Epidemiology and prevention of AIDS among intravenous drug users
Article Abstract:
In industrialized countries, intravenous drug users compose the second largest risk group after homosexuals for contracting AIDS. One study showed that 34 percent of adults with AIDS contracted it through intravenous drug use. The transmission of HIV among intravenous drug users occurs through the sharing of needle and syringes. Transmission by this means can occur very rapidly. In New York City, the prevalence of HIV among intravenous drug users was 9 percent in 1978 and was 60 percent in 1984, while in Bangkok, it was 0 percent in 1987 but 30 percent a year later. Intravenous drug users can also transmit HIV through heterosexual relationships and drug-using pregnant mothers can transmit the virus to their infants. In the United States, the spread of AIDS by intravenous drug use accounted for 55 percent of the heterosexual transmission of HIV and 70 percent of the perinatal transmission of AIDS. Prostitutes are commonly used by intravenous drug users. The use of condoms with regular sex partners, which would prevent transmission of HIV among intravenous drug users, is rare, although condom use among prostitutes is more common. A study was conducted in Amsterdam over a two-year period, from 1986 to 1988, to evaluate preventive measures to stop the spread of HIV among intravenous drug users. A needle and syringe exchange program is available in Amsterdam. Provision of needles and syringes did not lead to increased use of intravenous drugs. In time, the sharing of needles and syringes decreased among members of the study. The incidence of HIV infection did not increase in the two-year period, as would have been expected. The incidence was 33 percent in 1986 and was 32 percent in 1988. The study also examined the transmission of hepatitis B by sharing of needles and syringes, as an independent evaluation of needle sharing habits. The incidence of hepatitis B was 46 per 10,000 drug users in 1985 and 9 per 10,000 in 1988. Therefore, with extensive counselling, intravenous drug users can change their behavior patterns, if clean needles and syringes are available. An intensive prevention program is the most realistic approach to curb the epidemic among intravenous drug users. It is often felt that some intravenous drug users cannot change their behavior and therefore the epidemic among intravenous drug users can be curbed but not stopped all together. A prevention effort should be made which is aimed toward the sexual partners of intravenous drug users, to further halt the spread of AIDS to the heterosexual population. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Journal of Acquired Immune Deficiency Syndromes
Subject: Health
ISSN: 0894-9255
Year: 1990
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The supply and demand dynamics of sexual behavior: implications for heterosexual HIV epidemics
Article Abstract:
An epidemiological model of the transmission of the human immunodeficiency virus within the heterosexual population was investigated. Heterosexual men and women tend to change their numbers of sexual partners in part on the basis of availability of members of the opposite sex, somewhat like the supply-and-demand aspect of economics. During an epidemic, the number of available sexual partners will be altered and thus changes in sexual behavior will occur. Four ways that sexual behavior can change were examined, including two where only members of one sex change their behavior and two where those of both sexes change, one changing behavior as the consequence of the changes by the other. The epidemiological effects of these changes depend on the rate of transmission of HIV. If transmission is slow because of low rates of transmission of the virus and/or low rates of change of sexual partners, the effects of these four mechanisms on the number of infected individuals, within a 50-year-period, are not different from one another. On the other hand, if the rate of transmission is fast, either because of easy viral transmissibility or high rates of change of partners, then the type of mechanism becomes important in affecting the rate of change of sexual partners. However, in such a case the sexual behavioral changes occur too late and too many people are infected with the virus (HIV) to be able to decrease the total number of infected individuals, and the spread of the epidemic is not affected overall. However, if the rate of transmission is moderately fast, operation of the different mechanisms of change in sexual behavior can produce significant changes in the number of people that eventually become infected. The epidemiology of HIV infection in heterosexuals is predicted using a mathematical model that demonstrates the importance of supply and demand in sexual behavior and how it affects the rate of HIV transmission. The number of individuals that are likely to become infected with HIV is an important statistic when assessing the effectiveness of prevention strategies. ..DE (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Journal of Acquired Immune Deficiency Syndromes
Subject: Health
ISSN: 0894-9255
Year: 1991
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