of HIV in population subgroups of injection drug users (e.g., youth, women) in the United States.

  • Given the serious public health threat associated with HIV infection among injection drug users, their sexual partners and offspring, the Assistant Secretary for Health should ensure that AIDS prevention efforts targeted to injection drug users are expanded specifically to include behavioral interventions in order to limit the further spread of HIV infection.

  • AIDS behavioral prevention efforts need to target direct and indirect needle sharing and the sexual practices of injection drug users and their sex partners.

NOTES

1.  

The presence of maternal anti-HIV antibodies precludes an accurate diagnosis of HIV infection in infants by serologic methods. Other methods for diagnosis of neonatal infection, including HIV culture, immune-complex dissociated p24 (a viral core protein) assays, and polymerase chain reaction analyses permit the early diagnosis of HIV infection, but these techniques are expensive and not universally available.

2.  

The additional clinical conditions are pulmonary tuberculosis, recurrent pneumonia, and invasive cervical cancer, whereas the new laboratory marker of severe immunosuppression consists of a CD4+ T-lymphocyte count >200 per milliliter.

3.  

A detailed presentation of CDC's family of seroprevalence surveys is presented in a special issue of Public Health Reports (1990).

4.  

These disproportionately large increases in AIDS cases in 1993 were due to CDC's revised definition of AIDS.

REFERENCES

Allen, D.M., I.M. Onorato, and T.A. Green 1992 HIV infection in intravenous drug users entering drug treatment, United States, 1988 to 1989. American Journal of Public Health 82(4):541-545.

Angarano, G., G. Pastore, L. Monno, T. Santantonio, N. Luchena, and O. Schiraldi 1985 Rapid spread of HTLV-III infection among drug addicts in Italy. Lancet 2(8467):1302.

Anthony, J.C., D. Vlahov, K.E. Nelson, S. Cohn, J. Astemborski, and L. Solomon 1991 New evidence on intravenous cocaine use and the risk of infection with human immunodeficiency virus type 1. American Journal of Epidemiology 134(10):1175-1189.

Aral, S.O. 1993 Heterosexual transmission of HIV: The role of other sexually transmitted infections and behavior in its epidemiology, prevention and control. Annual Review of Public Health 14:451-467.

Astemborski, J., D. Vlahov, D. Warren, L. Solomon, and K.E. Nelson 1994 The trading of sex for drugs or money and HIV seropositivity among female intravenous drug users. American Journal of Public Health 84(3):382-387.



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