Document 0348
 DOCN  M9590348
 TI    Blood borne viruses in Australian IDUs: good news and bad news.
 DT    9509
 AU    Crofts N; Macfarlane Burnet Centre for Medical Research.
 SO    Annu Conf Australas Soc HIV Med. 1994 Nov 3-6;6:147 (unnumbered
       abstract). Unique Identifier : AIDSLINE ASHM6/95291751
 AB    Continued low incidence of HIV infection among female and heterosexual
       male injecting drug users (IDUs) in Australia are reassuring, but
       subject to several cautions. We do not at present have sufficient
       quality routine survey or surveillance data among many groups of IDUs,
       and rely instead on surveillance of voluntary testing for HIV. Barriers
       to voluntary testing for many groups of IDUs mean that infections can
       spread unnoticed. Development of national surveys and surveillance
       mechanisms (with a few exceptions) are long overdue, and it is
       encouraging that these are now beginning to be built. However, it is
       likely that if HIV were to spread rapidly in any subgroup of IDUs in
       Australia, it would first be in the most marginalised subgroups, which
       are also the least likely to be in contact with the agencies or networks
       through which these mechanisms operate--for instance, young homeless,
       aboriginal or Vietnamese IDUs. Continuing efforts to monitor the
       situation in the marginal as well as the core groups of IDUs are
       necessary. Complacency awaits at every corner. There are ample examples
       of rapidly changing situations with regard to drug use or injecting
       behaviour in response to changed local conditions, including changes in
       law and order approaches, around the world, from which we must benefit.
       Prevention is an ongoing and never finished task, and it is necessary to
       continue to seek new strategies as well as bolstering and expanding old
       strategies. Few Australian harm reduction programs have been subject to
       any form of evaluation, and the conclusion that there is little spread
       of HIV because of the existence of the programs is based on faith more
       than evidence. There are groups of IDUs in Australia among whom HIV has
       spread widely and is continuing to spread: especially gay men who
       inject. There are other groups among whom the threat of HIV spread must
       be considered high: Koori injectors and young prison entrants being two.
       And there are further groups about whom we know next to nothing: young
       Vietnamese injectors, for instance. All require special efforts, not
       complacency. Our harm reduction programs and our faith in them have
       received a severe blow by the news of continued spread of the
       blood-borne virus, hepatitis C. Several studies in different populations
       in different settings have documented continued spread of hepatitis C
       among Australian IDUs, including those in contact with HIV prevention
       programs including needle and syringe distribution and methadone
       maintenance programs. In fact, this extreme rate of continued spread
       should not have been a surprise, as.
 DE    Acquired Immunodeficiency Syndrome/EPIDEMIOLOGY/*TRANSMISSION
       Australia/EPIDEMIOLOGY  *Blood-Borne Pathogens  Cross-Sectional Studies
       Female  Human  HIV Infections/EPIDEMIOLOGY/*TRANSMISSION  Incidence
       Male  Needle Sharing/STATISTICS & NUMER DATA  *Population Surveillance
       Risk Factors  Substance Abuse,
       Intravenous/COMPLICATIONS/EPIDEMIOLOGY/*VIROLOGY  MEETING ABSTRACT

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