Ana Cristina Garcia Ferreira

The presenters covered several aspects of substance use and mental health: factors related to sexualized use of drugs in Latin America, gaps on assessing harm reduction and HIV care in South Africa, need for mental health interventions in Peru and Mexico policing education for prevention in people who use drug.

Reyes-Diaz described the pattern of recreational drug use and sexualized drug use in a large MSM internet survey in Latin America and Beltran showed characteristics and differences of substance use, STIs, and sexual risk behavior among men drug users in Mexico – both addressing high prevalence of risky-sexual behavior, sexual transmission infection diagnosis and polydrug in MSM. Scheibe evaluate people who inject drugs assessment to harm reduction strategies and to HIV services in South Africa, addressing needs to enhance prevention support and improve engagement in HIV care cascade. Galea showed high prevalence depression among MSM and TGW in HIV services in Peru and discussed the urgent need for action, focusing on “Low intensity” interventions as a tool. Mittal presented a project to align policing education with HIV prevention among drug users in Tijuana, with improvement following intervention, especially in women officers, indicating they can be peer models of STIs prevention.

The session pointed diverse and important issues regarding prevention in people who uses drugs, improving the knowledge of this key population and addressing the gaps and needs enhancing HIV and STIs prevention. The harm reduction effectiveness is laid in a complex engagement of substance use dependence, sexual risk behavior, mental health vulnerabilities and public health policies, which were carefully addressed by the authors, considering their local contexts.

Ricardo Baruch-Dominguez

Mental health and substance use issues play a very important role in the HIV epidemic, particularly for injected drug users but also for other key populations such as MSM and trans women. Doing prevention, testing and treatment present extra challenges when drug use or mental health issues are present.

Michael Reyes showed the results from LAMIS, the Latin American Men’s Internet Survey that included some questions regarding use of drugs for sex across different countries. Oscar Beltran presented a study with people who inject drugs where a comparison was made between those IDUs who are MSM and the ones who are not MSM which is something not very common. MSM had higher risks across the different áreas explored. Andrew Schiebe showed how Southafrica has a small but important epidemic among drug users. Jerome Galea showed how mental health is important for vulnerability to HIV but also puts people already living with HIV at risk of low ARV adherence, depression and drug use. Maria Luisa Mittal showed a program that trains police officers so they can understand in a better way the needs of IDUs.

The session presented different perspectives about the topic but it was too focused in Latin America, as well as too focused on drug use and not so much about mental health. Presentations were very good for showcasing human rights violations and the need to pay attention to political will to address these issues. There was a strong call to increase research about mental health because it has been an ignored theme.