Please cite this article in press as: Degenhardt, L., et al. What has been achieved in HIV prevention, treatment and care for people who inject drugs, 2010–2012? A review of the six highest burden countries. International Journal of Drug Policy (2013), http://dx.doi.org/10.1016/j.drugpo.2013.08.004 ARTICLE IN PRESS G Model DRUPOL-1248; No. of Pages 8 International Journal of Drug Policy xxx (2013) xxx–xxx Contents lists available at ScienceDirect International Journal of Drug Policy jo ur nal ho me p age: www.elsevier.com/locate/drugpo Review What has been achieved in HIV prevention, treatment and care for people who inject drugs, 2010–2012? A review of the six highest burden countries Louisa Degenhardt a,b,* , Bradley M. Mathers c , Andrea L. Wirtz d , Daniel Wolfe e , Adeeba Kamarulzaman f , M. Patrizia Carrieri g,h,i , Steffanie A. Strathdee j , Kasia Malinowska-Sempruch k , Michel Kazatchkine l , Chris Beyrer d a National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia b School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia c Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia d Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States e International Harm Reduction Development Program, Open Society Foundations, New York, NY, United States f Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia g INSERM, U912 (SESSTIM), Marseille, France h Université Aix Marseille, IRD, UMR-S912, Marseille, France i ORS PACA, Observatoire Régional de la Santé Provence Alpes Côte d’Azur, Marseille, France j University of California, San Diego, Division of Global Public Health, Department of Medicine, United States k Global Drug Policy Program, Open Society Foundations, Warsaw, Poland l UN Secretary-General special Envoy on HIV/AIDS in Eastern Europe and Central Asia, Geneva, Switzerland a r t i c l e i n f o Article history: Received 26 January 2013 Received in revised form 19 August 2013 Accepted 23 August 2013 Keywords: Injecting drug use, HIV, Needle and syringe programme Opioid substitution therapy, Antiretroviral therapy, Prevention a b s t r a c t Objective: In 2010 the international HIV/AIDS community called on countries to take action to prevent HIV transmission among people who inject drugs (PWID). To set a baseline we proposed an “accountability matrix”, focusing upon six countries accounting for half of the global population of PWID: China, Malaysia, Russia, Ukraine, Vietnam and the USA. Two years on, we review progress. Design: We searched peer-reviewed literature, conducted online searches, and contacted experts for ‘grey’ literature. We limited searches to documents published since December 2009 and used decision rules endorsed in earlier reviews. Results: Policy shifts are increasing coverage of key interventions for PWID in China, Malaysia, Vietnam and Ukraine. Increases in PWID receiving antiretroviral treatment (ART) and opioid substitution treat- ment (OST) in both Vietnam and China, and a shift in Malaysia from a punitive law enforcement approach to evidence-based treatment are promising developments. The USA and Russia have had no advances on PWID access to needle and syringe programmes (NSP), OST or ART. There have also been policy setbacks in these countries, with Russia reaffirming its stance against OST and closing down access to information on methadone, and the USA reinstituting its Congressional ban on Federal funding for NSPs. Conclusions: Prevention of HIV infection and access to HIV treatment for PWID is possible. Whether countries with concentrated epidemics among PWID will meet goals of achieving universal access and eliminating new HIV infections remains unknown. As long as law enforcement responses counter public health responses, health-seeking behaviour and health service delivery will be limited. © 2013 Elsevier B.V. All rights reserved. * Corresponding author at: National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia. Tel.: +61 2 9385 0333; fax: +61 2 9385 0222. E-mail address: L.Degenhardt@unsw.edu.au (L. Degenhardt). Introduction In The Lancet’s 2010 issue ‘HIV in people who use drugs’, there was a call for urgent action to prevent HIV transmission among people who inject drugs (PWID), and to ensure essential treatment and care be provided for drug dependence and HIV (Beyrer et al., 2010). To set a baseline for assessing progress, we proposed an “accountability matrix” to measure the response to HIV among PWID (Beyrer et al., 2010) in six countries that account for half 0955-3959/$ – see front matter © 2013 Elsevier B.V. All rights reserved. http://dx.doi.org/10.1016/j.drugpo.2013.08.004