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From New York, a success story of the reversal of a serious epidemic of HIV among injectors, with mass needle exchange in the starring role. It adds weight to studies which collectively indicate that multi-strand approaches featuring high-coverage syringe provision can curb the spread of HIV.
OFFCUT 2006 PDF file 137Kb
Gaps in British harm reduction defences permit minor resurgence in HIV infection
Gaps in harm reduction defences are permitting a minor resurgence in HIV infection in Britain and continued high rate of spread of hepatitis C; each year of the 2000s injectors were two to three times more likely to be infected with HIV than in the mid-90s.
DOCUMENT 2011 HTM file
Prevention and control of infectious diseases among people who inject drugs
European Union drug misuse and disease control agencies have come together to offer guidance on how to prevent injection-related disease spread in Europe. Towards the top of the list are widespread injecting equipment supply and heroin substitute prescribing, but neither chime well with the UK's recovery-focused addiction policies.
Until June 2008 Victoria in Canada had a comprehensive extended hours needle exchange at a fixed site in the city. Neighbourhood pressure led to closure, creating a natural experiment in the withdrawal of services. The result seemed to be more sharing of injecting equipment entailing a greater risk of infection.
STUDY 2012 HTM file
Estimating the cost-effectiveness of needle-syringe programs in Australia
Latest mathematical model from Australia probably broadly applicable also to the UK suggests that needle and syringe programmes have cost-effectively saved/improved lives, and in the long run save the health service money due to averted HIV and hepatitis C infections. But in both countries adequately curbing hepatitis C requires much more.
A major concern about needle exchanges is that after use the injecting equipment they supply will be left unsafely disfiguring public areas, but this US study based on a comparison between San Francisco (has legal exchanges) and Miami (exchanges illegal) strongly suggests the opposite.
Consolidates WHO guidance on HIV prevention, diagnosis, treatment and care for key populations including prisoners and people who inject drugs. Strongly advocates universal access of injectors to needle exchange and of dependent opioid users to indefinite, high dose methadone and buprenorphine maintenance.
Thorough search for evidence uncovers 37 studies which overall suggest that by tackling sexual and injecting risk behaviours, some interventions protect against HIV in adults with a history of criminal justice involvement. Methadone maintenance emerged as the best established.
Strong evidence from two US cities that moving from a blanket prohibition on possession of equipment for injecting illegal drugs to providing this equipment via legal needle and syringe programmes prevented thousands of HIV infections, resulting in large savings in the treatment of these infections.
REVIEW ABSTRACT 2009 HTM file
The primary prevention of hepatitis C among injecting drug users
To curb hepatitis C, UK government advisers call for substantial expansion of needle exchange provision so that a new set of equipment is available for every injection and for methadone programmes to provide access to injecting equipment and vice versa.
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