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Osborn's report surrounding the incidence of HIV and AIDS in Russia
highlighted the need for prevention methods1. It is unbelievable that an
illness with such great health consequences seems to have been so casually
ignored and allowed to spiral out of control. To think that Russia has
contributed to 36% of all cases ever registered in the entire World Health
Organisation European Region and has an incidence that has doubled in the
past five years is alarming1.
The spread of blood borne viruses through intravenous drug use can be
reduced by improving risk behaviours, as demonstrated by a number of
studies and literature reviews1-3. However, it is not merely enough to
ensure that needle exchange programmes are available to all those who need
them to reduce the incidences of blood borne viruses such as HIV and
hepatitis C. Although needle exchange programmes do indirectly reduce
rates of transmission by reducing rates of needle sharing 4, it has been
shown to be much more effective if this is part of a harm reduction
programme 5. One which also involves opiate substitution therapy (OST)5.
Van Den Berg et al showed that the use of OST or needle exchange
alone did not significantly reduce the rates of HIV and hepatitis
seroconversion in Amsterdam in 2007. However, when used in combination as
a harm reduction programme they were associated with a lower risk of HIV
and HCV infection in injecting drug users (IDUs)5.
The combined effects of harm reduction programmes are much more
successful at reducing the incidence of blood borne viruses5. They are
needed if there is to be any hope in reducing the incidence of HIV among
IDUs. This is why it it is just as important to lift the ban on opiate
substitution therapy as it is to achieve good access to needle exchange
programmes. The two should go hand in hand with each other and Russia
sorely needs both.
References:
1.Osborn A. WHO officials press Russia to consider needle exchanges
to reduce spread of HIV. BMJ 2010;341:c5169
2.Kwon JA, Iversen J, Maher L, Law MG, Wilson DP. The impact of
needle and syringe programs on HIV and HCV transmissions in injecting drug
users in Australia: a model-based analysis. J Acquir Immune Defic Syndr
2009;51(4):462-9.
2. Hernandez-Aguado I, Ramos-Rincin JM, Avino MJ, Gonzalez-Aracil J,
Perez-Hoyos S, de la Hera MG, et al. Measures to reduce HIV infection have
not been successful to reduce the prevalence of HCV in intravenous drug
users. European Journal of Epidemiology 2001;17:539-44.
3. Takacs IG; Demetrovics Z. The efficacy of needle exchange programs
in the prevention of HIV and hepatitis infection among injecting drug
users. Psychiatr Hung 2009; Vol. 24 (4), pp. 264-81.
4. Holtzman D, Barry V, Ouellet LJ, Des Jarlais DC, Vlahov D, Golub
ET, et al. 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. Prev Med
2009;49(1):68-73.
5. Van Den Berg C, Smit C, Van Brussel G, Coutinho R, Prins M. Full
participation in harm reduction programmes is associated with decreased
risk for human immunodeficiency virus and hepatitis C virus: evidence from
the Amsterdam Cohort Studies among drug users. Addiction 2007;102(9):1454-
62.
Harm Reduction Programmes
Osborn's report surrounding the incidence of HIV and AIDS in Russia
highlighted the need for prevention methods1. It is unbelievable that an
illness with such great health consequences seems to have been so casually
ignored and allowed to spiral out of control. To think that Russia has
contributed to 36% of all cases ever registered in the entire World Health
Organisation European Region and has an incidence that has doubled in the
past five years is alarming1.
The spread of blood borne viruses through intravenous drug use can be
reduced by improving risk behaviours, as demonstrated by a number of
studies and literature reviews1-3. However, it is not merely enough to
ensure that needle exchange programmes are available to all those who need
them to reduce the incidences of blood borne viruses such as HIV and
hepatitis C. Although needle exchange programmes do indirectly reduce
rates of transmission by reducing rates of needle sharing 4, it has been
shown to be much more effective if this is part of a harm reduction
programme 5. One which also involves opiate substitution therapy (OST)5.
Van Den Berg et al showed that the use of OST or needle exchange
alone did not significantly reduce the rates of HIV and hepatitis
seroconversion in Amsterdam in 2007. However, when used in combination as
a harm reduction programme they were associated with a lower risk of HIV
and HCV infection in injecting drug users (IDUs)5.
The combined effects of harm reduction programmes are much more
successful at reducing the incidence of blood borne viruses5. They are
needed if there is to be any hope in reducing the incidence of HIV among
IDUs. This is why it it is just as important to lift the ban on opiate
substitution therapy as it is to achieve good access to needle exchange
programmes. The two should go hand in hand with each other and Russia
sorely needs both.
References:
1.Osborn A. WHO officials press Russia to consider needle exchanges
to reduce spread of HIV. BMJ 2010;341:c5169
2.Kwon JA, Iversen J, Maher L, Law MG, Wilson DP. The impact of
needle and syringe programs on HIV and HCV transmissions in injecting drug
users in Australia: a model-based analysis. J Acquir Immune Defic Syndr
2009;51(4):462-9.
2. Hernandez-Aguado I, Ramos-Rincin JM, Avino MJ, Gonzalez-Aracil J,
Perez-Hoyos S, de la Hera MG, et al. Measures to reduce HIV infection have
not been successful to reduce the prevalence of HCV in intravenous drug
users. European Journal of Epidemiology 2001;17:539-44.
3. Takacs IG; Demetrovics Z. The efficacy of needle exchange programs
in the prevention of HIV and hepatitis infection among injecting drug
users. Psychiatr Hung 2009; Vol. 24 (4), pp. 264-81.
4. Holtzman D, Barry V, Ouellet LJ, Des Jarlais DC, Vlahov D, Golub
ET, et al. 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. Prev Med
2009;49(1):68-73.
5. Van Den Berg C, Smit C, Van Brussel G, Coutinho R, Prins M. Full
participation in harm reduction programmes is associated with decreased
risk for human immunodeficiency virus and hepatitis C virus: evidence from
the Amsterdam Cohort Studies among drug users. Addiction 2007;102(9):1454-
62.
Competing interests: No competing interests