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).


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