Repressive law enforcement responses to injection drug users in Southeast Asia are undermining the effort to slow the spread of HIV/AIDS in the region, analysts meeting in Bangkok said last week. Needle sharing among injection drug users could account for up to 50% of all new infections, they said.

Harassment and arrests of clients at needle exchange programs means many avoid them, while heavy-handed police crackdowns in places like Thailand have driven users deep underground, away from needle exchange programs and treatment services.

In Thailand, where a government "war on drugs" killed a reported 2,500 people over three months in 2003, police often blur the line between dealers and users, hindering efforts to treat addicts, said Precha Knokwan of the Thai Drug Users' Network. "The drug users themselves are afraid that they might be a victim of the police," he said.

It's a similar situation in Indonesia, where prisons are full of HIV-positive drug users who have no access to services, said Aditya Anugrah of the Indonesian Drug Users' Association. "Drug policies in Indonesia do not separate users from dealers," he said. That leads to needle-sharing and the spread of HIV, he said. "Our policies are focusing on sending people to jail and treating them as criminals rather than as health problems."

What is needed is harm reduction, but that requires the cooperation of governments and law enforcement, said Daniel Wolfe of the Open Society Institute. "Harm reduction measures can only work if law enforcement understands them and helps to enforce them," he said.