Overland heroin trafficking routes and HIV-1 spread in south and south-east Asia.

摘要: Objectives: Burma produces approximately 60% of the world’s heroin, Laos is third leading producer. Recent outbreaks injecting drug use and HIV-1 in Burma, India, China, Vietnam have been associated with Burmese Laotian overland heroin trafficking routes. We analyzed findings from narcotics investigations, molecular epidemiology studies HIV-1, epidemiologic behavioral use, to evaluate roles that export routes play spread south south-east Asia. Methods: reviewed medical literature, HIV, did key informant interviews users, traffickers, public health staff, control personnel. Results: Four recent among users appear linked Route 1: From Burma’s eastern border China’s Yunnan Province, initial subtype B, later C. 2: Eastern Yunnan, going north west, Xinjiang C, a B/C recombinant subtype. 3: Laos, through northern Vietnam, Guangxi E. 4: Western across Burma‐India Manipur, predominant B Conclusions: Overland dual epidemics HIV infection three Asian countries along four Molecular useful for mapping Single country programs are unlikely succeed unless regional narcotic-based economy addressed.