Document 0529
 DOCN  M9440529
 TI    Transmission of HIV among drug addicts in three French cities:
       implications for prevention.
 DT    9404
 AU    Ingold FR; Toussirt M; Institute for Epidemiological Research on Drug
       Dependence, Paris.
 SO    Bull Narc. 1993;45(1):117-34. Unique Identifier : AIDSLINE MED/94138312
 AB    In 1988, the Institute for Epidemiological Research on Drug Dependence
       conducted an ethnographic study designed to assess the results of
       liberalization of the sale of syringes. In that study, drug addicts were
       found to have gradually altered their customary practices by limiting
       the sharing of syringes. Two years later, a second study was conducted
       to further assess the behavioural changes under way. The whole survey
       covered 359 subjects--165 in Paris, 110 at Marseille and 93 at Metz.
       Almost all the subjects stated that they knew about the risks of
       transmission of the human immunodeficiency virus (HIV) by needle and
       during unprotected sexual intercourse. Almost all of them (98 per cent)
       knew that syringes were freely sold at pharmacies. Most of them (84 per
       cent) felt that they were generally well informed on the subject of AIDS
       and the ways in which the virus was transmitted. Prostitutes accounted
       for 17 per cent of the sample, with more women (32 per cent) than men
       (13 per cent) included in that category. The overwhelming majority of
       the subjects bought their syringes at pharmacies, and the trend towards
       the non-sharing of syringes was confirmed, a change in behaviour that
       has emerged mainly since 1987. Among the new generation of drug addicts,
       namely those who began to inject after 1987, the changes are reflected
       in a much lower rate of infection--2 per cent instead of 28 per cent of
       the total. About a third of the subjects, however, continued to engage
       in practices involving a certain level of risk. In a global context,
       including subjects who do not know how to properly clean a syringe, a
       variety of usually ineffective practices are followed, for example
       rinsing with water, lemon juice, or scent. The use of bleach remained
       limited, and few people considered cleaning with it. Liberalization of
       the sale of syringes seems to be essential to the prevention of AIDS
       among drug addicts. But this measure is not enough in itself. Apart from
       the overall problems of looking after the health of drug addicts and
       ensuring access to medical care, certain specific measures remain highly
       desirable. Of particular importance is the dissemination of information
       clearly describing effective methods of sterilizing syringes (including
       the use of bleach).
 DE    Adolescence  Adult  Disinfection  Female  Follow-Up Studies
       France/EPIDEMIOLOGY  Human  HIV
       Infections/EPIDEMIOLOGY/ETIOLOGY/*PREVENTION & CONTROL/  *TRANSMISSION
       *HIV Seroprevalence  *Knowledge, Attitudes, Practice  Male  Middle Age
       Needle Sharing/TRENDS  Needles  Prostitution  Risk Factors  Sex Behavior
       Sodium Hypochlorite  Substance Abuse,
       Intravenous/*COMPLICATIONS/PSYCHOLOGY  Support, Non-U.S. Gov't  Syringes
       Urban Population  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).