Chapter 1 reviews the epidemiology of HIV among IDUs, and discusses factors affecting HIV-related risks among IDUs. It also outlines major HIV prevention strategies for IDUs and their coverage. Chapters 2 and 3 provide the Committee’s evaluation, conclusions, and recommendations on the major HIV prevention strategies highlighted in the charge. Chapter 2 reviews HIV prevention strategies that are part of treatment for drug dependence, including both pharmacotherapies and psychosocial interventions. Chapter 3 reviews evidence regarding sterile needle and syringe access programs, and outreach and education efforts. Chapter 4 summarizes the Committee’s findings and highlights the importance of the local context—such as political, legal, and economic dimensions—in policy decisions, and provides recommendations that policymakers should consider when deciding which prevention programs to implement.
Several appendixes provide additional information on the following: the agenda of the Committee’s December 2005 information-gathering meeting (Appendix A); methods used in the Committee’s literature searches and review (Appendix B); case studies of HIV prevention for IDUs in select high-risk countries (Appendix C); summary of studies related to multi-component HIV prevention programs that include needle and syringe exchange (Appendix D); additional thoughts on a community randomized trial of multi-component HIV prevention programs (Appendix E); and committee member biographies (Appendix F).
Aceijas C, Stimson G, Hickman M, Rhodes T. 2004. Global overview of injecting drug use and HIV infection among injecting drug users. AIDS. 18:2295–2303.
DHHS (U.S. Department of Health and Human Services). 2006. Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents. [Online]. Available: http://aidsinfo.nih.gov/ContentFiles/AdultandAdolescentGL.pdf [accessed August 3, 2006].
IOM (Institute of Medicine). 1990. Treating Drug Problems: Volume 1. Washington, DC: National Academy Press.
IOM. 1995. Federal Regulation of Methadone Treatment. Washington, DC: National Academy Press.
IOM. 1997. Dispelling the Myths About Addiction. Washington, DC: National Academy Press.
McLellan T, Lewis D, O’Brien C, Kleber H. 2000. Drug dependence, a chronic mental illness: Implications for treatment, insurance, and outcomes evaluation. Journal of the American Medical Association. 284(13):1689–1695.
UNAIDS (Joint United Nations Programme on HIV/AIDS). 2006. 2006 Report on the Global AIDS Epidemic: A UNAIDS 10th Anniversary Special Edition. Geneva, Switzerland: UNAIDS.
WHO (World Health Organization), United Nations Office on Drugs and Crime, UNAIDS. 2004. Substitution Maintenance Therapy in the Management of Opioid Dependence and HIV/AIDS Prevention: Position Paper. Geneva, Switzerland: WHO.