Ball A L, Rana S, Dehne K L
Division of Mental Health and Prevention of Substance Abuse, World Health Organization, Geneva, Switzerland.
Public Health Rep. 1998 Jun;113 Suppl 1(Suppl 1):170-81.
Human immunodeficiency virus (HIV) infection associated with injecting drug use has been reported in at least 98 countries and territories worldwide. There is evidence that new epidemics are emerging in different regions, including Eastern Europe, Latin American, and the eastern Mediterranean. The authors provide a global overview of the situation of HIV infection associated with injecting drug use and responses that have been implemented in various developing and transitional countries.
Although there has been extensive documentation of the extent and nature of of HIV infection associated with injecting drug use in many developed countries and the various interventions implemented in those countries, there is very limited information on the situation in developing and transitional countries. This chapter brings together information from a broad range of sources, including published literature; "gray" or "fugitive" literature; data collected by the World Health Organization (WHO), the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the United Nations International Drug Control Programme (UNDCP); personal communications; and direct observation by the authors. The authors have traveled extensively to a wide range of developing and transitional countries and have accessed information not readily available to the international research community.
A wide range of HIV prevention strategies targeting injecting drug users (IDUs) has been implemented in developing countries and countries in transition. Interventions include opioid substitution pharmacotherapy, needle syringe exchange and distribution, condom and bleach distribution, outreach to IDUs, peer education programs, and social network interventions. In some communities, completely new models of intervention and service delivery have developed in response to specific local needs and limitations.
Although empirical data may currently be lacking to demonstrate the effectiveness of may HIV prevention programs targeting IDUs in developing and transitional countries, there is evidence that innovative HIV prevention initiatives are being implemented and sustained in a wide range of sociocultural settings.
据报道，全球至少98个国家和地区存在与注射吸毒相关的人类免疫缺陷病毒（HIV）感染情况。有证据表明，包括东欧、拉丁美洲和东地中海地区在内的不同区域正在出现新的疫情。作者对与注射吸毒相关的HIV感染情况以及不同发展中国家和转型国家所采取的应对措施进行了全球概述。
尽管许多发达国家已有大量关于与注射吸毒相关的HIV感染程度和性质的文献记录，以及在这些国家实施的各种干预措施，但关于发展中国家和转型国家情况的信息非常有限。本章汇集了广泛来源的信息，包括已发表的文献；“灰色”或“非正式”文献；世界卫生组织（WHO）、联合国艾滋病联合规划署（UNAIDS）和联合国国际药物管制规划署（UNDCP）收集的数据；个人交流；以及作者的直接观察。作者广泛走访了众多发展中国家和转型国家，获取了国际研究界不易获得的信息。
发展中国家和转型国家针对注射吸毒者（IDU）实施了一系列广泛的HIV预防策略。干预措施包括阿片类药物替代药物治疗、针头注射器交换与分发、避孕套和漂白剂分发、针对注射吸毒者的外展服务、同伴教育项目以及社会网络干预。在一些社区，针对特定的当地需求和限制，已经形成了全新的干预和服务提供模式。
尽管目前可能缺乏实证数据来证明发展中国家和转型国家针对注射吸毒者的许多HIV预防项目的有效性，但有证据表明，在广泛的社会文化背景下，正在实施并持续开展创新的HIV预防举措。
