"I do not doubt that [the pilot program] will help a minority of ID users, but it will not influence the course of the HIV epidemic in Taiwan." This, he said, begins in the prisons, which account for 70 percent of the total new cases of HIV infection among IDUs, according to CDC statistics.
A medical research journal published by Lee and two of his colleagues early this month investigated the educational needs of heroin users in Taiwan's female prisons. The findings indicated respondents had adequate knowledge about AIDS but held misconceptions regarding the modes of transmission. Many respondents who perceived themselves unsusceptible to AIDS rarely used condoms and occasionally shared needles.
"I think the health education class is practical. Before the class, I didn't know needle sharing was a route of HIV transmission," said one of the female prisoners quoted in the report.
Those who knew infected needles could transmit HIV still expressed resistance to use sterile equipment because of inconvenience.
"We know needle sharing is a route of HIV infection but sometimes we shared needles because of the overwhelming need for an instant drug fix. Everybody tries to escape reality while they are using drugs?maybe you are the next HIV-positive, who knows," another of the respondents explained in the report.
Case study: Taoyuan
Last year Taoyuan's four prisons combined had five cases of HIV infected IDU prisoners. By June of this year the figure soared to 149 new cases.
"This is an emergency situation that needs immediate action," said Lin Sheue-rong (林雪蓉) Director General of the public health Bureau in Taoyuan County.
A poster hanging in the health bureau, and one that is plastered inside every hospital and clinic in the county reads: "One in 10 intravenous drug users will get AIDS. Injecting drugs equals AIDS."
Such scare tactics are part of the health department's harm reduction program that will include a similar anti-drug slogan pasted onto syringe packages sold in each of Taoyuan's 600 pharmacies.
A special task force of nurses and social workers will also be employed to provide risk education to IDU prisoners. Bi-monthly visits will be increased to three times a week in order to establish a relationship of trust between medical professionals and patients, and in hopes of developing peer-led outreach programs after prisoners are released back into the community.
Taoyuan's first non-government-run NEP center is also proposed to open later this year. Chen Yi-ming (陳宜民), director of the AIDS Research and Prevention Center at National Yang Ming University and Director of Living with Hope Organization is set to head the center, which will provide AIDS education in addition to sterile injection equipment and disposal sites, Lin said.
Regardless of policies that violate laws, such as needle disposal or
possible safe shooting sites, the health bureau will provide financial support, she said.
"If we wait it is going to be too late. It is already too late, but late is better late than never," she said.
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