TY - JOUR
T1 - Maintaining low HIV seroprevalence in populations of injecting drug users
AU - Des Jarlais, Don C.
AU - Hagan, Holly
AU - Friedman, Samuel R.
AU - Friedmann, Patricia
AU - Goldberg, David
AU - Frischer, Martin
AU - Green, Steven
AU - Tunving, Kerstin
AU - Ljungberg, Bengt
AU - Wodak, Alex
AU - Ross, Michael
AU - Purchase, David
AU - Millson, Margaret E.
AU - Myers, Ted
PY - 1995/10/18
Y1 - 1995/10/18
N2 - Objectives. - To describe prevention activities and risk behavior in cities where human immunodeficiency virus (HIV) was introduced into the local population of injecting drug users (IDUs), but where seroprevalence has nevertheless remained low (<5%) during at least 5 years. Design and Setting. - A literature search identified five such cities: Glasgow, Scotland; Lund, Sweden; Sydney, New South Wales, Australia; Tacoma, Wash; and Toronto, Ontario. Case histories were prepared for each city, including data on prevention activities and current levels of risk behavior among IDUs. Participants. - Injecting drug users recruited from both drug treatment and nontreatment settings in each city. Interventions. - A variety of HIV prevention activities for IDUs had been implemented in each of the five cities. Results. - There were three common prevention components present in all five cities: (1) implementation of prevention activities when HIV seroprevalence was still low, (2) provision of sterile injection equipment, and (3) community outreach to IDUs. Moderate levels of risk behavior continued with one third or more of the IDUs reporting recent unsafe injections. Conclusions. - In low-seroprevalence areas, it appears possible to severely limit transmission of HIV among populations of IDUs, despite continuing risk behavior among a substantial proportion of the population. Pending further studies, the common prevention components (beginning early, community outreach, and access to sterile injection equipment) should be implemented wherever populations of IDUs are at risk for rapid spread of HIV.
AB - Objectives. - To describe prevention activities and risk behavior in cities where human immunodeficiency virus (HIV) was introduced into the local population of injecting drug users (IDUs), but where seroprevalence has nevertheless remained low (<5%) during at least 5 years. Design and Setting. - A literature search identified five such cities: Glasgow, Scotland; Lund, Sweden; Sydney, New South Wales, Australia; Tacoma, Wash; and Toronto, Ontario. Case histories were prepared for each city, including data on prevention activities and current levels of risk behavior among IDUs. Participants. - Injecting drug users recruited from both drug treatment and nontreatment settings in each city. Interventions. - A variety of HIV prevention activities for IDUs had been implemented in each of the five cities. Results. - There were three common prevention components present in all five cities: (1) implementation of prevention activities when HIV seroprevalence was still low, (2) provision of sterile injection equipment, and (3) community outreach to IDUs. Moderate levels of risk behavior continued with one third or more of the IDUs reporting recent unsafe injections. Conclusions. - In low-seroprevalence areas, it appears possible to severely limit transmission of HIV among populations of IDUs, despite continuing risk behavior among a substantial proportion of the population. Pending further studies, the common prevention components (beginning early, community outreach, and access to sterile injection equipment) should be implemented wherever populations of IDUs are at risk for rapid spread of HIV.
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U2 - 10.1001/jama.274.15.1226
DO - 10.1001/jama.274.15.1226
M3 - Article
C2 - 7563513
AN - SCOPUS:0028787806
SN - 0098-7484
VL - 274
SP - 1226
EP - 1231
JO - JAMA
JF - JAMA
IS - 15
ER -