This volume addresses the interface of two major national problems: the epidemic of HIV-AIDS and the widespread use of illegal injection drugs. Should communities have the option of giving drug users sterile needles or bleach for cleaning needs in order to reduce the spread of HIV? Does needle distribution worsen the drug problem, as opponents of such programs argue? Do they reduce the spread of other serious diseases, such as hepatitis? Do they result in more used needles being carelessly discarded in the community? The panel takes a critical look at the available data on needle exchange and bleach distribution programs, reaches conclusions about their efficacy, and offers concrete recommendations for public policy to reduce the spread of HIV/AIDS. The book includes current knowledge about the epidemiologies of HIV/AIDS and injection drug use; characteristics of needle exchange and bleach distribution programs and views on those programs from diverse community groups; and a discussion of laws designed to control possession of needles, their impact on needle sharing among injection drug users, and their implications for needle exchange programs.

Suggests that the intervention to help intravenous drug users to modify their behaviour to reduce the risk of AIDS infection should be community- based - this being the best way to affect the behaviour of people who decide not to avail themselves of the services of drug treatment centres.

Annotation "While providing background theory on harm reduction and pragmatic public health approaches to disease prevention, is focused on HIV/AIDS epidemic in the countries of Central and Eastern Europe and the Newly Independent States (CEE/NIS). This region now se"

AIDS and drug addiction is a topic of great and growing concern. AIDS first appeared among intravenous drug users in Europe in 1984, three years after the first cases were seen among homosexuals. This epidemic has spread more rapidly among intravenous drug users than in any other risk group. The high rates of HIV-1 seroprevalence among drug users in France, Italy, and Spain account for 85% of the total number of AIDS in intravenous drug users in Europe. It is anticipated that HIV-infected drug users will soon place a heavy burden on both drug treatment facilities and specialized health care units. The HIV-1 epidemic will also cross the former iron curtain. This contribution covers the wide and complex scene of drug problems and addiction as a whole. It gives researchers an opportunity to obtain background information on the spread of HIV and AIDS among intravenous drug users as well as on the clinical and psychological effects of HIV-1 infection and AIDS in Europe. The topics reviewed include surveys of intravenous drug use, HIV prevalence, detoxification, risk reduction, changing health behaviors, evaluating AIDS interventions and the impact of methadone maintenance treatment. This monograph will be of value to all clinicians, researchers, and policy makers who are concerned with the connection between intravenous drug use and AIDS.

The AIDS virus is spread by human behaviors enacted in a variety of social situations. In order to prevent further infection, we need to know more about these behaviors. This volume explores what is known about the number of people infected, risk-associated behaviors, facilitation of behavioral change, and barriers to more effective prevention efforts.