Center for Urban Epidemiologic Studies, New York Academy of Medicine, New York, New York 10029, USA.
Clin Infect Dis. 2010 May 15;50 Suppl 3(Suppl 3):S114-21. doi: 10.1086/651482.
Injection drug use contributes to considerable global morbidity and mortality associated with human immunodeficiency virus (HIV) infection and AIDS and other infections due to blood-borne pathogens through the direct sharing of needles, syringes, and other injection equipment. Of approximately 16 million injection drug users (IDUs) worldwide, an estimated 3 million are HIV infected. The prevalence of HIV infection among IDUs is high in many countries in Asia and eastern Europe and could exacerbate the HIV epidemic in sub-Saharan Africa. This review summarizes important components of a comprehensive program for prevention of HIV infection in IDUs, including unrestricted legal access to sterile syringes through needle exchange programs and enhanced pharmacy services, treatment for opioid dependence (ie, methadone and buprenorphine treatment), behavioral interventions, and identification and treatment of noninjection drug and alcohol use, which accounts for increased sexual transmission of HIV. Evidence supports the effectiveness of harm-reduction programs over punitive drug-control policies.
注射毒品的使用导致了相当大的全球发病率和死亡率，与人类免疫缺陷病毒（HIV）感染和艾滋病以及其他通过直接共享针头、注射器和其他注射设备传播的血源性病原体感染有关。在全球约 1600 万注射吸毒者（IDU）中，估计有 300 万人感染了 HIV。在亚洲和东欧的许多国家，IDU 中 HIV 感染的流行率很高，这可能会使撒哈拉以南非洲的 HIV 流行情况恶化。这篇综述总结了预防 IDU 中 HIV 感染的综合计划的重要组成部分，包括通过针具交换计划和加强药房服务无限制地获得无菌注射器、阿片类药物依赖治疗（即美沙酮和丁丙诺啡治疗）、行为干预以及识别和治疗非注射毒品和酒精使用，这会增加 HIV 的性传播。有证据表明，减少伤害方案比惩罚性药物管制政策更有效。
