EPIDEMIOLOGY OF HIV IN INTRAVENOUS-DRUG-USERS AND PUBLIC-HEALTH POLICY IN GERMANY

The paper assesses AIDS and drug policy development in Germany between 1982 and 1996 and relates it to the development of epidemiological re search in HIV among injecting drug users (IDUs). In a historical revie w, this paper outlines how results of epidemiological HIV surveillance studies among IDUs and public health responses were mutually dependen t. The authors argue that a specific development in HIV policy encoura ged a confounding of basic methodological concepts (validity and preci sion) in epidemiological research, which in turn led to misinterpretat ion of available data on seroprevalence trends in Germany. In order to overcome methodological shortcomings under given legal and practical restrictions, pragmatic approaches to increase validity of seroprevale nce and risk factor estimations are discussed.