul, the capital. Now, there are an estimated 19,000 intravenous drug users here, according to the World Bank. Addicts are not difficult to find, living in bombed-out buildings in the old part of the city and in Kota-e-Sangi, a neighborhood on the city's south side.
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