Preventing HIV Transmission The Role of Sterile Needles and Bleach (1995) / Chapter Skim
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INTRODUCTION
INTRODUCTION
Pages 9-20
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in specific populations (e.g., homosexual men, injection drug users, recipients of blood and blood products) was one of the original pieces of evidence that indicated the possibility that an infectious agent was the underlying cause of the disease (Friedland and Klein, 1987~.
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Estimates of current injection drug users in the United States range from 1.1 to 1.9 million people (Turner et al., 1989; Office of Technology Assessment, 1990; Research Triangle Institute, 1989; Valdiserri et al., 1993) , and more than 3.2 million people have injected drugs at some point in their lives (National Institute on Drug Abuse, 1991~.
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From page 11... ...
Congress has been intense between members who are particularly interested in AIDS prevention initiatives and members who are concerned that the use of federal funds to implement needle exchange programs would have the unintended effect of increasing injection drug use in those communities already plagued by drug abuse. To date, the impasse between these two camps has blocked any use of federal funds for needle exchange program services.
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The number of programs that provide referrals for the treatment of such abuse and the number of programs that do not provide such referrals." "5. The extent to which programs safely dispose of used hypodermic syringes and needles." In response to this request of Congress, the National Research Council/ Institute of Medicine established the Panel on Needle Exchange and Bleach Distribution Programs and outlined its charge as follows: The panel will gather and analyze the relevant research regarding the effect of such programs on rates of drug use, the behavior of drug users' and the spread of AIDS and other diseases, such as hepatitis' among intravenous drug users and their partners.
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Diverse AIDS prevention programs have been implemented in attempts to reduce the spread of HIV among injection drug users, their sexual partners, and their offspring. These include, but are not limited to, educational, testing and counseling, needle exchange, and bleach distribution programs.
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The first was designed to examine the impact of needle exchange and bleach distribution programs on drug-use behavior and the spread of HIV infection. The primary purpose of the workshop was to assist the panel in gathering and analyzing the relevant research regarding the effect of needle exchange and bleach distribution programs on rates of drug use, the behavior of drug users, and the spread of AIDS and other diseases, such as hepatitis, among intravenous drug users and their partners.
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The studies that examine needle exchange and bleach distribution programs have a variety of limitations, including inadequate samples, sample attrition, improper controls, problematic measures, and incomplete analyses. Nevertheless, the limitations of individual studies do not necessarily preclude us from being able to reach scientifically valid conclusions based on the body of literature available on the issues of interest.
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This chapter also summarizes field studies that have assessed how effectively injection drug users in real-life settings comply with current recommended standards of bleach disinfection. Finally, this chapter summarizes the findings of evaluation studies that have assessed the impact of bleach distribution programs.
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2. These statutes include the Comprehensive Alcohol Abuse, Drug Abuse, and Mental Health Amendments Act of 1988, the Health Omnibus Programs Extension of 1988, the Ryan White Comprehensive AIDS Resources Emergency Act of 1990, and the Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Acts of 1990 and 1991.
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From page 18... ...
Rockville, MD: National Institute on Drug Abuse. National Research Council/Institute of Medicine 1994 Proceedings, Workshop on Needle Exchange and Bleach Distribution Programs.
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Thompson 1993 Where injecting drug users receive HIV counseling and testing. Public Health Reports 108:294-298.
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