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Advances in Preventive Medicine
Volume 2013 (2013), Article ID 346372, 10 pages
http://dx.doi.org/10.1155/2013/346372
Review Article

30 Years on Selected Issues in the Prevention of HIV among Persons Who Inject Drugs

1The Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, 160 Water Street, FL 24, New York, NY 10038, USA
2Department of Psychiatry and Behavioral Medicine, Center for AIDS Intervention Research, Medical College of Wisconsin, Milwaukee, WI 53226, USA
3NYU College of Nursing, New York, NY 10003, USA
4Rollins School of Public Health, Emory University, Atlanta, GA 30329, USA
5Department of Hygiene, Epidemiology and Medical Statistics, Athens University Medical School, 11527 Athens, Greece
6Department of Public Health, University of Tartu, 50411 Tartu, Estonia

Received 16 October 2012; Revised 11 March 2013; Accepted 18 May 2013

Academic Editor: Catherine Hankins

Copyright © 2013 D. C. Des Jarlais et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

After 30 years of extensive research on human immunodeficiency virus (HIV) among persons who inject drugs (PWID), we now have a good understanding of the critical issues involved. Following the discovery of HIV in 1981, epidemics among PWID were noted in many countries, and consensus recommendations for interventions for reducing injection related HIV transmission have been developed. While high-income countries have continued to develop and implement new Harm Reduction programs, most low-/middle-income countries have implemented Harm Reduction at very low levels. Modeling of combined prevention programming including needle exchange (NSP) and antiretroviral therapy (ARV) suggests that NSP be given the highest priority. Future HIV prevention programming should continue to provide Harm Reduction programs for PWID coupled with interventions aimed at reducing sexual transmission. As HIV continues to spread in low- and middle-income countries, it is important to achieve and maintain high coverage of Harm Reduction programs in these locations. As PWID almost always experience multiple health problems, it will be important to address these multiple problems within a comprehensive approach grounded in a human rights perspective.