Samuel R. Friedman

Intravenous drug use and the heterosexual transmission of the human immunodeficiency virus

Women, and men who deny homosexual activity, account for slightly more than one third (3,929/7,696) of the cases of acquired immunodeficiency syndrome (AIDS) in New York City through September 1986.1 This percentage has been rising during the course of the epidemic. Intravenous (IV) drug users account for more than half (2,261/3,929) of these heterosexual cases, and an additional 134 cases have occurred in persons known to be heterosexual partners of IV drug users. The connections between AIDS, IV drug use, and the heterosexual transmission of the human immunodeficiency virus (HIV) pose one of the more difficult public health challenges facing the city and the country. In this paper we review data relevant to two questions: potential heterosexual transmission among IV drug users, and potential transmission from IV drug users to heterosexual partners who do not inject drugs.

Interventions for injecting drug users.

In response to the growing problem of transmission of HIV among intravenous drug users (IDUs) a variety of prevention interventions have been implemented in different parts of the world. Some of these interventions have been found effective in reducing as well as preventing transmission of HIV. A substantial body of empirical and theoretical evidence demonstrates that a reduction in the sharing of injection drug use equipment significantly reduces HIV transmission rates among IDUs. This paper presents brief summaries of some of these interventions that have been used with IDUs. Some of the existing interventions for HIV prevention include: education increasing availability of clean injection equipment decontamination of used needles and syringes pharmacological treatment of drug addiction outreach programs HIV testing organization of IDUs and social network intervention. More prevention intervention programs though need to be initiated in developing countries. Program planners and researchers need to strive for better implementation of these programs.

Intravenous Drug Use and AIDS

Intravenous (IV) drug users have been the second largest group of persons to have developed acquired immune deficiency syndrome (AIDS) in the United States and in Western Europe. 10,627 (18%) of the 59,287 adult cases reported in the United States have occurred in heterosexual IV drug users, and another 4325 (7%) in IV drug users who also had male homosexuality as a risk factor.1 In Europe, 1944 (19.5%) of the 9930 adult cases have occurred in heterosexual IV drug users, and another 259 (3%) in IV drug users who also had male homosexual activity as a risk factor.2