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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Abdool, Reychad Booth, Robert Strathdee, Steffanie A. Hankins, Catherine A. Hallett, Timothy B. Bobrova, Natalia Rhodes, Tim |
| Spatial Coverage | Ukraine Kenya Pakistan |
| Description | Author Affiliation: Strathdee SA ( University of California, San Diego, Division of Global Public Health, Department of Medicine, CA 92093-0507, USA. sstrathdee@ucsd.edu) |
| Abstract | We systematically reviewed reports about determinants of HIV infection in injecting drug users from 2000 to 2009, classifying findings by type of environmental influence. We then modelled changes in risk environments in regions with severe HIV epidemics associated with injecting drug use. Of 94 studies identified, 25 intentionally examined risk environments. Modelling of HIV epidemics showed substantial heterogeneity in the number of HIV infections that are attributed to injecting drug use and unprotected sex. We estimate that, during 2010-15, HIV prevalence could be reduced by 41% in Odessa (Ukraine), 43% in Karachi (Pakistan), and 30% in Nairobi (Kenya) through a 60% reduction of the unmet need of programmes for opioid substitution, needle exchange, and antiretroviral therapy. Mitigation of patient transition to injecting drugs from non-injecting forms could avert a 98% increase in HIV infections in Karachi; whereas elimination of laws prohibiting opioid substitution with concomitant scale-up could prevent 14% of HIV infections in Nairobi. Optimisation of effectiveness and coverage of interventions is crucial for regions with rapidly growing epidemics. Delineation of environmental risk factors provides a crucial insight into HIV prevention. Evidence-informed, rights-based, combination interventions protecting IDUs' access to HIV prevention and treatment could substantially curtail HIV epidemics. |
| ISSN | 01406736 |
| e-ISSN | 1474547X |
| Journal | The Lancet |
| Issue Number | 9737 |
| Volume Number | 376 |
| Language | English |
| Publisher | Elsevier |
| Publisher Date | 2010-07-24 |
| Publisher Place | Great Britain (UK) |
| Access Restriction | Open |
| Subject Keyword | HIV Infections Epidemiology Harm Reduction Health Services Needs And Demand Substance Abuse, Intravenous Complications Etiology Kenya Models, Theoretical Pakistan Risk Factors Socioeconomic Factors Ukraine Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, Non-P.H.S. Medicine |
| Content Type | Text |
| Resource Type | Article |
| Subject | Medicine |
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