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Recommendations for Control and Prevention of Human Immunodeficiency Virus (HIV) Infection in Intravenous Drug Users

Philip W. Brickner, MD; Ramon A. Torres, MD; Mark Barnes, JD; Robert G. Newman, MD; Don C. Des Jarlais, PhD; Dennis P. Whalen; and David E. Rogers, MD
[+] Article, Author, and Disclosure Information

Co-authorship by Dr. Des Jarlais and Mr. Whalen does not necessarily indicate that the New York State Division of Substance Abuse Services supports the positions taken in this paper.

This paper was developed from the studies of a committee on management of intravenous drug use and human immunodeficiency virus infection asked to make recommendations to the Advisory Council of the New York State AIDS Institute.

Requests for Reprints: Philip W. Brickner, MD, Department of Community Medicine, St. Vincent's Hospital and Medical Center of New York, 153 West 11th Street, New York, NY 10011.

Current Author Addresses: Drs. Brickner and Torres: Department of Community Medicine, St. Vincent's Hospital and Medical Center of New York, New York, NY 10011.

Mr. Barnes: Columbia University in the City of New York, School of Law, New York, NY 10027.

Dr. Newman: Beth Israel Medical Center, New York, NY 10003.

Dr. Des Jarlais: New York State Division of Substance Abuse Services,Research Department, New York, NY 10013.

Mr. Whalen: New York State Division of Substance Abuse Services,Albany, NY 12203.

Dr. Rogers: The New York Hospital-Cornell Medical Center, New York, NY 10021.

©1989 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1989;110(10):833-837. doi:10.7326/0003-4819-110-10-833
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Considerable evidence indicates that intravenous drug users are emerging as the group at greatest risk for both acquiring and spreading human immunodeficiency virus (HIV) infection. Thus, all possible methods to control the spread of HIV infection in intravenous drug users should be explored. Key recommendations are that HIV antibody testing of intravenous drug users should be voluntary, because mandatory testing is counterproductive; free distribution of needles and syringes to intravenous drug users should occur only in carefully controlled circumstances to determine its effectiveness in decreasing infection rates; and drug-free and methadone maintenance treatment programs should be available on demand to all intravenous drug users as a means of reducing the spread of HIV infection. At present, the primary strategy for prevention must be education resulting in behavioral change. Education is currently the only definitive means for controlling the spread of HIV infection among intravenous drug users, their sex contacts, and to fetuses.





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