New South Wales Public Health Bulletin New South Wales Public Health Bulletin Society
Supporting public health practice in New South Wales
RESEARCH ARTICLE

The effectiveness of harm reduction in preventing HIV among injecting drug users

Alex Wodak A C and Lisa Maher B
+ Author Affiliations
- Author Affiliations

A Alcohol and Drug Service, St Vincent’s Hospital, Darlinghurst NSW

B National Centre in HIV Epidemiology and Clinical Research, Darlinghurst NSW

C Corresponding author. Email: awodak@stvincents.com.au

NSW Public Health Bulletin 21(4) 69-73 https://doi.org/10.1071/NB10007
Published: 27 May 2010

Abstract

There is now compelling evidence that harm reduction approaches to HIV prevention among injecting drug users are effective, safe and cost-effective. The evidence of effectiveness is strongest for needle and syringe programs and opioid substitution treatment. There is no convincing evidence that needle and syringe programs increase injecting drug use. The low prevalence (~1%) of HIV among injecting drug users reflects the early adoption and rapid expansion of harm reduction in Australia. Countries that have provided extensive needle and syringe programs and opioid substitution treatment appear to have averted an epidemic, stabilised or substantially reduced the prevalence of HIV among injecting drug users. However, despite decades of vigorous advocacy and scientific evidence, the global coverage of needle and syringe programs and opioid substitution treatment falls well short of the levels required to achieve international HIV control.


Acknowledgments

The authors would like to thank Ms Leah McLeod for her assistance with the manuscript. Lisa Maher is supported by an NHMRC Senior Research Fellowship and the National Centre in HIV Epidemiology and Clinical Research is funded by the Australian Government Department of Health and Ageing, and is affiliated with the Faculty of Medicine, The University of New South Wales.


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