Historique
Article de Périodique
Prevention of HIV infection for people who inject drugs: why individual, structural, and combination approaches are needed. HIV in people who use drugs 2 (2010)
Auteur(s) :
DEGENHARDT, L. ;
MATHERS, B. ;
VICKERMAN, P. ;
RHODES, T. ;
LATKIN, C. ;
HICKMAN, M.
Année :
2010
Page(s) :
285-301
Sous-type de document :
Revue de la littérature / Literature review
Langue(s) :
Anglais
Refs biblio. :
150
Domaine :
Drogues illicites / Illicit drugs
Thésaurus mots-clés
PREVENTION
;
VIH
;
INJECTION
;
USAGER
;
EFFICACITE
;
INTERVENTION
;
REDUCTION DES RISQUES ET DES DOMMAGES
;
MODELE
Résumé :
HIV can spread rapidly between people who inject drugs (through injections and sexual transmission), and potentially the virus can pass to the wider community (by sexual transmission). Here, we summarise evidence on the effectiveness of individual-level approaches to prevention of HIV infection; review global and regional coverage of opioid substitution treatment, needle and syringe programmes, and antiretroviral treatment; model the effect of increased coverage and a combination of these three approaches on HIV transmission and prevalence in injecting drug users; and discuss evidence for structural-level interventions. Each intervention alone will achieve modest reductions in HIV transmission, and prevention of HIV transmission necessitates high-coverage and combined approaches. Social and structural changes are potentially beneficial components in a combined-intervention strategy, especially when scale-up is difficult or reductions in HIV transmission and injection risk are difficult to achieve. Although further evidence is needed on how to optimise combinations of interventions in different settings and epidemics, we know enough now about which actions are effective: the challenge is to deliver these well and to scale. [Author's abstract]
Affiliation :
National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW 2052, Australia / Australie