Oman

Oman is a high income country with adequate medical infrastructure. However, no updated information is available on drug use. Almost all the available information on PWIDs of the country comes from a study conducted in late 2006 with a total of 184 drug users including PWIDs recruited from three settings in Muscat (Oman MoH, 2007). The study showed that PWIDs are mainly male, single, with high rate of imprisonment, and high mobility in and outside of Oman (Abu-Raddad, Ayodeji Akala, et al., 2010). Heroin, Morphine or combinations were the primary drugs of injection (Oman MoH, 2012). 

Oman has a low HIV prevalence in the general population (Oman MoH, 2012). There have been reports that the country has faced a concentrated epidemic of HIV among PWIDs from several years ago (WHO, 2007). The 2006 study on PWIDs, as well as surveillance data from the years 2005 and 2006, presented a range of HIV prevalence from 7.7% to higher rates; however, no such evidence is available for the last five years (WHO, 2007). Although PWIDs are unsystematically tested when arrested and when entering prisons and drug-treatment facilities (Oman MoH, 2012). These results are not published in country reports. Despite good HIV knowledge among PWIDs, sharing injection equipment and unsafe sex were common risk behaviors and were reported from prisons (Abu-Raddad, Ayodeji Akala, et al., 2010; WHO, 2007). To date, it is reported that 4.2% of identified HIV cases are attributed to injecting drug use (Oman MoH, 2012). Oman is planning for a new BBS on approximately 400 PWIDs in Muscat through the respondent driven sampling (RDS) method (Oman MoH, 2010).

Implementation of the last AIDS National Strategic Plan (2007-2011) was mainly focused on screening of expatriates and ART (Oman MoH, 2012). NASP is being revised and includes a comprehensive response to HIV. For the time being, in Muscat, a very small HIV prevention for PWIDs is in place and is providing needles and syringes through outreach (Oman MoH, 2012). The program has not been scaled up for years. Pharmacies do not sell syringes without prescriptions (WHO, 2007). Twenty years ago, MMT was provided, but because of the low quality and insufficient supervision, it was stopped after only a few years. Methadone has been used for detoxification since 2003 in Ibn Sina hospital, the main psychiatric hospital treating drug addiction in Muscat (WHO, 2004). Recently, permission was given to start an OST pilot project (Oman MoH, 2012). VCT service is not functional; however in 2006, a considerable proportion of PWIDs reported that they have been tested for HIV and they knew the result (WHO, 2007); this was most likely done through mandatory testing. ART is widely available in Oman (Oman MoH, 2012).

The National AIDS Program faces inadequate institutional support, understaffing and constraints in resource allocation. Criminalization and high levels of stigma and discrimination of key populations have hampered effective HIV prevention. The role of NGOs in the national response is also limited (Oman MoH, 2012). Studies on various aspects of injecting drug use are needed. Establishment of HIV testing and counseling services, OST, and rapid expansion of outreach and harm reduction interventions are necessary and should be included in the next National AIDS Program.

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