Objective. As the acquired immunodeficiency syndrome (AIDS) epidemic among
drug users enters its third decade in the United States, it is important to
consider the role played by substance abuse treatment in the prevention of
human immunodeficiency virus (HIV) infection.
Methods. The authors review the research literature, examining findings fro
m studies with behavioral and serologic measures on the association among t
reatment participation, HIV risk reduction, and HIV infection.
Results. Numerous studies have now documented that significantly lower rate
s of drug use and related risk behaviors are practiced by injecting drug us
ers (IDUs) who are in treatment. Importantly, these behavioral differences,
based primarily on self-report, are consistent with studies that have exam
ined HIV seroprevalence and seroincidence among drug users,
Conclusion. The underlying mechanism of action suggested by the collective
findings of the available literature is rather simple-individuals who enter
and remain in treatment reduce their drug use, which leads to fewer instan
ces of drug-related risk behavior. This lower rate of exposure results in f
ewer infections with HIV, The protective effects of treatment, however, can
only be achieved when programs are accessible and responsive to the changi
ng needs of drug users. Future research needs to be directed at developing
a better understanding of the factors that enhance treatment entry and rete
ntion.