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HIV Prevention for Injecting Drug Users: The First 25 Years and Counting

From the Baron Edmond de Rothschild Chemical Dependency Institute (D.C.D.J.), Beth Israel Medical Center, New York, New York; and National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (S.S.), Centers for Disease Control and Prevention, Atlanta, Georgia.

Address correspondence and reprint requests to Don C. Des Jarlais, Beth Israel Medical Center/CDI, 160 Water Street—24th Floor, New York, NY 10038. E-mail: dcdesjarla{at}aol.com

During the last three decades, both the injection of illicit psychoactive drugs and HIV infection among injecting drug users (IDUs) have spread throughout industrialized and developing countries. Extremely rapid transmission of HIV has occurred in IDU populations with incidence rates of 10 to 50/100 person-years. In sharp contrast, there are many examples of very effective HIV risk reduction for IDUs, both in preventing initial epidemics and in bringing existing epidemics under control. IDUs are capable of learning basic information about HIV/AIDS and modifying their behavior to protect both themselves and their peers. Effective HIV prevention for IDUs requires programs that treat IDUs with dignity and respect, provide accurate information and the means for behavior change—access to sterile injection equipment, condoms, and drug abuse treatment. Programs that provide these services need to be implemented on a public health scale for IDU populations at risk for HIV infection.

Key Words: injecting drug use • HIV prevention • HIV/AIDS

Abbreviations: IDU = injecting drug user.

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