Without better information on the prevalence of HIV infection, the nation will be unable to prepare adequately for future demands for hospital beds and other health care services. Reliable assessment of the prevalence of HIV infection in a population requires drawing a sample from that population, obtaining a blood specimen from each person in the sample, and accurately testing the specimens for the presence of HIV. Unfortunately, less is known about the rates of HIV infection among IV drug users than is known about the prevalence of AIDS.
- People on ART take a combination of HIV medicines (called an HIV treatment regimen) every day.
- Because it is not possible to make this comparison directly, inference strategies turn to various proxies—for instance, extrapolating a trend from past history (before treatment) or using comparison groups.
- Typical statistical sampling procedures may not yield useful estimates, and even procedures that have been designed to sample rare and elusive populations (Sudman et al., 1988) are problematic.
- Some may be more likely to substitute other drugs for heroin, and some may be more likely to relapse after treatment.
Please consider making a gift to support Sepsis Alliance’s work to save lives and reduce suffering by improving sepsis awareness and care. It can develop quickly (called acute endocarditis) or more slowly (called infective endocarditis). Hepatitis doesn’t cause sepsis, but the virus can cause damage to your liver, which puts you at higher risk for infections. Sepsis, which was often called blood poisoning, is the body’s life-threatening response to infection. Like strokes or heart attacks, sepsis is a medical emergency that requires rapid diagnosis and treatment.
[Intravenous drug use and the spread of HIV; an international perspective]
In a society in which IV drug use is both illegal and highly stigmatized, IV drug users will often have many practical reasons for not admitting that they use drugs. This denial may well include their unwillingness to admit that they are still injecting drugs while in treatment or after they have left treatment. Consequently, it is critical that interviewers not be perceived as people who can have an effect iv drug use on drug treatment, legal proceedings, or other such interventions. Care must be taken to allow researchers to collect the best possible data while still protecting IV drug users’ privacy and maintaining the confidentiality of the information they provide. In the United States, there has been a similar complementarity between programs that provide the means for safer injection and drug treatment programs.
An evaluation of an ex-addict outreach program in Baltimore showed that IV drug users in the city were changing their behavior to reduce the risk of AIDS; however, the change could not be attributed to the efforts of the outreach workers (McAuliffe et al., 1987). In this sample, information and even perceived self-susceptibility were insufficient to alter behavior. If you inject drugs, sharing and reusing needles, syringes, or other injection equipment (“works”) like cookers can increase your chance of getting or transmitting HIV or hepatitis B and C. This is because the needles, syringes, or works may have blood in them, and blood can carry HIV. You should not share needles, syringes, or works for injecting silicone, hormones, or steroids for the same reason. A systematic review by Mathers et al. finds PWID have increased in several countries over
the last decade and are reported with a high prevalence of HIV34.
How does substance use increase the risk of getting HIV?
Given present levels of sexual activity, such programs—in particular, promotion of the use of condoms and spermicides—appear to be important areas on which to focus educational efforts and resources. The committee recommends that local public health authorities ensure that condoms are readily available to all sexually active persons . Promotion of condom use might be facilitated if condoms were sold in a wider variety of retail outlets, including supermarkets, convenience stores, and vending machines placed in diverse locales. Furthermore, because there is evidence suggesting that STDs may play a role as cofactors in the transmission of HIV, it is important to offer STD treatment as part of HIV/AIDS prevention efforts and to make that treatment as attractive as possible to those who need it. The committee recommends that local public health authorities ensure that treatment for all sexually transmitted diseases is readily available to all persons who may seek such treatment. As discussed in detail in Chapters 4 and 5, prevention programs should include planned variations of intervention strategies accompanied by sound evaluations to determine what is likely to be successful in preventing further infection and what is less likely to be helpful.
Much like the first sexual experience, the first injection experience may be anticipated or expected but not planned for (Des Jarlais et al., 1986c). Curiosity about IV drug use, whether sudden or long-standing, and association with people who inject drugs often lead to a moment when the uninitiated is present while drugs are being injected. Few people have hypodermic injection equipment “around the house,” and few are inclined to pierce their own skin with a needle. Therefore, newcomers to the IV drug-use world are likely to arrive without the proper equipment and to require help in executing the first injection. These circumstances make it highly probable that a novice will begin injecting in the presence of others and will share the equipment of those teaching the “art” of injection. The sharing of drugs and equipment that occurs during initial and subsequent drug-use episodes leads to the notion that communal or joint use is as natural as sharing alcohol, ice, and glasses at a cocktail party.
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Intravenous drug users often view the identifiers required in some research as an invasion of privacy and a means of uncovering issues and behaviors that they do not want uncovered. Yet these same identification practices can improve the quality and richness of data and facilitate the evaluation of programs. A careful balance must be struck between serving the need to collect useful data and respecting the sensitivities of study respondents. Other studies reported in 1987 indicate some limitations on the AIDS prevention efforts aimed at IV drug users.
- There has been much less research on initiation into the injection of other illicit drugs (e.g., cocaine or amphetamines) than on initiation into heroin use.
- Popular lore about heroin users holds that, once they are “hooked,” their appetite for the drug is so great that they will run any risk to obtain it.
Infectious diseases specialist Linda-Gail Bekker of the Desmond Tutu Health Foundation at the University of Cape Town runs one of the trials. Implementation trials start early 2024 in South Africa to help researchers find out what will make people use a two-monthly anti-HIV jab. • Most treatment failures are due to missed doses, so simplifying treatment regimens can be effective for patients with and without virologic suppression. • For HIV PrEP, options include daily or episodic emtricitabine/tenofovir disoproxil fumarate (Truvada) or daily emtricitabine/tenofovir alafenamide (Descovy) and injectable cabotegravir (Apretude) every four to eight weeks. People with HIV who take HIV medicine as prescribed can live long, healthy lives and help prevent HIV transmission.