segçbeKalneya)ay³karBüa)alBnüarCIvit nigGñkeRbIR)as;eRKOgejonedaycak;

WHO/HIV/2005.06

P½sþútagsMrab;skmµPaBsþIGMBICMgWeGds_ nigkareRbIR)as;

eRKOgejonedaykarcak;

segçbeKalneya)ay³ karBüa)alBnüarCIvit nig GñkeRbIR)as;eRKOgejonedaycak;

eKalneya)aysegçbenH KWBinitüeLIgvijnUvP½sþútagEdlmanrhUtmkTl;eBlbc©úb,nñenH sþIGMBIkarpþl;

karBüa)alBnüarCIvit dl;GñkeRbIR)as;RKOgejonedaycak;EdlmanpÞúkemeraKeGds_ . bBaðamYycMnYn EdlBak;B½n§nwgbBaðaevC¢saRsþ/ citþsaRsþ nigbBaðasgÁmk_RtUv)anelIkeLIgpgEdr rYmTaMgtMrUvkar RKb;RKgGnþrskmµPaBén»sf nigplRbeyaCn_énkic©GnþraKmn_kat;bnßyeRKaHfñak; enAkñúgkarKaMRT dl;karEfTaMd_l¥bMput sMrab;GñkeRbIR)as;eRKOgejonedaycak;EdlmanpÞúkemeraKeGds_ . bBaðaTUeTA EdlBak;B½n§eTAnwgkarEfTaMGñkpÞúkemeraKeGds_ RtUv)ansikSa-BinitüenAkñúgGtßbTrbs;GgÁkarsuxPaB BiPBelak ¬2003¦³ {BRgIkkarBüa)alBnüarCIvit enAkñúgsßanPaBEdlFnFanmankMrit¹} enAkñúgeBl EdlkarsegçbeKalneya)aydéTeTot {P½sþútagsMrab;skmµPaB ²} pþl;nUvBt’manGMBIkarkat;bnßy eRKaHfñak;)anl¥itl¥n;Cag . ÉksareKalCMhrrbs;GgÁkar WHO/UNODC/UNAIDS sþIGMBIkarBüa)al edaysarFatuCMnYs enAkñúgkarRKb;RKgkarejonGaePon nigkarbgáarCMgWeGds_ ³ pþl;nUvkarsegçbc,as;

las; GMBIeKalCMhrrbs;GgÁkarshRbCaCati sþIGMBIkarBüa)alkarejonGaePonedaysarFatuCMnYs .

Rbvtþisegçb

kar)a:n;RbmaNbgðajfa manGñkeRbIR)as;eRKOgejon edaycak;cMnYnCag 13 lannak; enATUTaMgBiPBelak

¬^Aceijas et al. 2004¦ ehIyfa enAkñúgBiPBelak TaMgmUl karqøgemeraKeGds_fµI² BI 5 eTA 10° Gac bNþalmkBIkareRbIR)as;eRKOgejonedaycak;

¬UNAIDS 2004¦ . karrIkraldalénemeraKeGds_

enAkñúgry³eBlfµI²enH enAkñúgbNþaRbeTsCaeRcIn enA GWru:bbUBa’ nigGasIukNþal PaKeRcInKWbNþalmkBIkar eRbIR)as;eRKOgejonedaycak; . karrIkraldalén emeeraKeGds_ EdlBak;B½n§nwgkareRbIR)as;eRKOgejon

edaycak; k_)anekIneLIgxøaMgEdr enAkñúgRbeTscin

\NÐÚensIu GIur:g; PUma GaRhVikxageCIgEb:kxagt,Úg énGaemrikLaTIn nigevotNam ¬Aceijas et al. 2004;

Rhodes T et al. 1999; Lai S et al. 2001; Hien et al. 2001; Panda et al. 2000¦. karrIkraldal énkareRbIR)as;eRKOgejonedaycak; enAkñúgcMeNam mnusScas;bnþrYmcMENkdl;GRtarIkraldalx<s;én emeraKeGds_enAkñúgRbeTsGuItalI/ B½rTuyháal;/

_______________________________________

1http://www.who.int/hiv/pub/prev_care/en/ScalingUp_E.pdf 2http://www.who.int/hiv/pub/advocacy/idupolicybriefs/en/

3 GgÁkarWHO/UNODC/UNAIDS (2004)

karBüa)alCMnYsedaysarCatienAkñúgkarRKb;RKgkarejonGaePon nigkarbgáarCMgWeGds_³ ÉksareKalCMhr ^Geneva ³ GgÁkar ^WHO .

eGs,a:j/ sIVús/ hULg;d_ nigRbeTsdéTeTot enAGWr:ubEb:kbs©wm ¬^Hamers nig Downs, 2004 nig

EMCDDA, 2004¦. kMeNInya:gxøaMg KWCalkçN³mYy énkarrIkraldalemeraKeGds_ EdlbNþalmkBIkar eRbIR)as;eRKOgejonedaycak; . tYya:gdUcCaenAkñúg ÉksarCaeRcIn EdlRtUv)ancgRkg)anbBa¢ak;fa GRta rIkraldalénemeraKeGds_ kñúgcMeNamGñkeRbIR)as;

eRKOgejonedaycak; )anekIneLIgBI 12° eTA 60- 70° enAkñúg ry³eBl 2 eTA 3 qñaM bu:eNÑaH ¬^Grassly

et al. 2003; De la Fuenteetal. 2003¦. karrIkral dalénemeraKeGds_ EdlbNþalmkBIkareRbIR)as;

eRKOgejonedaycak; CaFmµtacab;epþImeLIgBIGñkeRbI R)as;eRKOgejonedaycak; Edlmanv½yekµg²ePTRbus nigtamry³skmµpøÚvePTnanarbs;BYkeK rYcehIyBRgIk karqøgtamry³karrYmePTenaH eTAkan;édKUCaRbus bJ RsI k_dUcCaqøgTark tamry³karqøgBImþayeTAkUn . karrksIupøÚvePTEdlBak;B½n§eTAnwgkaredaHdUrePT CamYynwgeRKOgejon bJsMrab;]btßmÖdl;kareRbIR)as;

eRKOgejon GacbgáCas<ancMlgrvagGñkEdleRbIR)as;

RKOgejon nigGñkEdlmineRbIR)as;eRKOgejon . kar eRbIR)as;eRKOgejonedaycak; k_GacnaMeGaymankar qøgemeraKeføImRbePT ^B/ ^C nig ^D pgEdr nigbgá eGaymanbBaðasuxPaBdéTeTotrYmman³ kareRbIhYs kMritdUs karkkQamkñúgsrésEv:n nigkarcMlgeraK F¶n;F¶reday)ak;etrIepSg²eTot . müa:geTot GñkeRbI R)as;eRKOgejonedaycak;mYycMnYn manRbvtþiyUr GEgVgénCMgWpøÚtvcitþ Edlmin)aneFIVeraKvinicä½y bJkar Büa)alRtwmRtUveLIy . GñkeRbIR)as;eRKOgejon edaycak;CaeRcInnak; RbQmmuxnwgbBaðasgÁm EdlrYm man PaBGaRsUv nigkarerIseGIgEdlBak;B½n§eTAnwgkar eRbIR)as;eRKOgejon nig sßanPaBénCMgWeGds_ nig¼bJ

CMgWeføImrbs;BYkeK . sMBaFesdækic©kñúgkar]btßmÖdl;

karejoneRKOgejon nigbT]RkidæEdlekIteLIgBIkar eRbIeRKOgejon k_dUcCac,ab;EdlpþnÞaeTabT]Rkidædl;

GñkeRbIR)as;eRKOgejonEdlmaneRKOgejonCab;nwgxøÜn enaHmann½yfa enAkñúgRbeTsPaKeRcInbMput manGñk eRbIR)as;eRKOgejonPaKeRcInRtUv)andak;Kuk EdlnaM eGaymanplvi)aksgÁm nigsuxPaBCabEnßmeTot .

lT§PaBeRbIR)as;karBüa)alBnüarCIvit

KuNPaBCIvitrbs;GñkpÞúkemeraKeGds_ . sMrab;GñkeRbI R)as;eRKOgejonedaycak; EdlmanpÞúkemeraKeGds_

karBüa)aleday ^ARV GacCYyelIkTwkcitþGñkCMgW eGaymkrkesvaEfTaMsuxPaB/ sMrYldl;karbgáar kareFVIetsþrkemeraKeGds_ nigkarpþl;RbwkSa k_dUcCa karEfTaM kar]btßmÖKaMRT nigkarBüa)alCm¶WeGds_

pgEdr . vak_CacMNucdMbUgpgEdrénkarcUlxøÜnmkrk karBüa)aleraKejoneRKOgejon nigeraKdéTeTot EdlekItCamYyKñadUcCa eraKrebg/ eraKeføImRbePT ^B nig ^C .l. b:uEnþ enAkñúgeBlEdlkarBüa)alBüarCIvit kan;EtmaneRcInenaH CaerOy² GñkeRbIR)as;eRKOgejon edaycak; enAEtminRtUv)aneKrab;bBa©ÚleT,Iy . eTaHbICaeKGacTTYl)annUvGtßRbeyaCn_TaMgenH k_eday manTsSn³TanmYycMnYnfa GñkeRbIR)as;eRKOg ejonedaycak; KWCaebkçCnd_kRm sMrab;karBüa)al

ARV edaysarGñkejoneRKOgejon mineKarBtamkar eRbIR)as;»sf bJk_edaysarbBaðasµúRKsµajénkareRbI R)as;fñaM nigCMMgWcMruHepSg²eTotdUcCa eraKeføImRbePT ^C eFIVeGayGñkeRbIR)as;eRKOgejonedaykarcak;Edlman qøgeraKcMruHenaH manPaBlM)akCaxøaMgkñúgkarBüa)al

nig mankareqøIytb)antictYc eTAnwgkarBüa)aleday

»sf ^ARV . eTaHbICa]bsKÁTaMgenH KWCabBaðaBit R)akd sMrab;mnusSCaeRcIn EdleRbIR)as;eRKOgejon edaycak;k_eday k_bTBiesaFn_d_eRcIn nigkarsikSa mYycMnYnFM)ancgRkgCaÉksarfa karEfTaMCMgWeGds_

EdlRtUv)anerobcMBiess sMrab;GñkeRbIR)as;eRKOg ejonedaycak; k_dUcCaGñkpÞúkemerakeGds_d_éTeTot Edr KWEtgTTYl)annUveCaKC½ykMritx<s; .

P½sþútag

karRKb;RKgGñkeRbIR)as;eRKOgejonedaycak; Edlqøg emeraKeGds_ minmanGIVxusKñaCadMukMPYnBIkarRKb;RKg GñkpÞúkemeraKeGds_déTeToteT . karRKb;RKgenH rYmbBa©ÚlnUvkarkMNt;dMNak;kaleraKsBaØa nigdMNak;

kalPaBsuaM^(CD4) EdlbNþalmkBIkarxUcxatPaBsuaM mkBIviFIbgáarkar nigkarBüa)aleraKqøg»kasniym nana nigkarBüa)aleday»sf ^ARV . lkçN³vinicä½y eraKsBaØa nigPaBsuaM sMrab;karcab;epþImkarBüa)al

»sf ^ARV sMrab;GñkeRbIR)as;eRKOgejonedaycak;

EdlqøgemeraKeGds_; minxusKñaBIGnusasn_TUeTA

¬^{WHO 2003}¦ enaHeT ehIyKYrRtUv)ancab;epþImeRbI R)as;edayGñkEdlqøgemeraKeGds_eTAtamdMNak;

kal dUcxageRkam³

• dMNak;kalTI 4 énCMgWeGds_ EdlRtUv)an kMNt;edayGgÁkar ^WHO, edayminKitBIcMnYn ekasika ^CD4 bJ

• dMNak;kalTI 3 énCMgWeGds_ EdlRtUv)an kMNt;edayGgÁkar ^WHO, ¬edayKitBicarNar eTAelIcMnYnekasika CD4 <350mm³ sMrab;

CYydl;kareFIVesckþIsMerc¦ bJ

• dMNak;kalTI 1 bJTI 2 énCMgWeGds_ EdlRtUv )ankMNt;edayGgÁkar ^WHO, edaycMnYn ekasika CD4 <200/mm³ .

»sf ^ARV TaMgGs;naeBlbc©úb,nñ man\T§iBlbnÞab;

bnSM nigsarCatiBulxøaMg Edl\T§iBlbnÞab;bnSM nig sarCatiBulTaMgenaH xøHGacnaMeGaymanGRtaCMgWqøg nigGRtasøab;x<s; . \T§iBlbnÞab;bnSMEdlexSayCageK nigTUeTACageK GacbgáeGaymankarxUcxatdl;kar eKarBtamkareRbIR)as;»sf nigGacnaMeGaymankgVH RbsiT§PaBkñúgkarBüa)al nigkMeNIneRKaHfñak; énkar RbqaMgtbeTAnwg»sf (drug resistance) (Dobkin 2005).

mankarbgðajGMBI kareKarB)anl¥ eTAtamkarBüa)al eday»sf ^ARV edayGñkeRbIR)as;eRKOgejoneday cak; ¬viTüasßan Open Society qñaM 2004¦ . eTaHbI Caya:gdUcenHk_eday karsikSamYycMnYnFM )ancgRkg GMBIkarlM)ak EdlCaerOy² GñkeRbIR)as;eRKOgejon edaycak; )anCYbRbTHenAkñúgkarTTYlyk nigkarrkSa xøÜneGaysßitenAkñúgkarEfTaMCMgWeGds_ nigTajyknUv GtßRbeyaCn_eBjeljBIkarEfTaMenaH k_dUcCalT§PaB CMnH eTAelI]bsKÁTaMgenH tamry³karBüa)alkar ejoneRKOgejon/ kmµviFIcuHdl;mUldæan karpþl;»sf EdlmankarRtYtBinitü nigkarBüa)alEdlRtUv)anegát edaypÞal; (directly observed therapy-DOT) (Bouhnik et al. 2002; Carrieri et al. 1999; Palepu et al. 2003; Clarke et al. 2003; Palepu et al.

2001; Pach et al. 2003; Chen et al. 2003; Wood et al. 2003; Mockroft et al. 1999; McCanne-Katz et al. 2002; Moatti et al. 2000; Carrieri et al.

2003; Lucas et al. 2004; Conway et al. 2004;

McCanne-Katz et al. 2002; Malta et al. 2003) . P½sþútagviTüasaRsþbgðajfa kmµviFIEdlpþl;karBüa)al karejonGaePonedaysarFatuCMnYs begáInnUvlT§PaB

eRbIR)as;m¢úlEdlmankarsMlab;emeraK nigpþl;nUvesva bgáardéTeTot Edlkat;bnßykarqøgemeraKeGds_fµI² enAkñúgcMeNamGñkeRbIR)as;eRKOgejonedaycak;

¬Wodak et al. 2005; Des Jarlais et al. 2005;

Farrel et al. 2005¦. kareRbIR)as;buKÁlikcuHdl;

mUldæan nigmitþGb;rMmitþ EdlmanRbvtþipÞal;xøÜnGMBIkar eRbIR)as;eRKOgejon nigkarqøgemeraKeGds_ man RbsiT§PaBKYreGaykt;sMKal; kñúgkardak;bBa©ÚlRbkb edayeCaKC½ynUvGñkEdleRbIeRKOgejonedaycak;

eTAkñúgkmµviFIEfTaMCMgWeGds_ rYmTaMgkarelIkkMBs;kar eKarBtamkarBüa)al enATUTaMgBiPBelak ¬^{Coyle et}

al. 1998; Needle et al. 2005¦ .

karBüa)alCMnYsedaysarFatuemtadUn (methadone)

bJb‘URBIN½hVIún (buprenorphine) eFIVeGayGñkejon GaePon GacrkSanUvesßrPaBénCIvitrbs;eK ecosvag bJ GacRKb;RKgbBaðaCaeRcInEdlbNþalmkBIkareRbIR)as;

eRKOgejonedaykarcak; ehIykarBüa)alRbePTenH KWCaFatumYyd_sMxan;enAkñúgyuT§saRsþ edIm,IrkSaGñk eRbIR)as;eRKOgejonedaycak; eGaysßitenAkñúgkar Büa)al ¬Mattick et al. 2002¦ . vak_pþl;pgEdrnUv cMNuccab;epþImbEnßm sMrab;BRgIkkarBüa)aleday

»sf ^ARV, elIkkMBs;nUvkareKarBtamkareRbIR)as;

»sf nigbegáInlT§PaBkñúgkarTTYlykkarEfTaM

¬Clarke et al. 2002; Moscatello et al. 2003;

Lucas 2004; WHO et al. 2004; Open Society Institute 2004; Farrel et al. 2005¦ .

RbkarsMxan;enaH eKRtUvKitTukCamunnUvGnþrskmµPaB rvagemtadUn bJb‘URBIN½hVIún CamYynwg»sf ^ARV nig RtUvEktMrUvkMritdUseTAtamenaH ¬Antoniou et al.

2002; Dobkin 2005¦ . GnþrskmµPaBEdlCMruj eGaymankarbBaÄb;kareRbIGaePonqab;eBk GacCMruj

eGaymankarlab;eTAeRbIehr:UGIun/ CMrujeGaymankar ElgTukcitþRKUeBTü nignaMeGayKµanqnÞ³TTYlykkar Büa)aleday»sf ARV (Dobkin 2005) .

eKGacRtUvkarfñaMs<wkbEnßm edIm,IBüa)alkarQWcab;

xøaMgEdlekItmanfµI² bJyUrmkehIy enAkñúgcMeNamGñk eRbIR)as;eRKOgejonedaycak; enAeBlEdleKminGac pþl;nUvkarbM)at;karQWcab;)anRKb;RKan; tamkMritdUs FmµtaRbcaMéf¶ ¬Dobkin 2005¦ . vak_mansar³sMxan;

pgEdr EdleKRtUvKitCamun nUvGnþrskmµPaB EdlGac ekIteLIg rvagfñaMs<wk nig»sf ^ARV mYycMnYn

¬sUmemIl www.hiv-druginteractions.org nig

Dobkin 2005.

GñkeRbIeRKOgejonedaycak;mYycMnYn nwgRtUv)aneKCYb RbTHenAtammnÞIreBTü/ Kuk bJenAkñúgkEnøgepSgeTot ehIyGacRbQmmuxnwgeRKaHfñak; edaysareraKsBaØa énkarQb;eRbIeRKOgejon (Withdrawal syntoms)

enAeBlEdlkareRbIR)as;GaePonrbs;BYkeK GacRtUv )anbBaÄb; . karpþl;nUvkarbnSabCatiBul edayeRbI R)as; bU‘RBIN½hVIún/ emtadun bJkøÚnIDIn GaceFIVeGayBYkeK manesßrPaB edIm,ICYysMrYldl;karvaytMéleraKsBaØa nigkarBüa)al (Umbricht et al. 2003).

karqøgeraKcMruHedayeraKeføImRbePT ^B bJ ^C nigCMgWeføIm EdlbNþalmkBIeRKOgRsvwg ekIteLIgCaTUeTAenAkñúg cMeNamGñkeRbIR)as;eRKOgejonedaycak; EdlmanpÞúk emeraKeGds_ . sßanPaBCMgWTaMgenHGacbgáIneRKaHfñak;

énCatiBulenAkñúgeføIm nigkareFIVeGaymankarxUcxat dl;RbtikmµsrIr³KImI (metabolism) rbs;»sf ^ARV mYycMnYn . eTaHbICamankarBak;B½n§TUeTA rvagCatiBul kñúgeføIm CamYynwg»sf ^ARV k_eday 90° énGñkpÞúk emeraKeGds_ edayminKitBIkarqøgeraKeføIm nwgGacsuaM

CamYynwgkarBüa)aleday»sf ^ARV edayKµan CatiBulF¶n;F¶renAkñúgeføIm ¬Sulkowski et al. 2000¦ ehtuenH eKcaM)ac;RtUvyl;dwgGMBIGnþrskmµPaB»sf EdlGacekIteLIgeLIg CaBiessenAkñúgeBlBüa)al CMgWeføImRbePT ^C .

karRKb;RKgGñkCMgWrebg CaTUeTAmanPaBRbhak;

RbEhlKña CamYyGñkEdlmanpÞúkemeraKeGds_ nigGñk EdlKµanpÞúkemeraKeGds_ ehIyeyIgmanesckþIENnaM lMGitGMBIkarBüa)alEbbenH ¬]TahrN_¶ sUmemIl

American Thoracic Society-2003¦.karBicarNar d_sMxan; rYmbBa©ÚlnUvGnþrskmµPaB rvag»sfrebgmYy cMnYn CamYynwg»sf ^ARV rvag»sfrebgmYycMnYn CamYynwgemtadUn bJb‘URBIN½hVIún nigrYmbBa©ÚlnUvkar kMNt;eBlevla énkarcab;epþImnUvkarBüa)aleday

»sf sMrab;mnusSEdlmaneraKrebgskmµ ^(Dobkin

2005) .

cMnucBak;B½n§nwgeKalneya)ay nigkar erobcMkmµviFI

GñkeRbIR)as;eRKOgejonedaycak; EdlmanpÞúkemeraK eGds_TaMgGs; mansiT§iesµIKñaCaTUeTA kñúgkarTTYlyk karBüa)aleday»sf ^ARV edayEp¥kelITsSn³sux PaBsaFarN³ nigsiT§mnusS . GñkeFIVeKalneya)ay edIrtYnaTId_sMxan;kñúgkarFananUvTsSn³xagelIenHeday eFIVkarelIkkMBs;karBüa)al GñkeRbIR)as;eRKOgejon edaycak;EdlmanpÞúkemeraKeGds_ enAkñúgRbeTs rbs;eK . kareqøIytbRKb;RCugeRCay cMeBaHemeraK eGds_ enAkñúgcMeNamGñkeRbIR)as;eRKOgejoneday cak;rYmman³ karbgáar karBüa)al nigesvaKaMRT déT eTot KWedIm,IFananUvkarTTYlykeGay)aneRcInbMput nUvesvaTaMgenHehIy)ankan;qab;kan;Etl¥ .

bEnßmBIelIemeraKeGds_ GñkeRbIR)as;eRKOgejoneday cak; )anbegáInnUv)atuPaBénkarejoneRKOgejon CMgW EdlqøgtamQam nigbBaðasuxPaBCaeRcIneTot Edl Bak;B½n§CamYynwgkarcak;eRKOgejon . karbgáar nigkarBüa)alnUvCMgWTaMgenaH )ankat;bnßyGRtaCMgWqøg nigGRtasøab; nigCYysMrYldl;dMeNIrkarEfTaMCMgWeGds_

dl;GñkeRbIR)as;eRKOgejonedaycak; .

KnøwHsMrab;karBüa)aleday»sf ^ARV nigkarBüa)al nUvral;CMgWqøgdéTeTot EdlRbkbeTAedayRbsiT§PaB enaH KWCakarvaytMél nigkarGb;rMedayRbugRby½tñ dl;buKÁl EdlnaMeTArkkarbegáItnUvEpnkarBüa)al sMrab;buKÁlmñak;²edIm,IbegáInkareKarBkarBüa)aleGay mankMritx<s; . esvasgÁm karGb;rM karKaMRT dl;kar eKarBtamkarBüa)alkarejoneRKOgejon b¤ sarFatu epSg²eTot KWCaFatud_sMxan;énkmµviFIEfTaMCMgWeGds_

EdlmanRbsiT§PaB. RbsinebIGñkeRbIR)as;eRKOgejon edaycak; GacrkSanUvkarNat;CYbBüa)al nigeKarB tamkalviPaKeRbI»sfenaH KGacmanlT§PaBeqøIytb eTAnwgkarBüa)aleday»sf ^ARV RbkbedayeCaK C½y dUcKñanwgGñkpÞúkemeraKeGds_déTeTotEdr . enA kñúgsßanPaBEdlman karEfTaMRbkbedaykarykcitþ Tukdak;enaH ral;karlab;bJkareRbIR)as;eRKOgCabnþenaH GacRtUv)ancat;Tukfa CabBaðaEdlTamTareGayman karykcitþTukdak;bEnßm nigGacRtUv)anRKb;RKgdUcKña eTAnwgCMgWdéTeTot EdlekIteLIgkñúgeBlCamYyKña .

eKalkarN_sMrab;kmµviFIEdleCaKC½y pþl;dl;GñkeRbIeRKOgejonedaykarcak;

kargarlM)akd_FMenAkñúgkarpþl;karEfTaMdl;GñkeRbIR)as;

eRKOgejonedaycak; EdlmanpÞúkemeraKeGds_enaH KWCatMrUvkarrbs;eKnUvesvaCaeRcInkñúgeBlEtmYy .

kmµviFIEfTaMevC¢saRsþEdleeCaKC½ysMrab;GñkeRbIR)as;

eRKOgejonedaykarcak; )anrkeXIjnUveKalkarN_

sMxan;²CaeRcIndUcxageRkam³

• karEfTaMevC¢saRsþþ RtUvEtmansMrab;GtifiCn nig sßitenAkñúgmUldæanEdlCaEpñkmYy énehdæa rcnasm<½n§EfTaMsuxPaBTUeTA minykéfø nig manPaBgayRsYl edaymanbuKÁlikEdlecH ykcitþTukdak; nigminlMeGog .

• karEfTaMevC¢saRsþ RtUvmanlkçN³RKb;RCug eRCay edaymanesva EdleKRtUvkarbMput kñúg cMnYnGtibrmaEdlGacmanenAkñúgmYykEnøg².

• karEfTaMevC¢saRs RtUvpþl;eTAeGayGñkeRbI R)as;eRKOgejonedaycak; eTAtamkMritkMlaMg EdlbuKÁlenaHGacTTYlyk)an edIm,IkMueGay buKÁlenaH XøatecjBIkarBüa)al .

yuT§saRsþcuHdl;mUldæan KWCaFatumYy

•

énkarEfTaMGñkCMgWeGds_ edaymankmµviFIEdl manRbsiT§PaBCaeRcIn ehIybegáIt)annUvTMnak;

TMngya:grwgmaM CamYyGgÁkarEdlmanmUldæan kñúgshKmn_ tMNageGayRkummnusSEdlrg eRKaH nigkareRbIR)as;mitþGb;rMmitþ nigGñkpþl;

RbwkSa EdlecjBIRkumTaMgenaH . karbnþnUvkarEfTaM KWCakarBicarNa

d_sMxan;

• rd_sMxan;enA

edIm,IeFIVeGayGñkeRbIR)as;eRKOgejonedaycak; Gac

Og

kñúgeBlbegáItesvaevC¢saRsþ nigsMrab;rkSa mnusSeGaysßitenAkñúgEfTaM-Büa)al . TTYlykkarBüa)aleday»sf ^ARV Rbkbeday eCaKC½yenaH vaTamTareGaymankarykcitþTukdak;

eTAelItMrUvkarBiessrbs;eK CaBiessTak;TgeTAnwg

kareKarBtamkareRbIR)as;»sfEdl)ankMNt; . kar ykcitþTukdak;ditdl; k_RtUvEteFIVeLIgpgEdrenAkñúgkar eFIVeraKvinicä½y nigkarRKb;RKgCMgWqøgepSg²dUcCa CMgW rebg CMgWeføImRbePT ^B nigRbePT ^C, GnþrskmµPaB

»sf CaBiesskñúgkarBüa)alcMruH nigkarBüa)al CMnYs .

karkMNt;eBlevlasMrab;karcab;epþImnUvkarBüa)al eday ^ARV KWCabBaðasMxan;sMrab;GñkeRbIR)as;eRK ejonedaycak;. karFanafaBYkeKTTYl)annUvBt’man RtwmRtUv nigTTYl)ankarelIkTwkcitþeGaycab;epþImkar Büa)al ehIykarvaytMél nigedaHRsaynUv]bsKÁ EdlGacmankñúgkareKarBtamkarBüa)al KWCaRbkard_

sMxan; . vakarRbesIrEdr kñúgkarBnüarbnþic cMeBaH karcab;epþImkarBüa)alenAkñúgRKb;krNI ¬elIkElgEt CMgWF¶n;F¶rbMput¦ edIm,IGacmanlT§PaBGnuvtþnUvCMhan TaMgenH CaCagkareFVIeGaykarBüa)albraC½y nig begáItPaBsauMeTAnwgfñaM (drug resistance) .

RbeTsCaeRcIneKarBtamyuT§viFIsuxPaBsaFarN³rbs;

GgÁkarsuxPaBBiPBelak sMrab;karBüa)aleday»sf

ARV EdlrYmbBa©ÚlnUvrbbfñaM ^first-line nig ^second-

line CabTdæan . RbsinebICatiBulvivtþeTACaPñak;gar

first-line enaH vaGacRtUv)anCMnYseday»sf ^ARV enAkñúgRbePTEtmYy . buKÁlmñak;² eFIVkarpøas;bþÚreTA rkkarBüa)al second-line RbsinebIkarbraC½y rbs;karBüa)alenA ^first-line ¬eraKsBaØa nigRbB½n§

karBarkñúgxøÜn¦ ekIteLIg . rbbfñaMEdlgayRsYl CaBiess RbsinebIRtUv)anpþl;eGayenAkñúgkarpSMEdl mankMritdUsefrenaH pþl;nUvKuNsm,tþid_eRcIn tamry³ cMnYnRKab;fñaMtictYc . b:uEnþ CamYyeraKqøgdéTeTot karBüa)aledaysarFatuCMnYs nigkarBüa)alCMgW

»kasniym/ enaHkarBüa)aleday»sf ^ARV minGac eFIVeLIgedayRtg;²EtmþgeT ehIykarEktMrUvGacRtUv )aneFIVeLIgCacaM)ac; (Dobkin 2005) .

edIm,ICYyeGaymankareKarBtamkarBüa)alenaH kar RtYtüBinitüCabnþnUvkarBüa)al KWCaviFId_RbesIr edIm,I tamdanrkbBaðaenAkñúgkareKarBtamkarBüa)alenaH . RbsinebIGaceFIV)an karBüa)alKYrRtUvpþl;eGayenAkúñg kEnøgEfTaMGñkCMgWTUeTA EdlGaceGayGñkpþl;karEfTaM TTYl)annUvBt’manCaGtib,rmaGMBIkareKarBtam nig kareqøIytbeTAnwgkarBüa)al . tamc,ab; enAkñúgeBl EdlGñkCMgWcab;epþImTTYlkarBüa)alenaH brimaN

»sfmYycMnYntUc KYrRtUv)anpþl;eGayenAkñúgcenøaH eBljwkjab; . enAeBlEdlsßanPaBCMgWmanesßrPaB ehIyenaH cenaHeBlénkarpþl;fñaMGacRtUv)anBnüar . pÞúymkvij GñkeRbIR)as;eRKOgejonCaRbcaMedaycak;

Edl\riyabTrbs;eKmankarERbRbYl enaHRtUv)an dak;eTAkñúgkalviPaKénkarpþl;fñaMjwkjab; edIm,IeGay eKGaceFIVkarRtYtBinitü[)anditdl; ehIykarCYyGac RtUv)aneKpþl;eGayTan;eBl .

karpSarP¢ab;rvagkarkat;bnßyeRKaHfñak;

karkat;bnßyeRKaHfñak;

¢Ún am

nig

)anbgðajBI

GnþrskmµPaB»sfénkarBüa)alCMnYs

karBüa)al eday»sf ^ARV .

nig kmµviFIBüa)al

karpSarP¢ab;ya:gCitsñiT§rvag

nigkmµviFIBüa)alCMgWeGds_ GacCYyeGaymankarBa )anqab;rh½snUvGñkeRbIeRKOgejonEdlqøgemeraK eGds_edIm,ITTYlkarEfTaM/ pþl;nUvkarRtYtBinitüt dan nigedaHRsaybBaðaGnþrskmµPaBén»sf)anl¥

ehIyCYyBRgwgnUvsarGMBIkarbgáarCMgWeGds_ TnÞwmnwg karBRgwgkarbgáarkarBarkarqøg ^HIV enAkñúgcMeNam GñkejonEdlKµanpÞúkemeraKeGds_ . kmµviFIkat;bnßy eRKaHfñak; Edl)anbegáItnUvkarTukcitþ nigkareCOCak;

KWmanbTBiesaFn_kñúgkarcuHCYbpÞal; nigkñúgkarR)aRs½y Tak;TgCamYyGµñkeRbIR)as;eRKOgejonedaycak; nig GacCYyTb;sáat;PaBsµúRKsµajEpñkevC¢saRsþ citþ saRsþ EdlbNþalmkBIkareRbIR)as;»sf nigCYy sMrYldl;karEfTaMGñkCMgWeGds_ . kmµviFITaMgenH KYrEt cUlrUYmkñúgkareFIVEpnkarkarBüa)alCMgWeGds_ dl;;Gñk eRbIR)as;eRKOgejonedaycak; edaydwknaMkarcuHdl;

mUldæan edIm,IeFVIetsþrkemeraKeGds_dl;GñkeRbIR)as;

eRKOgejonedaycak;/ eFVIkarBieRKaHeyabl; nig Büa)al ehIytamdanEfTaMGñkeRbIR)as;eRKOgejon TaMgLayEdle)aHbg;ecalkarEfTaM .

kic©GnþraKmn_mitþGb;rMmitþEdlcuHdl;mUdæan

PaBeCaKC½y enAkñúgkarGb;rM nigkarelIkTwkcitþdl;Gñk eRbIR)as;eRKOgejon eGayEsVgrkkarEfTaMEdlman RbsiT§PaB . RkumKaMRT bJkmµviFIGb;rM KYrRtUv)an begáIteLIg bJrYmbBa©ÚleTAkñúgkmµviFIBüa)alCMgWeGds_

TUeTAsMrab;GñkeRbIR)as;eRKOgejonedaycak; CaBiess edIm,IeRtomlkçN³dl;GñkeRbIR)as;eRKOgejon Edl manpÞúkemeraKeGds_ GMBI\T§iBlbnÞab;bnSMEdlekItman eLIgedaysarkarBüa)aleday»sf ^ARV nigCYy KaMRTdl;dMNménkarBüa)alpgEdr .

nig»sfBüarCIvit

»sfBnüarCIvitenaH karR)aRs½yTak;Tgjwkjab; nig edaycMhr rvagGñkpþl;karEfTaMGñkCMgWeGds_/ Gñkpþl;

karEfTaMGñkeRbIR)as;eRKOgejonEdlmanpÞúkemeraK eGds_ nigbuKÁlikpþl;karBüa)aledaysarFatuCMnYs KWCaRbkard_mansar³sMxan; enAeBlEdlcab;epþImeFVI

CaTUeTA mnusSEdlsßitenAeRkamkarBüa)aledaysar FatuCMnYs KYrRtUv)anBinitütamdanyMnYs KYrRtUv)anBinitütamdanya:gditdl; enAeBl mankarERbRbYlenAkñúgkarpþl;fñaMepSg²eTotrbs;eK nig edIm,IBinitütamdanGnþrskmµPaB CamYy»sfEdl lk;tamcieBa©Imfñl; . manKMrUCaeRcInEdlmanRbs PaB sMrab;karrYmbBa©Úl rvagkarEfTaMCMgWeGds_ nigkar Büa)aledaysarFatuCMnYs EdlkñúgenaHrYmman³

• karEfTaMevC¢saRsþedayeFIVkarbBa¢ÚnmnusSeTA kan;KøInIkEfTaMCMgWeGds_EdlenACit/

mankarERbRbYlenAkñúgkarpþl;fñaMepSg²eTotrbs;eK nig edIm,IBinitütamdanGnþrskmµPaB CamYy»sfEdl lk;tamcieBa©Imfñl; . manKMrUCaeRcInEdlmanRbs PaB sMrab;karrYmbBa©Úl rvagkarEfTaMCMgWeGds_ nigkar Büa)aledaysarFatuCMnYs EdlkñúgenaHrYmman³

• karEfTaMevC¢saRsþedayeFIVkarbBa¢ÚnmnusSeTA kan;KøInIkEfTaMCMgWeGds_EdlenACit/

iT§i

karpþl cMeBaH

hIy nþBUC/

a:gditdl; enAeBl iT§i

karpþl cMeBaH

hIy nþBUC/

• begáItkarBüa)aledaysarFatuCMnYs enAkñúg KøInIkEfTaMCMgWeGds_/ bJ

• begáItkarBüa)aledaysarFatuCMnYs enAkñúg KøInIkEfTaMCMgWeGds_/ bJ

• pþl;nUvkarEfTaMbzmenAnwgkEnøgsMrab;GñkeRbI eRKOgejonedaycak; EdlpÞúkemeraKeGds_

• pþl;nUvkarEfTaMbzmenAnwgkEnøgsMrab;GñkeRbI eRKOgejonedaycak; EdlpÞúkemeraKeGds_

enAtamkEnøgBüa)alkarejoneRKOgejon .

;nUvkarykcitTukdak;Biess RsþI nigGñkrksIupøÚvePT

enAtamkEnøgBüa)alkarejoneRKOgejon .

;nUvkarykcitTukdak;Biess RsþI nigGñkrksIupøÚvePT

mYycMnYnFMénGñkeRbIR)as;eRKOgejonedaycak; e EdlmanpÞúkemeraKeGds_ KWCaRsþIenAkñúgv½yb lT§PaBeRbIR)as;esvaBnüarkMeNIt n

mYycMnYnFMénGñkeRbIR)as;eRKOgejonedaycak; e EdlmanpÞúkemeraKeGds_ KWCaRsþIenAkñúgv½yb lT§PaBeRbIR)as;esvaBnüarkMeNIt nigesvabgáarkar cMlgemeraKBImþayeTATark-rYmTaMg karEfTaM nigkar Büa)alRsþIxøÜnÉg RtUvEtCaEpñkmYyEdlminGacxVH)an enAkñúgkarEfTaMbnþ . RsþImanépÞeBaHCaeRcInnak; Edl manemeraKeGds_ min)anTTYlnUvkarBinitüépÞeBaH nigmkBinitüEtkñúgeBlsMralb:ueNÑaH . edIm,Ibgáarkar cMlgemeraKBImþayeTATark buKÁlikenAkñúgmnÞIrsmÖB RtUvmansMPar³sMrab;eeFIVetsþPøam² (quality rapid-test kits) EdlmanKuNPaB nigmanrbbfñaMseRgÁaHbnÞan;

kñúkarsMralkUn (emergency nevirapine-based drug regimen)¹ . karpþl;nUvkareFIVetsþrkemeraKeGds_

igesvabgáarkar cMlgemeraKBImþayeTATark-rYmTaMg karEfTaM nigkar Büa)alRsþIxøÜnÉg RtUvEtCaEpñkmYyEdlminGacxVH)an enAkñúgkarEfTaMbnþ . RsþImanépÞeBaHCaeRcInnak; Edl manemeraKeGds_ min)anTTYlnUvkarBinitüépÞeBaH nigmkBinitüEtkñúgeBlsMralb:ueNÑaH . edIm,Ibgáarkar cMlgemeraKBImþayeTATark buKÁlikenAkñúgmnÞIrsmÖB RtUvmansMPar³sMrab;eeFIVetsþPøam² (quality rapid-test kits) EdlmanKuNPaB nigmanrbbfñaMseRgÁaHbnÞan;

kñúkarsMralkUn (emergency nevirapine-based drug regimen)¹ . karpþl;nUvkareFIVetsþrkemeraKeGds_

1 sUmemIlÉksarrbs;GgÁkar^WHOtamGas½ydæan³

CaRbcaMenAkñúgsßanPaBTaMgenH RtUv)aneKpþl;Gnusasn_

enAkñúgeBlEdlesvaBüa)almanvtþman ² . GñkeRbIeRKOgejonedaykarcak;TaMgburs nig

http://www.who.int/hiv/pub/mtct/en/

RsþI Edl r

Bn§naKar

;karTak;Tg RtUvcat;TukfaCa»kassMrab;

þl;

ig

lk; bJCYjdUrpøÚvePTedIm,IeRKOgejon TamTarnUvesva evC¢saRsþ nigesvasgÁmbEnßmeTot edIm,Ikat;bnßyka cMlgtampøÚvePT nigTamTarnUvkarKaMRTdl;karEfTaM nigkarBüa)al . skmµPaBmitþGb;rMmitþtammUldæan nigkarKaMRTdl;karEfTaM RtUvsMrbsMrYledIm,IeTAeGay dl;GñkTaMgLayNaEdlsßitenAkñúgeRKaHfñak;edaysar karcak;eRKOgejon nigkarrksIupøÚvePT .

briyakaspþac

karbgáaremeraKeGds_ nigkarEfTaM . karbnþesva RtUveFIVeLIgTaMgeTAkan; nigmkBIshKmn_ enAkñúgeBl EdlmnusSpøas;TI rvagshKmn_ nigTIXMuXaMg . kar bnSabCatiBulenAkñúgbriyakaspþac;karTak;TgenH

(closed seetings) RtUvmanlkçN³CabuKÁl nigRtUvp nUvkarpþac;BIkarejonedaymankarRtYtBinitü edIm,Ikat;

bnßyeGaysßitenAkñúgkMritTabbMputnUvPaBF¶n;F¶rén Gakar³EdlbNþalmkBIkarQb;eRbIeRKOgKejon n plvi)akevC¢saRsþF¶n;F¶n;epSg²eTot . RtUvbegáIteLIg nUvviFIsaRsþ nigKMrUnana edIm,ICYysMrYleGaymankic©

shRbtibtþikarrvagGñkpþl;esvaEfTaMsuxPaB nig buKálikGb;rMEkERb bJmRnþIsnþisuxsaFarN³ .

2sUmemIlesckþIENnaMGMBIkareFIVetsþCaRbcaMrbs;GgÁkar

WHO/UNAIDS tamGas½ydæan³ http://www.unaids.org/

Unaids/EN/In+focus/Topic+areas/HIV+diagnostic+tests.asp

esckþIsnñidæan

GñkeFIVeKalneya)ay RtUvEte cMNayx<s; rbs;sg

FIVkarBicarNarGMBIkar Ám nigesvasuxPaBsaFarN³Edl

øÚv

g

on GV, Hickman M and Rhodes United Nations Reference

on and Care among

(2003). Treatment nd Mortality Weekly

d 6 February 2005.

ctions between recreational drugs and antiretroviral

-

it^]

Moreau J, and Moatti (2002). Nonadherence

Y, Reynaud-Maurupt C and Chesney M (1999).

ch

IeRKOg

dou A, Lepeu G, Sobel A, and Obadia Y (2003). The Manif-2000 Study

ti

o MJ, Cloud GA, Raper JL, Chatham AG, Acosta EP, Taylor KH,

(2002). Directly observed antiretroviral therapy for injecting drug

S, Delamere S, McCullough L, Hopkins S, Bergin C, and Mulcahy F (2003). Assessing limiting factors to the acceptance of antiretroviral

bNþalmkBIkareRbIR)as;eRKOgejonedaycak; k_dUc CakMeNInénkarqøgemeraKeføImRbePT ^{B, C} nig emeraK eGds_ nigGRtasøab; RbsinebIkarBüa)alBnüarCIvit

(ARV) nigGnþraKmn_kat;bnßyeRKaHfñak; minpþl;lT§

PaBeRbIR)as;eTAdl;GñkeRbIR)as;eeRKOgejoneday cak; . kargard_lM)akenAEtsßitenAmanenAeLIyenA kñúgkaredaHRsaykarqøgemeraKeGds_enAkñúgcMeNam GñkeRbIR)as;eRKOgejonedaycak; . ]bsKÁsgÁm esdækic© nig]bsKÁpøÚvc,ab; k_dUcCabBaðapøÚvkay nigp citþ RtUvEtRtUv)anedaHRsay edIm,ITb;sáat;Rbkbeday RbsiT§PaBnUvkarraldalCMgWEbbenH nigedIm,IFananUv karEfTaMdl;GñkTaMgLayNa Edl)anrgeRKaHrYceTA ehIyenaH .

Éksareya

Aceijas C, Stims T on behalf of the

roup on HIV/AIDS Preventi G

IDU in Developing and Transitional Countries (2004) Global overview of injecting drug use and HIV infection among injecting drug users AIDS, 18:2295-2303 [karbgáar nigkarEfTaMCMgWeGds_enAkñúg cMeNamGñkeRbIR)as;eRKogeRKOgejonedaykarcak;enAkñúg RbeTskMBugGPivDÆn_ nigGnþrkal^]

American Thoracic Society, CDC and Infectious Diseases Society of America

ofTuberculosis. Morbidity a

Report 52 (RR11); 1-77. [smaKmebHdUgGaemrik/

smaKmRbyuT§nwgCMgWqøgrbs;Gaemrik ¬2003¦ . karBüa)alCMgWrebg^]

http://www.cdc.gov/mmwr/preview/mmwrhtml/

rr5211a1.htm cite

Antoniou T and Tseng L (2002). Intera agents. Annual of Pharmacotherapy, 36:1598 1613. [GnþrskmµPaBrvageRKOggejon nig»sfBnüarCIv

Bouhnik AD, Chesney M, Carrieri P, Gallais H, among HIV-infected injecting drug users: the impact of social instability. American Journal of Addiction, 11(4):271-8. [karmintmtamkarBüa)al enAkñúgcMeNamGñkeRbIR)as;eRKOgejonedaycak; Edlman pÞúkemeraKeGds_³ plb:HBal;énGesßrPaBsgÁm^]

Carrieri MP, Moatti JP, Vlahov D, Obadia Access to antiretroviral treatment among Fren HIV infected injection drug users: the influence of continued drug use. Journal of Epidemiological Community Health, 53:4–8. [lT§PaBeRbIR)as;

karBüa)alBüarCIvitenAkñgcMeNamCnCati)araMgEdleRb ejonedaycak; ehIyqøgemeraKeGds_³ \T§iBlénkar eRbIeRKOgejonedayminQb;^]

Carrieri MP, Rey D, Loun

Group. Evaluation of buprenorphine maintenance treatment in a French cohort of HIV-infected injecting drug users. Drug Alcohol Dependence, 72:13-21. [karvaytMélGMBIkarBüa)alkaredaysarCa bU‘RBIN½hVIún enAkñúgcMeNamRkumCnCati)araMgEdleRbIeRKOg ejonedaycak; ehIyqøgemeraKeGds_^]

Chen RY, Westfall AO, Mugaver

Carter J and Saag MS (2003). Duration of Highly Active Antiretroviral Therapy Regimens. Clinical Infectious Diseases, 37:714–22 [ry³eBlénrbbfñaM BnüarCIvitEdlmanskmµPaBxøaMg^]

Clarke S, Keenan E, Ryan M

users with HIV; The AIDS Reader 12(305-7):

412-316. [karBüa)alBnüarCIvitedaymankarsegát eday pÞal; sMrab;GñkeRbIERKOgejonedaycak; EdlmanpÞúkemeraK eGds_^]

Clarke

therapy in a large cohort of injecting drug users.

HIV Medicine, 4:33–7. [karvaytMélktþakMNt;kñúgkar TTYkyknUvkarBüa)alBnüarCIvit enAkñúgRkummnusSEdleRbI eRKOgejonedaycak;^]

Conway B, Prasad Jones M, Jutha S, S

J, Reynolds R, Farley J, mith N, Mead A and DeVlaming S (2004). Directly Observed Therapy

in

raK

rug users: A review of published outcome data. In:

rBintü

o G, Parras F, I (2003).

Lessons from the History of the Human

h Drug

gejon^]

International Journal of Drug Policy

are and Drug Users, WHO, Geneva, Switzerland. Forthcoming.

E 04, European Monitoring Centre for

Farrell M, Gowing L, Walter Ling J M and Ali R ournal

Grassly NC, Lowndes CM and Rhodes T (2003).

e :25–43.

Hamers FF and Downs AM (2004) The changing

ien N, Giang L, Binh P, Deville W, van

ctors of

Lai S, Liu W, Chen J, Yang J, Li ZJ, Li RJ, Liang in 0.

for the Management of HIV–Infected Patients a Methadone Program. Clinical Infectious Diseases, 38:S402–8. [karBüa)alBnüarCIvitEdlman karsegátedaypÞal; sMrab;RKb;RKgGñkCMgWEdlqøgeme eGds_ enAkñúgkmµviFIBüa)aledayeRbIsarCatiemtadUn^]

Coyle SL, Needle RH, Normand J (1998).

Outreachbased HIV prevention for injecting d Needle RH, Coyle S,Cesari H, editors. HIV prevention with drug-using populations–current status and future prospects. Public Health Reports, 113(Suppl 1):19-30. [karbgáaremeraKeGds_

enAtammUldæansMrab;GñkeRbIeRKOgejonedaycak;³ ka eLIgvijnUvTinñn½ylT§plEdl)anpSBVpSay . karbgáar emeraKeGds_CamYynwgRkummnusSeRbIeRKOgejon- sßanPaB bc©úb,nñ nigTsSn³vis½ysMrab;GnaKt^]

De la Fuente L, Bravo MJ, Barri Suarez M, Rodes A and Noguer

Immunodeficiency Virus/Acquired Immunodefi ciency Syndrome Epidemic among Spanis Injectors. Clinical Infectious Diseases, 37 (Supplement 5): S410–5. [emeronEdlTTYl)anBIRbvtþi CMgWeGds_enAkñúgcMeNamCnCatieGs,a:jEdleRbIeRKO

Des Jarlais et al. (2005). Interventions to reduce the sexualrisk behaviour of injection drug users.

(Supplement). Forthcoming. [GnþraKmn_edIm,Ikat;bnßy

\riyabTeRkaHfñak;rbs;GñkeRbIeRKOgejon^]

Dobkin, J (2005). Comprehensive C Treatment of HIV-Positive Injecting

[karEfTaMeBjelj nigkarBüa)alGñkeRbIeRKOgejonEdl manCMgWeGds_^]

MCDDA 20

Drugs and Drug Addiction. Annual report on the state of the drugs problem in the European Union and Norway 2004, EMCDDA, Lisbon, 2004.

http://anualreport.emcdda.en.int [mCÄmNÐlBinitü tamdaneRKOgejon nigkarejoneRKOgejon . r)aykarN_

RbcaMqñaMsþIGMBIsßanPaBénbBaðaeRKOgejonenAkñúgshKmn_GWr:ub nigRbeTsN½rev:^]

(2005). Effectiveness of drug dependence treatment in HIV prevention. International J of Drug Policy (Supplement). Forthcoming.

[RbsiT§PaBénkarBüa)alkarejoneRKOgejonkñúgkarbgáar emeraKeGds_^]

Modeling emerging HIV epidemics: the role of injection drug use and sexual transmission in th Russian Federation, China, and India.

International Journal of Drug Policy, 14 [karbegáItKMrUénkarratt,atemeraKeGds_³ tYnaTIénkareRbI eRKOgejonedaykarcak; nigkarcMlgCMgWkameraKenAkñúg shB½n§rusSIú^]

face of the HIV epidemic in western Europe:

what are the implications for public health policies? Lancet 364:83-94 [karERbRbYlénkar raldalemeraKeGds_enAkñúgGWr:ubbs©wm³ etIGIVeTACatMruy sMrab;eKalneya)aysuxPaBsaFarN³?^]

H

Ameijden E and Wolffers I (2001). Risk fa HIV infection and needle sharing among injecting drug users in Ho Chi Minh City, Vietnam. Journal of Substance Abuse, 13:45–58.

[ktþaeRKafñak;énkarqøgemeraKeGds_ nigkareRbIm¢úlrYmKña enAkñúgcMeNamGñkeRbIeRKOgejonedaykarcak;enAkñúgTIRkug hUCImij RbeTsevotNam^]

FX, Liang SL, Zhu QY and Yu XF. (2001).

Changes in HIV-1 incidence in heroin users Guangxi province, China.

Journal of AIDS, 26:365–7 [karERbRbYlénGRtaqøg emeraK ^HIV-1 enAkñúgcMeNamGñkeRbIehr:UGIunenAkñúgextþxVagsIu RbeTscin^]

Lucas GM, Weidle PJ, Hader S and Moore RD (2004). Directly Administered Antiretroviral Therapy in an Urban Methadone Maintenance Clinic: A Nonrandomized Comparative Study.

Clinica Infectious Diseases, 38:S409–13 [karBüa)aledayeRbI»sfBnüarCIvitedaypÞal;enAkñúgKøInIk Büa)alkarejonedayemtadUnenATIRkug^]

Malta M, Carneiro-da-Cunha C, Kerrigan D, Strathdee SA, Monteiro M and Bastos FI (2003).

Case management of human immunodeficiency virus-infected injection drug users: a case study in Rio de Janeiro, Brazil. Clinical Infectious Diseases, 15;37 Supplement 5:S386-91.

[karRKb;RKgCMgWenAkñúgcMeNamGñkeRbIeRKOgejonedaycak;

EdlqøgemeraKeGds_^]

Mattick RP, Breen C, Kimber J, Davoli M (2002).

Methadone maintenance therapy versus no opioid replacement therapy for opioid dependence (Cochrane review). In: The Cochrane Library, Issue 4. [karBüa)alCMnYseday emtadUn CamYynwgkarBüa)alCMnYsedayKµanCatiGaePon sMrab;karejobGaePon ^]

Moatti JP, Carrieri MP, Spire B, Gastaut JA, Cassuto JP and Moreau J (2000). Adherence to HAART in French HIV-infected injecting drug users: the contribution of buprenorphine drug maintenance treatment. Journal of Acquired Immune Defi ciency Syndrome, 14:151-5.

[kareKarBtamkarBüa)al ^HAART enAkñúgcMeNamCnCati eRbIeRKOgejonedaykarcak; EdlmanemeraKeGds_³ karrYmviPaKTanrbs;karBüa)alCMnYsedayb‘URBIN½hIVún ^]

McCance-Katz EF, Gourevitch MN, Arnsten J, Sarlo J, Rainey P and Jatlow P (2002). Modified directly observed therapy (MDOT) for injection drug users with HIV disease.

American Journal of Addiction, 11(4):271-8. [kar Büal)alEbb ^MDOT sMrab;GñkeRbIeRKOgejonedaycak;

ehIyEdlmanpÞúkemeraKeGds_^]

McCance-Katz EF, Gourevitch MN, Arnsten J, Sarlo J, Rainey P and Jatlow P (2002). Modified directly observed therapy (MDOT) for injection drug users with HIV disease.

American Journal of Addiction, 11(4):271-8. [kar Büal)alEbb ^MDOT sMrab;GñkeRbIeRKOgejonedaycak;

ehIyEdlmanpÞúkeGds_^]

Mocroft A, Madge S, Johnson AM, Lazzarin A, Clumeck N, Goebel FD, Viard JP, Gatell J, Blaxhult A and Lundgren JD (1999).

A comparison of exposure groups in the EuroSIDA study: starting highly active antiretroviral therapy (HAART), response to HAART and survival. Journal of Acquired Immune Defi ciency

Syndrome, 22:369-378. [kareRbobeFobRkumEdl RbQmmuxnwgeRKaHfñak;enAkñúgkarsikSaCMgWeGds_enAGWr:ub³ karcab;epþImBüa)aleda»sfBnüarCIvit ^ARV EdlxøaMg

(HAART) kareqøIytbeTAnwgkarBüa)alEbb ^HAART nigkarrs;ranmanCIvit^]

Moscatello G, Campello P, Benettuci JA (2003).

Bloodborne and sexually transmitted in drug users in a hospital in Buenos Aires, Argentina.

Clinical Infectious Diseases 37 Supplement 5:S343/7 [CMgWEdlqøgtamQam nigCMgWkameraKenAkñúg cMeNamGñkeRbIeRKOgejonenAkñúgmnÞIreBTüenAkñúgtMbn;

Buenos Aires énRbeTs Argentina]

Needle R H, Burrows D, Friedman S, Dorabjee J, Touzé G, Badrieva L, Grund J-P C, Suresh Kumar M, Nigro L, Manning G and Latkin C (2005). Effectiveness of community-based outreach in preventing HIV/AIDS among injecting drug users. International Journal of Drug Policy (Supplement). Forthcoming. [RbsiT§PaBénskmµPaB cuHdl;mUldæanenAkñúgshKmn_kñúkarbgáarCMgWeGds_enAkñúg cMeNamGñkeRbIeRKOgejonedaycak;^]

Open Society Institute (2004). Breaking down the barriers Lessons on Providing HIV Treatment to Injecting Drug Users. New York, International Harm Reduction Programme. Open Society Institute. [karraylMGitGMBIemeronEdlTTYl)an sþIGMBI ]bsKÁkñúgkarpþl;karBüa)alCMgWeGds_dl;GñkeRbIeRKOgejon edaycak;^]

www.soros.org/initiatives/ihrd/articles_publication s/publications/arv_idus_20040715

Pach A 3rd, Cerbone FG and Gerstein DR (2003). A Qualitative Investigation of Antiretroviral Therapy Among Injection Drug Users. AIDS and Behavior, Vol. 7, n° 1. [kar GegátGMBIkarBüa)alBnüarCIvitenAkñúgcMeNamGñkeRbI eRKOgejonedaycak; ^]

Palepu A, Yip B, Miller C, Strathdee SA, O’Shaughnessy MV, Montaner J and Hogg RS.

(2001). Factors associated with the response to antiretroviral therapy among HIV-infected patients with and without a history of injection drug use. AIDS, 15:423–4. [ktþaBak;B½n§enAkñúgkar eqøIytbeTAnwgkarBüa)alBnüarCIvit enAkñúgcMeNamGñkCMgW EdlqøgemeraKeGds_ EtKµanRbvtþieRbIeRKOgejoneday karcak;^]

Palepu A, Tyndall M, Yip B, O’Shaughnessy MV, Hogg RS and Montaner JS (2003). Impaired virologic response to highly active antiretroviral therapy associated with ongoing injection drug use. Journal of Acquired Immune Deficiency Syndrome, 32(5):522-6 [kareqøIytbvIrus EdlcuHexSay cMeBaHkarBüa)aleday»sf ^ARV EdlxøaMg Bak;B½n§eTAnwg kareRbIR)as;GaePonedaycak;^]

Panda S, Chatterjee A, Bhattacharya SK, Manna B, Singh PN, Sarkar S, Naik TN, Chakrabarti S and Detels R (2000). Transmission of HIV from injecting drug users to their wives in India.

International Journal STDAIDS, 7:468–73.

[karqøgemeraKeGds_BIGñkeRbIeRKOgejonedaycak;

eTARbBn§rbs;eKenAkñúgRbeTs\NÐa^]

Rhodes T, Ball A, Stimson GV, Kobyshcha Y, Fitch C, Pokrovsky V, Bezruchenko-Novachuk M, Burrows D, Renton A and Andrushchak L.

(1999). HIV infection associated with drug injecting in the newly independent states, eastern Europe: the social and economic context of epidemics. Addiction 94:1323–36. [karqøg emeraKeGds_EdlBak;B½n§eTAnwgkarcak;eRKOgejonenAkñúg rdæEdleTIbnwgTTYl)anÉkraCü enAkñúgGWr:ubxagekIt³ sßanPaBénkarraldaleTAtamsgÁm nigesdækic©^]

Sulkowski MS, Thomas DL, Chaisson RE and Moore RD (2000). Hepatotoxicity associated with antiretroviral therapy in adults infected with the human immunodeciency virus and the role of

hepatitis C or B virus infection. Journal of the American Medical Association, 283:74-80. [kar manCatiBulenAkñúgeføImEdlbNþalmkBIkarBüa)aleday

»sf ^ARV enAcMeNammnusSeBjv½yEdlqøgemeraKeGds_

nigtYnaTIrbs;emeraKeføImRbePT ^B bJ ^C]

Umbricht A., Hoover D, Tucker, Leslie, Chaisson R and Preston K (2003). Opioid detoxification with buprenorphine, clonidine, or methadone in hospitalized heroin-dependent patients with HIV infection. Drug and Alcohol Dependence, 69:

263-272 [karbnSabCatiGaePonedayeRbIb‘URBIN½hIúVn køÚnIDIn bJemtadUnenAkñúgcMeNamGñkejonehr:UGIunEdlqøgemeraK eGds_^]

UNAIDS (2002). Report of the Global HIV/AIDS Epidemic, Geneva, Switzerland.

[r)aykarN_rbs;GgÁkar ^UNAIDS sþIGMBIkarraldalénCMgW eGds_enAkñúgBiPBelak^]

Wodak et al. (2005). Effectiveness of sterile needle and syringe programmes. International Journal of Drug Policy (Supplement).

Forthcoming. [RbsiT§iPaBénkmµviFIm¢úl nigsWraMg Edl RtUv)ansMlab;emeraKrYcehIy^]

Wood E, Montaner JS, Yip B, Tyndall MW, Schechter MT, O’Shaughnessy MV and Hogg RS (2003). Adherence and plasma HIV RNA responses to highly active antiretroviral therapy among HIV-1 infected injection drug users.

Canadian Medical Association Journal, 169(7):656-61. [kareKarBtamkarBüa)al nigeqøIytb rbs; plasma HIV RNA cMeBaHkarBüa)alBnüarCIvitEdl xøaMgenAkñúgcMeNamGñkeRbIeRKOgejonedaycak; Edlman emeraK ^HIV-1]

World Health Organization, United Nations Offi ce on Drugs and Crime and Joint United Nations Programme on HIV/AIDS (2004) Substitution maintenance therapy in the management of opioid dependence and HIV/AIDS prevention:

position paper Geneva: World Health Organization

[karBüa)aledayCMnYs enAkñúgkarRKb;RKgkarejonGaePon nigkarbgáarCMgWeGds_³ ÉksareKalCMhrTIRkug hSWENv GgÁkarsuxPaBBiPaBelak^]

sMrab;Bt’manbEnßmeTot sUmTak;Tg^: GgÁkarsuxPaBBiPBelak Epñk^HIV/AIDS tamGas½ydæan³

20, avenue Appia CH-1211 Geneva 27 Switzerland E-mail: hiv-aids@who.int

http://www.who.int/hiv/en