A Tale of Two Countries: Attempts to Control HIV among Injecting Drug Users in Australia and the United States

1997 ◽  
Vol 27 (1) ◽  
pp. 117-134 ◽  
Author(s):  
Alex Wodak ◽  
Peter Lurie
Keyword(s):  
United States ◽  
Harm Reduction ◽  
Injection Drug Users ◽  
Drug Users ◽  
Methadone Maintenance ◽  
Good Control ◽  
The United States ◽  
Exchange Programs ◽  
Needle Exchange Programs ◽  
Reduction Strategies

Prevalence of injectable drug use is surprisingly similar in Australia and the United States. HIV prevalence among injection drug users (IDUs) is less than 5% in Australia and about 14% in the United States. IDUs accounted for 2.5% of AIDS cases in Australia in 1994 and 28% in the United States in 1993. Harm reduction was officially adopted in Australia in 1985 but has been explicitly rejected by the U.S. government. In 1994, needle programs exchanged over 10 million syringes from over 4,000 outlets in Australia while 55 needle exchange programs in the United States exchanged almost eight million syringes. Since 1985, methadone maintenance expanded almost ten-fold in Australia but barely increased in the United States. Timely and vigorous adoption of harm reduction strategies in Australia and the relative lack of such programs in the United States is the most plausible explanation for the good control of HIV among IDUs in Australia and poor control in the United States.

Ethical Issues Raised by Needle Exchange Programs

1995 ◽  
Vol 23 (4) ◽  
pp. 382-388 ◽  
Author(s):  
Sana Loue ◽  
Peter Lurie ◽  
Linda S. Lloyd
Keyword(s):  
Public Health ◽  
United States ◽  
Injection Drug Users ◽  
Drug Users ◽  
Ethical Issues ◽  
United States Public Health ◽  
Needle Exchange ◽  
The United States ◽  
Exchange Programs ◽  
Needle Exchange Programs

United States public health experts have long expressed concern about the prevalence of the human immunodeficiency virus (HIV) among injection drug users (IDUs). The United States has the largest reported IDU population in the world: 1.1 to 1.5 million. Recent estimates from the Centers for Disease Control and Prevention (CDC) suggest that 50 percent of incident HIV infections occur among IDUs, with additional infections occurring among their sex partners and offspring. More than 33 percent of new AIDS cases occur in IDUs, their sexual partners, and their children. Almost one half of all women diagnosed with AIDS in the United States are IDUS. Many of the remaining infected women were infected as a result of sex with a male IDU.While public health agencies, legislators, community leaders, and religious groups have engaged in vigorous debate over the merits of needle exchange programs (NEPs) as an intervention to reduce HIV transmission, the programs, some legal and some illegal, have been implemented in fifty-five cities across the country.

The influence of needle exchange programs on injection risk behaviors and infection with hepatitis C virus among young injection drug users in select cities in the United States, 1994–2004

2009 ◽  
Vol 49 (1) ◽  
pp. 68-73 ◽  
Author(s):  
Deborah Holtzman ◽  
Vaughn Barry ◽  
Lawrence J. Ouellet ◽  
Don C. Des Jarlais ◽  
David Vlahov ◽  
...  
Keyword(s):  
United States ◽  
Hepatitis C ◽  
Risk Behaviors ◽  
Injection Drug Users ◽  
Drug Users ◽  
Needle Exchange ◽  
The United States ◽  
Exchange Programs ◽  
Needle Exchange Programs ◽  
Injection Risk

Profiles of Self-Reported HIV-Risk Behaviors Among Injection Drug Users in Methadone Maintenance Treatment, Detoxification, and Needle Exchange Programs

2006 ◽  
Vol 23 (1) ◽  
pp. 11-19 ◽  
Author(s):  
Hayley Diana Mark ◽  
Joy Nanda ◽  
Annet Davis-Vogel ◽  
Helen Navaline ◽  
Roseanne Scotti ◽  
...  
Keyword(s):  
Risk Behaviors ◽  
Hiv Risk ◽  
Methadone Maintenance Treatment ◽  
Injection Drug Users ◽  
Drug Users ◽  
Maintenance Treatment ◽  
Methadone Maintenance ◽  
Needle Exchange ◽  
Exchange Programs ◽  
Needle Exchange Programs

scholarly journals Pre-Exposure Prophylaxis Training among Medical Schools in the United States

2021 ◽  
Vol 12 ◽  
pp. 215013272110287
Author(s):  
Robert L. Cooper ◽  
Mohammad Tabatabai ◽  
Paul D. Juarez ◽  
Aramandla Ramesh ◽  
Matthew C. Morris ◽  
...  
Keyword(s):  
United States ◽  
Hiv Prevention ◽  
Injection Drug Users ◽  
Drug Users ◽  
Healthcare Providers ◽  
Medical Schools ◽  
The United States ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Exposure Prophylaxis

Pre-Exposure Prophylaxis (PrEP) has been shown to be an effective method of HIV prevention for men who have sex with-men (MSM) and -transgender women (MSTGWs), serodiscordant couples, and injection drug users; however fewer than 50 000 individuals currently take this regimen. Knowledge of PrEP is low among healthcare providers and much of this lack of knowledge stems from the lack or exposure to PrEP in medical school. We conducted a cross sectional survey of medical schools in the United States to assess the degree to which PrEP for HIV prevention is taught. The survey consisted Likert scale questions assessing how well the students were prepared to perform each skill associated with PrEP delivery, as well as how PrEP education was delivered to students. We contacted 141 medical schools and 71 responded to the survey (50.4%). PrEP education was only reported to be offered at 38% of schools, and only 15.4% reported specific training for Lesbian, Gay, Bisexual, and Transgender (LGBT) patients. The most common delivery methods of PrEP content were didactic sessions with 11 schools reporting this method followed by problem-based learning, direct patient contact, workshops, and small group discussions. Students were more prepared to provide PrEP to MSM compared to other high-risk patients. Few medical schools are preparing their students to prescribe PrEP upon graduation. Further, there is a need to increase the number of direct patient contacts or simulations for students to be better prepared.

Viral Hepatitis A

2021 ◽  
Author(s):  
Kenrad E Nelson ◽  
Brittany L Kmush
Keyword(s):  
United States ◽  
Acute Hepatitis ◽  
Injection Drug Users ◽  
Drug Users ◽  
Hepatitis A ◽  
Hepatitis A Virus ◽  
Severe Disease ◽  
The United States ◽  
Childhood Immunization ◽  
Effective Prevention

Epidemics of infectious jaundice have been reported throughout recorded history. However, the proof that many of these outbreaks and individual cases of acute hepatitis were caused by a viral infection, the hepatitis A virus (HAV), did not appear until the 1960s. After the transmission of infection to marmosets and humans, the epidemiologic and virologic characteristics that differed between hepatitis A and hepatitis B virus infections were defined more clearly. After the development and licensure of hepatitis A vaccines in the 1990s, it became possible to implement an effective prevention program involving routine immunization of young children in the United States and several other Western countries. However, despite the dramatic efficacy of the childhood immunization program in reducing the incidence of acute hepatitis from HAV in the population, older children and adults remained susceptible. Significant morbidity continues to occur in the United States among international travelers, injection drug users, persons with underlying liver disease, and other high-risk populations. Since HAV is a global pathogen, the prevention of increasing morbidity from hepatitis A attributable to the incidence of clinically more severe disease increases in countries transitioning from high to intermediate or low endemic status is a major public health challenge. In this review, we discuss the epidemiology, virology, clinical characteristics, and prevention of hepatitis A infections. This review contains 8 figures, 3 tables and 89 references Key words: epidemiology, global impact, hepatitis A vaccine, hepatitis A virus, prevention, reservoirs, risk factors, treatment

Multiple Access to Sterile Syringes for Injection Drug Users: Vending Machines, Needle Exchange Programs and Legal Pharmacy Sales in Marseille, France

2001 ◽  
Vol 7 (1) ◽  
pp. 40-45 ◽  
Author(s):  
J.P. Moatti ◽  
D. Vlahov ◽  
I. Feroni ◽  
V. Perrin ◽  
Y. Obadia
Keyword(s):  
Injection Drug Users ◽  
Multiple Access ◽  
Drug Users ◽  
Needle Exchange ◽  
Injection Drug ◽  
Exchange Programs ◽  
Needle Exchange Programs ◽  
Vending Machines

The Incidence of Kaposi Sarcoma Among Injection Drug Users With AIDS in the United States

2004 ◽  
Vol 37 (2) ◽  
pp. 1282-1287 ◽  
Author(s):  
Jonnae O Atkinson ◽  
Robert J Biggar ◽  
James J Goedert ◽  
Eric A Engels
Keyword(s):  
United States ◽  
Injection Drug Users ◽  
Drug Users ◽  
Kaposi Sarcoma ◽  
The United States ◽  
Injection Drug
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