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Full Participation in Harm Reduction Programs Is Associated With Decreased Risk for Human Immunodeficiency Virus and Hepatitis C Virus: Evidence From the Amsterdam Cohort Studies Among Drug Users

January 30, 2008

In this study, researchers explored the link between participation in harm reduction programs and HIV and hepatitis C virus (HCV) incidence among ever-injecting drug users enrolled in the Amsterdam Cohort Studies. Poisson regression was used to evaluate the association.

Researchers assessed methadone use and needle exchange program (NEP) use for 714 drug users at risk of HIV and hepatitis C infection. The study used five categories measuring participation, spanning from no involvement (injecting drug use and no methadone use in the past six months, no NEP use) to full participation (60 mg or more of methadone/day and no current injection drug use, or 60 mg or more of methadone/day and current injecting but all injecting needles through NEP).

Alone, neither methadone nor NEP use was significantly associated with HIV/HCV seroconversion. In combination, however, full participation in these programs was associated with lowered risk of infection in ever-injecting drug users compared to those who did not participate, a relation holding after correcting for potentially confounding variables (incidence rate ratio 0.43 (95 percent confidence interval, 0.21-0.87) and 0.36 (95 percent CI, 0.13-1.03)).

The authors concluded that full participation in a harm reduction program is associated with a lower incidence of HCV and HIV infection in ever-injecting drug users. Combined measures, rather than methadone or NEP alone, "might contribute to the reduction of the spread of these infections."

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Excerpted from:
Addiction
1.30.2008; Vol. 102; No. 9: P. 1454-1462; Charlotte Van Den Berg, Colette Smit, Giel Van Brussel, Roel Coutinho, Maria Prins




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