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Suggested Citation:"Appendix F Biographies." Institute of Medicine. 2007. Preventing HIV Infection Among Injecting Drug Users in High-Risk Countries: An Assessment of the Evidence. Washington, DC: The National Academies Press. doi: 10.17226/11731.
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Appendix F
Biographies

COMMITTEE MEMBERS

Hugh Tilson, M.D., DrP.H. (Chair), is a Clinical Professor of Public Health Leadership and an Adjunct Professor of Epidemiology and Health Policy at the School of Public Health at the University of North Carolina(UNC). Dr. Tilson received his Doctorate of Medicine (M.D.) from Washington University in St. Louis, Missouri (1964). He is also a Board Certified Specialist in Preventive Medicine and holds both a master’s degree and doctoral degree in Public Health from the Harvard School of Public Health (1969– 1972). Dr. Tilson is a practicing epidemiologist and outcomes researcher, with a career in preventive medicine and public health spanning more than 40 years. Fifteen years of public service includes duties as a U.S. Army Preventive Medicine Officer in Europe; Consultant to the Federal Office of Economic Opportunity, National Center for Health Services Research, and Veterans Administration; Local Public Health Officer and Human Services Director for Portland, Oregon; and State Public Health Director for North Carolina. Before leaving Oregon for duties in North Carolina, he served as President of the National Association of County Health Officers. He spent 15 years in the multinational pharmaceutical industry for the Wellcome Foundation, latterly GlaxoWellcome. He was founding Co-President of the International Society for Pharmacoepidemiology. In June 1996, he joined the faculty of the UNC School of Public Health. Dr. Tilson currently serves on the faculties of the North Carolina Schools of Medicine, Pharmacy and Public Health, where he is both Clinical and Adjunct Professor. He has

Suggested Citation:"Appendix F Biographies." Institute of Medicine. 2007. Preventing HIV Infection Among Injecting Drug Users in High-Risk Countries: An Assessment of the Evidence. Washington, DC: The National Academies Press. doi: 10.17226/11731.
×

served as Chair of the Clinical Steering Committee for the Pharmaceutical Research and Manufacturers Association (PhRMA). A Fellow of the American College of Epidemiology, and former Vice-Chair of the American Board of Preventive Medicine, Dr. Tilson also served as President of the American College of Preventive Medicine from 1995 to 1997. A founding member of the American Academy of Pharmaceutical Physicians, now the Academy of Pharmaceutical Physicians and Investigators (APPI), he is APPI Vice-President for Policy. Dr. Tilson has served as a member of seven IOM committees, and served as Chair of the Committee on Post-market Surveillance of Pediatric Medical Devices.


Apinun Aramrattana, M.D., Ph.D., is a medical epidemiologist and a leading drug use researcher in Thailand. He is the Deputy Director of the Research Institute of Health Sciences and also the Director of the Northern Substance Abuse Center at Chiang Mai University. Dr. Apinun has been one of the principal researchers who organized the first and second national household surveys of drug use in Thailand in 2001 and 2003. He is the Thailand Principal Investigator on a number of National Institutes of Health (NIH)-supported HIV prevention trials for injection drug users and methamphetamine-using youth, and he is directing a study for the HIV Prevention Trials Network on buprenorphine/naloxone substitution maintenance therapy vs. buprenorphine/naloxone detoxification as an HIV prevention strategy. He also works closely with relevant narcotics control agencies to facilitate policy-relevant research and development projects.


Samuel A. Bozzette, M.D., Ph.D., is Senior Natural Scientist at The RAND Corporation and Adjunct Professor of Medicine (Infectious Diseases) and of International Relations at the University of California (UC) San Diego. He is board-certified in Internal Medicine and Infectious Diseases, and is a Fellow of the American College of Physicians and the Infectious Diseases Society of America. He has a long record of clinical, translational, outcomes, and health economics research, resulting in over 125 scientific publications in universally respected journals and three dozen chapters, reports, and editorials. He headed the Opportunistic Infections and later the Outcomes working groups for the National Institute of Allergy and Infectious Disease’s (NIAID’s) AIDS Clinical Trials Group and was a leader in the California Collaborative Treatment Group. He has been a Principal Investigator for many large research projects, such as the nationally representative HIV Cost and Services Utilization Study. He founded the Center for Research in Patient-Oriented Care at the Veteran Affairs (VA) San Diego and did seminal work in modeling of potential bioterrorist attacks. Dr. Bozzette is involved in teaching clinical and research skills, and co-directs a training program in Public Policy and Biologic Threats for the

Suggested Citation:"Appendix F Biographies." Institute of Medicine. 2007. Preventing HIV Infection Among Injecting Drug Users in High-Risk Countries: An Assessment of the Evidence. Washington, DC: The National Academies Press. doi: 10.17226/11731.
×

Carnegie Corporation and the UC Institute on Global Conflict and Cooperation. He is a member of the American Society for Clinical Investigation and the Association of American Physicians. Dr. Bozzette holds an M.D. from the University of Rochester and a Ph.D. in Policy Analysis with Distinction in Economics and Quantitative Methods from the Pardee RAND Graduate School of Policy Studies. He has participated in many national, institutional, and civic committees, including an IOM committee on reviewing data needs for the Ryan White Care Act, the VA’s National Committee on Clinical Practices Guidelines, and advisory boards for the Zoological Society of San Diego.


David D. Celentano, Sc.D., M.H.S., is a Professor and Director of the Infectious Disease and Epidemiology program and Deputy Chair of the Department of Epidemiology, with joint appointments in the School of Medicine, and International Health and Health, Behavior and Society at the Johns Hopkins University Bloomberg School of Public Health. His research integrates behavioral science theory and research with epidemiology, in the study of infectious diseases. While trained in a chronic disease paradigm (alcoholism and cancer control), he began his research in HIV/AIDS and sexually transmitted diseases (STDs) in the early 1980s. He has worked on some of the major cohort studies (ALIVE, MACS) in HIV epidemiology, as well as conducted intervention research in the United States for heterosexual men and women, injection drug users, and young men who have sex with men. He returned to international research in 1990, when he began a long-term collaboration with Chiang Mai University in northern Thailand. He has worked on and directed numerous HIV/AIDS and STD epidemiological investigations and preventive interventions. More recently, his group has been conducting a prospective study of hormonal contraception in relation to HIV seroconversion, a study with significant family planning policy and health implications. He is currently the Principal Investigator of four NIH-supported studies in Thailand and one in India, focusing on interventions to influence the association between opiate use, methamphetamine use, and other drugs on HIV as well as community-randomized HIV prevention trials. The focus of these interventions is to harness indigenous peer networks for risk reduction. He has over 300 peer-reviewed publications and numerous book chapters. Dr. Celentano has served on two previous IOM studies including the committee reviewing data needs for the Ryan White Care Act and the committee on prevention and control of sexually transmitted diseases.


Mathea Falco, J.D., is the President of Drug Strategies, a nonprofit research institute in Washington, D.C., that identifies more effective approaches to substance abuse. She is also Associate Professor of Public Health at the

Suggested Citation:"Appendix F Biographies." Institute of Medicine. 2007. Preventing HIV Infection Among Injecting Drug Users in High-Risk Countries: An Assessment of the Evidence. Washington, DC: The National Academies Press. doi: 10.17226/11731.
×

Weill Medical College of Cornell University. The author of The Making of a Drug-Free America: Programs That Work, Ms. Falco comments frequently on drug policy in the media and in public speeches across the country. Until 1993, she was the Director of Health Policy in the Department of Public Health, Cornell University Medical College in New York City. From 1977 to 1981, Ms. Falco was Assistant Secretary of State for International Narcotics Matters. In earlier positions, she served as Chief Counsel and Staff Director of the U.S. Senate Judiciary Committee, Juvenile Delinquency Subcommittee, and as Special Assistant to the President of the Drug Abuse Council. Ms. Falco is a member of the Council on Foreign Relations and a member of the Board of Directors of the Richard and Rhoda Goldman Fund. She has served on the Board of Overseers of Harvard University, the Board of Trustees of Radcliffe College, and as the Chair of the Visiting Committee on Harvard University Health Services. She has been a member of the national Boards of Directors of Girl Scouts, USA; Big Brothers of America; the International Women’s Health Coalition; the Ploughshares Fund; the International Center for Research on Women; the Bridge Fund, and the National Council on Crime and Delinquency. Ms. Falco is a graduate of Radcliffe College and Yale Law School.


Theodore M. Hammett, Ph.D., is a Vice President at Abt Associates Inc., a leading policy research firm with headquarters in Cambridge, Massachusetts. In his 26 years with Abt Associates, Dr. Hammett has focused on HIV/AIDS, particularly in relation to correctional and drug-using populations. Since 2000, he has been principal investigator for a cross-border HIV prevention project for injection drug users, sex workers, and their sexual partners/clients in China and Vietnam, funded by the National Institute on Drug Abuse (NIDA) and the Ford Foundation. Dr. Hammett is also working with Family Health International (FHI) to develop and evaluate interventions to help people being released from drug rehabilitation centers in Vietnam to make healthier transitions to the community. He is a faculty member, focusing on HIV prevention for injection drug users, for an HIV/AIDS policy training program for government officials in China and Vietnam being developed and implemented by the Kennedy School of Government (Harvard University), Tsinghua University (Beijing), and the Ho Chi Minh Political Academy (Hanoi). Dr. Hammett has spoken before numerous national and international conferences, testified before the National Commission on AIDS, and participated in an invited consultation on HIV/AIDS in Prisons at the World Health Organization in Geneva. He has published numerous books, articles, and reports on HIV/AIDS, tuberculosis, and STDs as they affect criminal justice agencies, correctional inmates, and drug-involved populations. In October 2002, Dr. Hammett was

Suggested Citation:"Appendix F Biographies." Institute of Medicine. 2007. Preventing HIV Infection Among Injecting Drug Users in High-Risk Countries: An Assessment of the Evidence. Washington, DC: The National Academies Press. doi: 10.17226/11731.
×

awarded the B. Jaye Anno Award for Excellence in Communication by the National Commission on Correctional Health Care.


Andrei P. Kozlov, Ph.D., graduated in 1972 with a biology degree from St. Petersburg University. From 1972–1975, he completed his postgraduate (Ph.D.) studies at the N.N. Petrov Research Institute of Oncology. In 1978– 1979, Dr. Kozlov served in a tenured Research Training Fellowship awarded by the International Agency for Research on Cancer at the laboratory of Robert Gallo at the National Cancer Institute. Currently, he combines several positions: Director of the Biomedical Center, Chairman of an Annual International Conference on “AIDS, Cancer and Public Health,” Professor of Biology at St. Petersburg University, and Principal Investigator for a number of international projects. He was among those who discovered first cases of HIV infection in Russia, performed the first isolation of HIV and field studies, described the nascent phase of HIV/AIDS epidemic that took place in Russia in the 1980s and 1990s and transition to concentrated phase, started the first scientifically based preventive programs in HIV/AIDS in Russia, and initiated the Master of Public Health program at St. Petersburg University. Dr. Kozlov also started cohort and preventive studies related to injecting drug users in Russia. Dr. Kozlov is involved in numerous publications which elaborate a national strategy in the field of HIV/AIDS. He was elected a full member of the Russian Medical-Technical Academy. For several years he served as a member of the Advisory Board for the Committee of Science and Education of the Russian Parliament. He won the Russian national Chumakov, Vernadsky, and Mechnikov awards for research in AIDS, immunology, and biotechnology, and the international Paul Harris Fellowship for his contribution in fighting AIDS and other infectious diseases.


Shenghan Lai, M.D., Ph.D., is a Professor of Pathology, Epidemiology, Radiology, and Medicine at the Johns Hopkins School of Medicine, an Adjunct Professor at the Institute of Human Virology, University of Maryland, and a Voluntary Professor at the University of Miami School of Medicine. Before joining Hopkins, he was the Scientific Director of the Comprehensive Drug Research Center, University of Miami School of Medicine. Dr. Lai is recognized as a leading epidemiology researcher in infectious disease epidemiology, and statistical analysis, and world renowned for his research on the effects of HIV infection and cocaine use on subclinical cardiovascular disease, and medical consequences of HIV infection and drug abuse, and international health. Dr. Lai’s professional training included medicine, epidemiology, and biostatistics. Dr. Lai received his degrees from Peking Union Medical College in Beijing and the Uniformed

Suggested Citation:"Appendix F Biographies." Institute of Medicine. 2007. Preventing HIV Infection Among Injecting Drug Users in High-Risk Countries: An Assessment of the Evidence. Washington, DC: The National Academies Press. doi: 10.17226/11731.
×

Services University of the Health Sciences in Bethesda, Maryland. He has 140 peer-reviewed publications and numerous book chapters. While trained in medicine and epidemiology, he began his research in HIV/AIDS and STDs in the late 1980s. Dr. Lai has been heavily involved in epidemiology and prevention of HIV infection among IDUs, sex workers, and men who have sex with men for more than 10 years. Dr. Lai is currently the Principal Investigator of four NIH-supported studies in both the United States and China, focusing on HIV natural history and cardiovascular complications of HIV and drug abuse. Dr. Lai is also the Biostatistics Core Leader for Johns Hopkins Reynolds Cardiovascular Research Center.


Ajay Mahal, Ph.D., is an Assistant Professor of International Health Economics at the Department of Population and International Health, Harvard School of Public Health. He has extensive research and policy experience in India, Sri Lanka, Jamaica, Palestine, and elsewhere. His current research interests include the economics of HIV/AIDS, assessing the expenditure implications of aging and changing medical technology in developing countries and ways of integrating human rights concerns into development work. He has written extensively on the economic and human development impacts of the AIDS epidemic, and on the use of policy interventions to address it. In 2002, he worked with a team of professionals at the United Nations Development Programme in New Delhi on a study to assess policy responses to the AIDS epidemic in South Asia, and the emerging lessons for the design of optimal strategies to address HIV in that part of the world. He was most recently the Principal Investigator on a team of Harvard and Nigeria-based researchers to measure the economic impacts of the AIDS epidemic in Nigeria. Dr. Mahal has also served recently as a technical advisor to the Indian National Commission on Macroeconomics and Health (NCMH) in New Delhi that was chaired by the health and finance ministers of India, to develop a long-term strategy for the health sector in India. Prior to his appointment at Harvard, Dr. Mahal was a senior researcher at the National Council of Applied Economic Research in New Delhi, India’s premier nongovernment economic research organization. Dr. Mahal has previously served as a resident advisor as part of a health policy advisory team to the Palestinian Authority, based in Gaza, in addition to working on health research and policy-related projects in Sri Lanka, Jamaica, and Nigeria. He has been a consultant to the World Bank, the World Health Organization, the United Nations Development Programme, the Asian Development Bank, the United Nations Conference on Trade and Development, and a number of government and nongovernment organizations. Dr. Mahal holds degrees from Columbia University (Ph.D., 1995) and the University of Delhi (M.A., 1985; B.A. 1983).

Suggested Citation:"Appendix F Biographies." Institute of Medicine. 2007. Preventing HIV Infection Among Injecting Drug Users in High-Risk Countries: An Assessment of the Evidence. Washington, DC: The National Academies Press. doi: 10.17226/11731.
×

Richard S. Schottenfeld, M.D., is a Professor of Psychiatry at Yale University and an experienced clinical researcher who has focused on the efficacy, accessibility, and availability of substance abuse treatments in the United States and abroad. In clinical trials and clinical epidemiologic studies, Dr. Schottenfeld has developed new programs integrating substance abuse treatment with general medical services as well as alternative opioid agonist maintenance programs using medication and behavioral counseling. Current U.S. studies evaluate opioid agonist maintenance treatment in primary medical care settings and novel medications combined with behavioral treatment for heroin and cocaine dependence. Current international studies evaluate the efficacy of naltrexone and buprenorphine treatment with HIV risk reduction and drug abuse counseling for opioid-dependent individuals in Malaysia and Iran. In addition to his Medical School position, Dr. Schottenfeld is the Master of Davenport College (one of Yale’s twelve residential colleges).


Suniti Solomon, M.D., is the founder-director of the Y.R. Gaitonde Center for AIDS Research and Education (YRG CARE), a premier HIV/AIDS care and support centre in Chennai, India. She and her colleagues documented the first evidence of the HIV infection in India in 1986. When serving at the Madras Medical College and Government General Hospital as a Professor of Microbiology, she set up the first voluntary testing and counseling centre and an AIDS Research Group in Chennai. Dr. Solomon is a member of the National Technical Team on women and AIDS, a member of the advisory board of International AIDS Vaccine Initiative-India, a member of the Scientific Committee of the National AIDS Research Institute, Pune, Government of India, a permanent member on the Microbicides Committee of the Indian Council for Medical Research (ICMR), a member on the board of AVAHAN, the India HIV/AIDS Initiative of the Bill & Melinda Gates Foundation, a Trustee At-Large of the International Association of Physicians in AIDS Care, and a member of the Asia Data Safety Monitoring Board of the Division of AIDS, NIH, U.S.. Dr. Solomon is the Indian Principal Investigator of several pioneering HIV research studies: the U.S. National Institute of Mental Health’s multi-country HIV/STD Prevention Trial; the U.S. National Institute of Allergy and Infectious Diseases’ HIV Prevention Trial Networks; an NIH award that will measure stigma in health care settings in Southern India; and a Phase III study of 6 percent CS GEL, a candidate microbicide of CONRAD. She is the Director of the Southern India program of the Brown-Tufts Fogarty AIDS Training and Research Project. Dr. Solomon’s experience covers a wide range of aspects related to HIV infection, from biomedical to socio-economic. She has deep interest in community education and mobilization and leads an effort that supports a Phase I HIV vaccine trial at Chennai with community education

Suggested Citation:"Appendix F Biographies." Institute of Medicine. 2007. Preventing HIV Infection Among Injecting Drug Users in High-Risk Countries: An Assessment of the Evidence. Washington, DC: The National Academies Press. doi: 10.17226/11731.
×

and volunteer enrollment. She received a Lifetime Achievement Award for her work with AIDS from the State Government’s Medical University in December 2001 and a second Lifetime Achievement Award in 2005 from the Tamil Nadu State AIDS Control Society. Dr. Solomon has published extensively on HIV epidemiology, prevention, care and support, biomedical research, research ethics, and gender issues. She holds an M.D. in microbiology from Madras University. She has trained in pathology in the United Kingdom and the United States. Dr. Solomon currently serves as the President of the AIDS Society of India.

IOM STAFF

Patrick W. Kelley, M.D., DrP.H., joined the Institute of Medicine in July 2003, serving as the Director of the Board on Global Health and the Board on African Academy Science Development. Previously he served in the U.S. Army for more than 23 years as a physician, residency director, epidemiologist, and program manager. In his last Department of Defense (DoD) position, Dr. Kelley founded and directed the Presidentially mandated DoD Global Emerging Infections Surveillance and Response System (DoD-GEIS). This responsibility entailed managing approximately $42 million dollars of emerging infections surveillance, response, training, and capacity-building activities undertaken in partnership with numerous elements of the federal government and with health ministries in over 45 developing countries. He also designed and established the DoD Accessions Medical Standards Analysis and Research Activity, the first systematic DoD effort to apply epidemiology to the evidence-based development and evaluation of physical and psychological accession standards. Dr. Kelley is an experienced communicator, having lectured in over 20 countries and authored over 50 scholarly papers and book chapters. He also designed and served as the specialty editor for the two volume textbook entitled: Military Preventive Medicine: Mobilization and Deployment. Dr. Kelley obtained his M.D. from the University of Virginia and his DrP.H. from the Johns Hopkins School of Hygiene and Public Health.


Alicia R. Gable, M.P.H., is a Senior Program Officer with the Board on Global Health. She joined the IOM in 1999 and has served as Study Director on several domestic and international HIV policy studies, including Measuring What Matters: Allocation, Planning, and Quality Assessment for the Ryan White CARE Act and Review of the HIVNET 012 Perinatal HIV Prevention Study. She also served as a staff officer on three major IOM reports related to the safety of childhood vaccines and on the President’s Emergency Plan for AIDS Relief evaluation study. Prior to joining the IOM, Ms. Gable completed a fellowship in health systems adminis-

Suggested Citation:"Appendix F Biographies." Institute of Medicine. 2007. Preventing HIV Infection Among Injecting Drug Users in High-Risk Countries: An Assessment of the Evidence. Washington, DC: The National Academies Press. doi: 10.17226/11731.
×

tration at the Washington Hospital Center in Washington, D.C. She also worked as an economist at Research Triangle Institute and Triangle Economic Research in North Carolina, where she designed and conducted health valuation surveys and natural resource damage assessments. Ms. Gable completed her undergraduate studies at the University of North Carolina at Chapel Hill and her Master of Public Health in health management and policy at the University of Michigan at Ann Arbor.


Alyson Schwaber, M.P.H., is currently a Senior Program Associate working on the study on the Prevention of HIV Infection among Injecting Drug Users in High-Risk Countries. Ms. Schwaber joined the IOM in November 2004 as a Research Associate for the study, Options for Overseas Placement of U.S. Health Professionals. Prior to joining the National Academies, Ms. Schwaber was a program manager of sustainable development focused on Africa at Sister Cities International in Washington, D.C. She served as a Peace Corps volunteer in community health in Mauritania from 1999–2001. Following her service, she remained in Mauritania for 2 additional years to work with an HIV/AIDS prevention and education project of an international non-governmental organization. Ms. Schwaber completed her undergraduate studies at Penn State University and her Master of Public Health at Johns Hopkins Bloomberg School of Public Health.


Sheyi Lawoyin, M.P.H., joined the Institute of Medicine in September 2004 and most recently provided support to the Board on Global Health’s study on HIV Prevention among Injecting Drug Users in High-Risk Countries. Prior to this, she served as a Senior Program Assistant with the Board on Population Health and Public Health Practice in conjunction with the Board on Global Health. In this capacity, she assisted with providing support for the studies on Reducing Tobacco Use and CDC Quarantine Station Expansion Plans at U.S. Ports of Entry. Ms. Lawoyin recently completed her Master of Public Health degree at the George Washington University’s School of Public Health and Health Services with a concentration in Health Policy. Her area of concentration included research in global health policy issues in the areas of HIV/AIDS, malaria and global development. During her graduate studies, she completed an internship with the U.S. Department of State, working at the U.S. Consulate General in Lagos, Nigeria. Her work included conceptualizing, planning and implementing HIV/AIDS educational awareness workshops for young women between the ages of 18–30.

Suggested Citation:"Appendix F Biographies." Institute of Medicine. 2007. Preventing HIV Infection Among Injecting Drug Users in High-Risk Countries: An Assessment of the Evidence. Washington, DC: The National Academies Press. doi: 10.17226/11731.
×
Page 274
Suggested Citation:"Appendix F Biographies." Institute of Medicine. 2007. Preventing HIV Infection Among Injecting Drug Users in High-Risk Countries: An Assessment of the Evidence. Washington, DC: The National Academies Press. doi: 10.17226/11731.
×
Page 275
Suggested Citation:"Appendix F Biographies." Institute of Medicine. 2007. Preventing HIV Infection Among Injecting Drug Users in High-Risk Countries: An Assessment of the Evidence. Washington, DC: The National Academies Press. doi: 10.17226/11731.
×
Page 276
Suggested Citation:"Appendix F Biographies." Institute of Medicine. 2007. Preventing HIV Infection Among Injecting Drug Users in High-Risk Countries: An Assessment of the Evidence. Washington, DC: The National Academies Press. doi: 10.17226/11731.
×
Page 277
Suggested Citation:"Appendix F Biographies." Institute of Medicine. 2007. Preventing HIV Infection Among Injecting Drug Users in High-Risk Countries: An Assessment of the Evidence. Washington, DC: The National Academies Press. doi: 10.17226/11731.
×
Page 278
Suggested Citation:"Appendix F Biographies." Institute of Medicine. 2007. Preventing HIV Infection Among Injecting Drug Users in High-Risk Countries: An Assessment of the Evidence. Washington, DC: The National Academies Press. doi: 10.17226/11731.
×
Page 279
Suggested Citation:"Appendix F Biographies." Institute of Medicine. 2007. Preventing HIV Infection Among Injecting Drug Users in High-Risk Countries: An Assessment of the Evidence. Washington, DC: The National Academies Press. doi: 10.17226/11731.
×
Page 280
Suggested Citation:"Appendix F Biographies." Institute of Medicine. 2007. Preventing HIV Infection Among Injecting Drug Users in High-Risk Countries: An Assessment of the Evidence. Washington, DC: The National Academies Press. doi: 10.17226/11731.
×
Page 281
Suggested Citation:"Appendix F Biographies." Institute of Medicine. 2007. Preventing HIV Infection Among Injecting Drug Users in High-Risk Countries: An Assessment of the Evidence. Washington, DC: The National Academies Press. doi: 10.17226/11731.
×
Page 282
Preventing HIV Infection Among Injecting Drug Users in High-Risk Countries: An Assessment of the Evidence Get This Book
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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-wide—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 challenge—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.

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