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The following is an excerpt from an ANCD report:

The link between amphetamine-type stimulant use and the transmission of HIV and other blood-borne viruses in the Southeast Asia region.

Lao, officially known as the Lao People’s Democratic Republic (Lao PDR), is a communist, single-party state, with a population of 6.6 million. The capital, Vientiane, has a population of 730 000. Lao is a landlocked country bordered by Myanmar and China to the northwest, Viet Nam to the east, Cambodia to the south, and Thailand to the west. Lao PDR is a signatory to the IDADIN.

Amphetamine-type stimulant use

ATS pills are the most commonly used drug in Lao and there are an estimated 35 000–40 000 people dependent on ATS (United Nations Office on Drugs and Crime, 2010b). Although the type of ATS is not specified, it could be assumed that dependence is on ATS pills, as no reports of MDMA or crystal methamphetamine are recorded.

Manufacture, trafficking and seizures

There were no reports of the manufacturing of any type of ATS in Lao (United Nations Office on Drugs and Crime, 2010b). However, more than two million ATS pills were seized in 2009, compared to 1.2 million in 2008 (United Nations Office on Drugs and Crime, 2010b). The majority of ATS pills are thought to originate in nearby Myanmar, although there are reports that Lao is becoming a major transit country for ATS and precursor chemicals, with trafficking of drugs from Myanmar to Thailand (United Nations Office on Drugs and Crime, 2010b).

Injecting drug use

Data on injecting drug use in Lao are limited. One quantitative study of ATS users in the capital Vientiane and the province of Vientiane found minimal rates of injecting among 19–25 year-old current and former users of ATS (0.9% in the capital (n=223), and 1.8% in the province (n=220)) (Phimphachanh et al., 2009). However, there is concern that injecting among those living on the Lao–Viet Nam border is high and accompanied by high rates of HIV (27%) (Laos National Committee for the Control of AIDS, 2010). An estimated 2 per cent of Chinese migrant workers inject drugs. Among female migrant workers, 3.9 per cent used drugs and half reported injecting (United Nations Office on Drugs and Crime, 2010b).  Among male migrant workers, 40 per cent are thought to use drugs, of which 3 per cent reported injecting drug use. Injecting is also thought to occur among MSM populations but there were no available data.

Drug-related arrests

Arrests for ATS pills amounted to 81 per cent of total arrests in 2009, a decrease from the 94 per cent reported in 2006 and 2007 (United Nations Office on Drugs and Crime, 2010b). Between 2008 and 2009, arrests for ATS pills in 2009 increased by 60 per cent.

Drug treatment

Compulsory drug treatment centres providing ATS treatments are located in seven provinces of Lao. However, figures were available for only one centre in the capital Vientiane, where 95 per cent of admissions were for ATS users (United Nations Office on Drugs and Crime, 2010b). There are no harm reduction services in treatment centres and no information regarding ATS treatment programs.

HIV in the community and among injecting drug users

The population HIV prevalence in Lao is 0.2 per cent. Among high-risk groups, however, prevalence is considerably higher. Among MSM in the capital Vientiane, HIV prevalence is 5.6 per cent, although other regions report no HIV among this population. Among female sex workers, HIV prevalence is around 1 per cent (UNAIDS, 2010a). There are no data on HIV among PWID.

HIV testing of high-risk groups

There are now 110 specialised testing sites for sex workers and MSM in Lao, and the proportion of MSM reportedly tested for HIV tripled to 22 per cent between 2006 and 2008. However, there are no data on testing among PWID groups since they are not included as a population group in sentinel surveillance activities (Hagarty, 2010).

HIV anti-retroviral treatment

Coverage of ART in Lao is estimated at 100 per cent (Mesquita et al., 2008). However, there are no data available on HIV-positive ATS users receiving HIV ART.

Harm reduction

There are no government-sanctioned needle and syringe programs and no reports of needle and syringe distribution from NGOs (Hagarty, 2010). Limited OST for opiate dependency is available in four provinces in Lao (Hagarty, 2010). Three hospitals provide OST for approximately 64 women and OST is reportedly available in two drug treatment centres (Hagarty, 2010).

Prevention education

HIV prevention is targeted towards marginalised groups, and comprehensive interventions, including peer-led behaviour change, have been delivered to MSM and sex workers (Laos National Committee for the Control of AIDS, 2010). However, there are no prevention programs targeting PWID.