An opportunity lost: HIV infections associated with lack of a national needle-exchange programme in the USA

  title={An opportunity lost: HIV infections associated with lack of a national needle-exchange programme in the USA},
  author={Peter Lurie and Ernest M. Drucker},
  journal={The Lancet},

Costs and effectiveness of a syringe distribution and needle exchange program for HIV prevention in a regional setting

  • J. CabasésE. Sánchez
  • Medicine, Political Science
    The European Journal of Health Economics, formerly: HEPAC
  • 2003
This study assessed the costs and effectiveness of an HIV prevention program based on the distribution of anti-AIDS kits and a needle exchange service in Navarra, Spain, and concluded that this program was cost-saving from the health care system perspective.

Costs and Effectiveness of a syringe distribution and needle exchange programme for HIV prevention in a regional setting

The programme has been cost saving from the health care system perspective and the number of averted HIV infections among IDUs due to their injecting behaviour, and life expectancy of HIV+ persons is confirmed.

The impact of needle-exchange programs on the spread of HIV among injection drug users: A simulation study

NEPs are effective at reducing the spread of HIV; even under the worst case scenario of low risk users more likely to attend the NEP, one additional partner per month as a result of attending the N EP, and poor NEP attendance, the estimated prevalence was still less than that from the scenario without an NEP.

Cost–threshold analyses of the National AIDS Demonstration Research HIV Prevention Interventions

The results of this analysis strongly suggest that the NADR interventions were cost-saving overall and were, at the very least, cost-effective at all eight sites.

The cost-effectiveness of HIV preventive measures among injecting drug users in Svetlogorsk, Belarus.

Harm reduction activities among IDUs can be cost-effective, even when IDU HIV prevalence and incidence is high, and increased and consistent allocation of resources to harm reduction projects could significantly reduce the pace of the HIV epidemic in Eastern Europe.

Cost‐Effectiveness of Syringe Exchange as an HIV Prevention Strategy

  • F. Laufer
  • Medicine, Political Science
    Journal of acquired immune deficiency syndromes
  • 2001
Using imputed costs for donated services and estimates of lifetime costs to treat an HIV infection, syringe exchange was demonstrated to be a cost‐saving strategy from a societal perspective.

Do needle exchange programmes increase the spread of HIV among injection drug users?: an investigation of the Vancouver outbreak.

No evidence is found that this NEP is causally associated with HIV transmission, and by attracting higher risk users, NEP may furnish a valuable opportunity to provide additional preventive/support services to these difficult-to-reach individuals.

Efficient allocation of resources to prevent HIV infection among injection drug users: the Prevention Point Philadelphia (PPP) needle exchange program.

It is shown that cost-effective allocation within a multi-site NEP requires that sites be located where the density of IDUs is highest, and that the number of syringes exchanged per client be equal across sites, which derives primarily from PPP's low marginal costs per distributed needle.



Estimating the value of preventing a human immunodeficiency virus infection.

Risk reduction among intravenous drug users in Amsterdam under the influence of AIDS.

It is concluded that ample provision of needles and syringes is an important starting point but in itself not enough to produce the necessary drastic change in risk behavior and intensive counseling of the drug user is also needed.

HIV prevalence estimates and AIDS case projections for the United States: report based upon a workshop.

Both AIDS case projections and HIV-prevalence estimates are influenced by the slowing of the rapid upward trend in AIDS incidence that occurred in 1987, particularly among homosexual and bisexual men who are not intravenous drug users.

Maintaining low HIV seroprevalence in populations of injecting drug users.

In low-seroprevalence areas, it appears possible to severely limit transmission of HIV among populations of IDUs, despite continuing risk behavior among a substantial proportion of the population.

Syringe and needle exchange as HIV/AIDS prevention for injection drug users.

The hypothesis that a syringe exchange program would stimulate increased drug abuse in terms of frequency of injection or recruitment of new and/or younger users was not supported.

The estimated prevalence and incidence of HIV in 96 large US metropolitan areas.

  • S. Holmberg
  • Medicine
    American journal of public health
  • 1996
Relatively high prevalences of HIV in at-risk heterosexual persons in several cities indicate the potential for an increase in transmission among them, and the size and direction of the human immunodeficiency virus epidemic in US metropolitan statistical areas with populations greater than 500,000 is estimated.

Reduced risk of hepatitis B and hepatitis C among injection drug users in the Tacoma syringe exchange program.

The results suggest that use of the exchange led to a significant reduction in hepatitis B and hepatitis C in the county and may have also prevented a substantial proportion of human immunodeficiency virus infections in injection drug users.

A method for evaluating needle exchange programmes.

The method is illustrated using 20 months of data collected in conjunction with the evaluation of New Haven, Connecticut's needle exchange programme, and the results suggest that needle-borne HIV transmission among participating clients has been reduced by at least 33%.

HIV-1 Infection Among Intravenous Drug Users in Manhattan, New York City, From 1977 Through 1987

Seroprevalence rates among intravenous drug users in the borough of Manhattan stabilized between 55% and 60% from 1984 through 1987; this relatively constant rate is attributed to new infections, new seronegative persons beginning drug injection, seropositive persons leaving drug injection and increasing conscious risk reduction.