Vidyya Medical News Service
Volume 6 Issue 292 Published - 14:00 UTC 08:00 EST 18-Oct-2004 Next Update - 14:00 UTC 08:00 EST 19-Oct-2004
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Substitution treatment helps prevent spread of HIV among high risk group

Injecting drug users are particularly vulnerable to HIV and other blood-borne pathogens as a result of both shared injecting devices and sexual behaviour. Between 5 and 10% of global HIV infections result from use of injected drugs.

Oral substitution treatment for opioid users is documented as reducing the incidence of illicit drug use among this population; however it is unclear what effect this type of treatment has on HIV risk behaviours and the transmission of HIV.

A recent review of 28 studies, involving nearly 8000 participants evaluated the effects of oral substitution treatment on behaviours of drug users with a high risk for HIV transmission. Evidence showed that substitution treatment is associated with reductions in illicit opioid use, injecting use and sharing of injecting equipment.

Users undergoing substitution treatment were also less likely to report multiple sexual partners, or to exchange sex for drugs or money. On the basis of these changes in risk behaviours, the authors concluded that oral substitution treatment is associated with a reduced transmission of HIV among opioid drug users.

Oral substitution treatment programs for opioid users in countries with emergent or established HIV and drug use problems should be strongly supported.

Review title: Substitution treatment of injecting opioid users for prevention of HIV infection

The Cochrane Library Newsletter, Issue 4, 2004

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