IMPACT OF HIV RISK AND INFECTION AND THE ROLE OF PREVENTION SERVICES

Blood-borne infection associated with injection drug use is a signific ant cause of morbidity and mortality. Over the last decade, HIV infect ion and its clinical sequelae have had a significant impact on researc h and interventions involving injecting drug users (IDUs) in the Unite d States and elsewhere. Discussed are some of the major intervention o ptions for reducing blood-borne infections in general and HIV in parti cular. The use of multiple interventions is considered within the comm unity context in which both IDUs and service providers operate. Interv ention options discussed include treatment for drug dependence; volunt ary and confidential HN testing and counseling; community health outre ach; bleach distribution; and easy, legal access to needles and syring es through pharmacy sales and needle exchange programs. Many surveilla nce and evaluative studies have examined multiple intervention efforts that include all or some of these program components and suggest posi tive outcomes. However, these studies tend to be limited by experiment al designs that restrict attribution of casual inference. Examples of such programs in the United States and abroad are examined in terms of their potential for reducing HN risk behaviors and averting new infec tions. nle article concludes that diversity among AIDS prevention prog rams, rapid deployment (at earlier stages of epidemics), and effective coordination (minimization of interagency conflicts) are important fa ctors in successful AIDS prevention programming and attaining disease prevention objectives. (C) 1996 Elsevier Science Inc.