Drug dependence is a complex, chronic, relapsing condition that is often accompanied by severe health, psychological, economic, legal, and social consequences. Injecting drug users are particularly vulnerable to HIV and other bloodborne infections (such as hepatitis C) as a result of sharing contaminated injecting equipment. All drug-dependent individuals, including injecting drug users (IDUs), may be at increased risk of HIV infection because of high-risk sexual behaviors. There are an estimated 13.2 million injecting drug users (IDUs) world-wideâ€"78 percent of whom live in developing or transitional countries. The sharing of contaminated injecting equipment has become a major driving force of the global AIDS epidemic and is the primary mode of HIV transmission in many countries. In some cases, epidemics initially fueled by the sharing of contaminated injecting equipment are spreading through sexual transmission from IDUs to non-injecting populations, and through perinatal transmission to newborns. Reversing the rise of HIV infections among IDUs has thus become an urgent global public health challengeâ€"one that remains largely unmet.
In response to this challenge, the Institute of Medicine convened a public workshop in Geneva in December 2005 to gather information from experts on IDU-driven HIV epidemics in the most affected regions of the world with an emphasis on countries throughout Eastern Europe, the Commonwealth of Independent States, and significant parts of Asia. Experts from other regions also provided information on their experiences in preventing HIV infection among IDUs. This report provides a summary of the workshop discussions.
Preventing HIV Infection among Injecting Drug Users in High Risk Countries describes the evidence on the intermediate outcomes of drug-related risk and sex-related risk prior to examining the impact on HIV transmission. This report focuses on programs that are designed to prevent the transmission of HIV among injecting drug users. These programs range from efforts to curtail non-medical drug use to those that encourage reduction in high-risk behavior among drug users. Although the report focuses on HIV prevention for IDUs in high-risk countries, the Committee considered evidence from countries around the world. The findings and recommendations of this report are also applicable to countries where injecting drug use is not the primary driver, but in which injection drug use is nevertheless associated with significant HIV transmission.
Table of Contents
|1 HIV/AIDS in Injecting Drug Users||33-73|
|2 Treatment for Drug Dependence||74-136|
|3 Sterile Needle and Syringe Access and Outreach and Education||137-186|
|4 Taking Action||187-198|
|Appendix A Agenda for Information-Gathering Meeting, Geneva, December 2005||199-204|
|Appendix B Literature Search Strategies||205-210|
|Appendix C Country Case Studies||211-224|
|Appendix D Tables Summarizing the Evidence on Multi-Component HIV Prevention Programs That Include Needle and Syringe Exchange||225-268|
|Appendix E Additional Thoughts on a Community Randomized Trial of Multi-Component HIV Prevention Programs||269-273|
|Appendix F Biographies||274-282|
The National Academies Press (NAP) has partnered with Copyright Clearance Center's Rightslink service to offer you a variety of options for reusing NAP content. Through Rightslink, you may request permission to reprint NAP content in another publication, course pack, secure website, or other media. Rightslink allows you to instantly obtain permission, pay related fees, and print a license directly from the NAP website. The complete terms and conditions of your reuse license can be found in the license agreement that will be made available to you during the online order process. To request permission through Rightslink you are required to create an account by filling out a simple online form. The following list describes license reuses offered by the National Academies Press (NAP) through Rightslink:
Click here to obtain permission for the above reuses. If you have questions or comments concerning the Rightslink service, please contact:
Rightslink Customer Care
Tel (toll free): 877/622-5543
To request permission to distribute a PDF, please contact our Customer Service Department at 800-624-6242 for pricing.
To request permission to translate a book published by the National Academies Press or its imprint, the Joseph Henry Press, please click here to view more information.